I have been on LTD with Manulife for just over a year and a half. I work with my GP, Psychiatrist, and a therapist. The therapy is a year long program and I have been connected for a little under two months. I am still trying to figure out the best medication, my psychiatrist is changing all of medications at our next appointment. I was contacted by my case manager who stated that I will not meet the change of definition this January. She believes I had been on the same medication for two years which is not true, she told me I was wrong three timeâs when I told her that she was incorrect. As a result of this phone call she requested an update from my therapist which was provided as well a a report from my pharmacy for the past year. I received a letter soon after from Manulife which stated they were unable to determine at this point if I meet the change of definition. After this my Case Manager called me again and stated that I was to be given OT Reactivation therapy. I am not ready for this as I am still in therapy and I am still not on the right medication. My psychiatrist is very supportive and agrees that my symptoms have not been addressed that would allow me to take part in rehab at this point.
Sorry for the long novel but any advice/feedback would be appreciated. My case manager is very aggressive and I feel that she is not listening.
I am off for Clinical Depression, Social and Generalized anxiety, and unspecified trauma disorder. I do plan on fighting for continued LtD past the two year mark
First, I am going to reiterate what I have said before: This is why I do NOT talk to my case manager over the phone. I have too much anxiety and it puts them in a position of power over you. They know all the questions they are going to ask ahead of time and you donât. Itâs an unfair advantange, sort of like being interviewed by the police without having a lawyer present. They expect you to answer their questions immediately but sometimes my brain doesnât work that way and I need some time to think about what I want to say. Also, via phone does not leave a paper trail but email does. You have proof of everything that was said. By requesting communication only via email or postal mail, you put the ball back in your court. I highly recommend doing this. Do not let them tell you that you canât do this, you very much can. They might not like it, but tough luck for them.
Second, the 2 year deadline for mental health is a tough one and is often contested by these insurance corporations. Thereâs two reasons for this: #1) Mental illness is not something that can be âseenâ and therefore it is easy to frustrate the situation by requesting objective evidence when it is hard to get, and #2) People with mental illness are far more likely to be in a fragile state and give up their claim or become overwhelemed (or kill themselves even). Itâs sad but true but this is what the LTD company hopes for. If you have resolve you WILL win. Period. Your doctor, psychiatrist and therapist are what matters. The LTD company can say whatever they want but it is just jibber jabber. Document everything. If they are asking you to begin return to work or occupational therapy and you are NOT medically cleared to do it, then you need to get that in writing. Have your doctor, therapist and psychaitrist write a short letter saying that you are not medically cleared for OT and send your case manager this.
Coming back to what I said in #1⌠always remember that the case manager is not your friend. And you are not theirs. Do not be nice to them or mean, just be firm and respectful. Let them know you will not be itimidated or messed with. Eventually they will go on and find an easier target to pick on and youâll be left alone.
Itâs a good idea. You can tell your case manager that you are not feeling well to talk over the phone and ask her to email you her questions. This is what I started doing after my case manager twisted my words. Now at least I have time to think about the answers and also my anxiety went down.
Yes it is the best thing I ever did. At first there was resistance, they would say âWe really need to do this over the phone, donât worry, it will only take 30 minutes and they are just standard questionsâ but I refused. I told them there wasnât any reason they couldnât send the questions via email or post mail and accommodate me. It has resulted in a reduced contact level with my case manager. Whereas they used to phone maybe 5-6 times a year I now hear from them twice a year if that. I can take 1 or 2 days to respond and even have my wife proof read my email for me to make sure I am saying what I mean to say. It is the best thing I ever did. I think @David_Brannen could do an article on it. Of course some people (older generation especially) probably find phone much better and email to be uncomfortable, so in that case stay the course
Yes, I think this is is a great article topic Adam and we will feature this topic next week on our weekly Q&A call.
