How often for doctor reporting requests?

I received an email from my disability insurer this morning confirming I am approved for LTD until January 2020. My 2 year mark is approaching in May 2020.

How often can a disability insurer request information from your treating doctors/specialists?

My doctor has just answered a questionnaire for the disability insurer on October 31st, confirming I am undergoing ongoing care, and am unable to work at my (former) job or any job. In fact, she (and my other professionals) has chastised them for harassing me and wasting her time. Today’s email was to tell me they are asking her to complete another updated questionnaire.

Ironically, I see the doctor today (for further specialist referrals and a medication change). In 2 years, my disability insurer has already sent me to 2 therapists and an IME - along with my family doctor, psychologist and another IME with a psychiatrist.

Honestly, I am afraid of losing my family doctor if this constant paperwork keeps up.

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I think as often as they want. :frowning:
They know that if they ask too often you will get a lawyer.

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I spoke to my doctor about it. She’s noting it in the next questionnaire she completes and says if it keeps up she’ll lodge her own complaint.

Thanks to @Steve1959 I managed to get my CPPD application in today! He helped me considerably on how to present my application and supporting documents. Of course all the questions here and on the forum helped a lot :slight_smile:

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All the best MarilynM and I truly do hope that you are approved with your CPPD Benefits Application.


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The big LTD insures have internal policies for claims managers to request reports at specific times in relation to the two year change of definition. Often at 12 and 18 months. However if they request it at 12 months and it’s takes 4 months for the doctor to get it to them, they will still request again at 18 months as per their policies, even though the last report just got in 2 months ago.

With smaller LTD insurers it can be all over the map. With no rhyme or reason.

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.

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My case manager is so cheap. She tries not to pay a doctor’s fee so she delays these requests all the time. And often asks me to send her specialist or any other reports.

My therapist had to even negotiate the fee for the reports with her as she offered very low fee. She had no choice but to agree to pay my therapist a decent amount for her work.

If my insurer wants medical information or an update, they have to request it from my doctor. I don’t even provide the medications I am on. The insurer threatened to cut me off for not being truthful when reporting when, in telephone conversation I called a medication by it’s brand name, when I was issued the generic. You should have reported the proper medication They are trying anything to get me off the plan. It is downright ridiculous.

As for the reports, they will write to me that they’ve sent a letter to my doctor and haven’t. She logs in all her correspondence for insurance purposes, even junk mail. But then in my file request (I’ve had 3 since 2017) there will be some generic letter to her signed by a completely different person than I dealt with (that she never received) saying if she agrees with whatever proposed then don’t bother to respond.
So no response from my doctor means she’s okay with it right?

In my file were a few letters to me that I never received that slipped through their electronic system and were mailed to me instead of emailed on their secure system. Uh huh. I never received them. There would be notes of phone conversations where, compared to my phone records, I never received or made a call.
I also get a lot of “Oh I thought I sent that to you.” especially if it crosses over with my legal case with my former employer.

They dated the most recent letter/form notice for September 6th and yet did not actually send that letter or forms until the end of October, making it as if she was late in completing them. My doctor has started to note that in the return letters/forms she completes. She (along with all my other specialists) have also noted in letters/forms the insurers are directly detrimental to my health.

I try not to be paranoid or not take it personally, but it is very difficult.

You’re lucky, I am responsible for all fees.

There have been statements supposedly mailed to me that I never received.
I suggested they use a secure email system (the same company uses one for the employer group health) but they are not set up for that.

Why so? Don’t they send reports directly to your doctor?

I have been very lucky and oh so grateful for my doctors. Other than the CPPD application I haven’t had to pay for any reports.

My case manager does weird things too. She even send a questionnaire to my doctor where wrote that I had told her that my health and cognitive functions improved. It never happened. I never said that. My therapist told me not to panic just yet.

I guess this is how they manage their cases and cut you off as soon as they find a weak spot.

They use secure email to send me email. I don’t use it to respond, just using my regular email so I can keep track on my end.
When I first started my claim my first 2 (3?) caseworkers never used it. I was terminated the first time and produced all the conversations we had together (weirdly, none of those caseworkers are with the insurer anymore). I was reinstated after that and signed up for secure mail.

I get everything sent to me.
If it becomes a burden I will ask them to go through my doctor.

My short-term disability case manager used to do that. She was very aggressive. She sent me a bunch of forms every TWO weeks for my GP to fill. My GP didn’t mind. He never charges me for any forms. So he filled the forms during my visit, gave them to me and I faxed them to my ST disability insurer. Then my case manager decided to send me forms to give to my psychotherapist. My psychotherapist said that she didn’t want me to pay for the forms so she told me to ask the insurer to send the forms directly to her. She explained to me that when the insurer sends the forms directly to the doctor then it is their responsibility to pay and not the patient’s. She told me to tell the insurer that it was for “confidentiality reasons”. I told my case manager that my therapist had asked her to send the forms directly to her and she wouldn’t give the form to me for “confidentiality reasons”. After that my case manager never send any forms to neither me nor my doctor. At the end of STD she just forwarded my case to LTD. She was even cheaper than my current case manager. My guess that they have to report every penny they spend on a case. So constantly asking for the reports is not reasonable. And that she was asking me to bring her the same reports every two