David Brannen
Disability Lawyer with Resolute Legal
The response posted above is based on the limited factual information made available and is not intended as a full and complete response to the question. The only reliable manner to obtain complete and adequate legal advice is to consult with a lawyer, fully explain your situation, and allow the lawyer enough time to research the applicable law and facts required to give an adequate opinion. The basic information provided above is intended as a public service only, a full one-on-one discussion with a lawyer should be done before taking any any action. The information posted on this forum is available to the viewing public and is not intended to create a lawyer client relationship with any person. If you want one-on-one advice, please click here to request a free consultation or call toll free 1-877-282-5188 to speak with a member with our disability claim support team.
Hi Sean, I encourage you to get a consultation with a disability either with us or another firm. The key thing to understand is that the insurance company has a process or formula they follow as people approach the change of definition. It is like a train that does not leave the track no matter what you or your doctors say.
They best thing you can do is to handle it in a way that maintains your credibility because in situations like this a denial at the change of definition may be inevitable. However, this does not mean it cannot be reversed and your benefits approved soon thereafter.
Hang in there. this is a common situation but you can overcome it.
David
David Brannen
Disability Lawyer with Resolute Legal
The response posted above is based on the limited factual information made available and is not intended as a full and complete response to the question. The only reliable manner to obtain complete and adequate legal advice is to consult with a lawyer, fully explain your situation, and allow the lawyer enough time to research the applicable law and facts required to give an adequate opinion. The basic information provided above is intended as a public service only, a full one-on-one discussion with a lawyer should be done before taking any any action. The information posted on this forum is available to the viewing public and is not intended to create a lawyer client relationship with any person. If you want one-on-one advice, please click here to request a free consultation or call toll free 1-877-282-5188 to speak with a member with our disability claim support team.
Sean, I am a big advocate of people educating themselves and getting advice as early as possible. Contact a law firm that will focus on educating you about ALL options, not just selling you on hiring the firm. Also, some lawyers will offer to help at the internal appeals stage (where you are now) rather than only waiting ot get involved if a lawsuit is filed. It is not common for lawyers to get involved at this stage but we are strong advocates of it because it will cost you less in the long run, and we have had good success in helping people win internal appeals (before lawsuit).
David Brannen
Disability Lawyer with Resolute Legal
The response posted above is based on the limited factual information made available and is not intended as a full and complete response to the question. The only reliable manner to obtain complete and adequate legal advice is to consult with a lawyer, fully explain your situation, and allow the lawyer enough time to research the applicable law and facts required to give an adequate opinion. The basic information provided above is intended as a public service only, a full one-on-one discussion with a lawyer should be done before taking any any action. The information posted on this forum is available to the viewing public and is not intended to create a lawyer client relationship with any person. If you want one-on-one advice, please click here to request a free consultation or call toll free 1-877-282-5188 to speak with a member with our disability claim support team.
Thank you everyone for your feedback and advice. Unfortunately because my job is unionized, I have to receive support from my union and canât receive support from a lawyer.
I definitely see the game my case manager is playing and will have all further communication through email or mail so that I have a paper trail. Thank you, Adam and Elaine, for pointing me in this direction.
Thank you David for your advice and insight. It really heps
We recommend that you have all your interaction with Manulife in writing instead of phone calls. Their case manager has been known to document your conversation and use as written evidence of your progress. Whether the report support or disapproves your claim, it is not up to your discretion, and you may find discrepancy between what your said (memory) vs what the case manager actually types out.
We have been doing all interaction thru written means (ie emails or mails) and we have declined to speak to any non-medical personal for whatsoever reason just so they cannot type up some report based on that case managerâs impression (ie non medical expert).
Vocal interaction without consented recording can lead to a lot of mis-communication, manipulation, or mis-remembering things. If you plan to take legal action eventually, it is the best you have every thing written & recorded.
So I sent an email requesting communication through email or mail. My case manager replied through email stating she was acknowledging my request but stated that my rehab worker would still need to communicate through telephone.
I replied stating that I can provide information through written communication to her.
I do not understand my case managers rationale. She can communicate as per my request but not my rehab specialist? She can get all information/updates through email.
Any feedback or others experience would really help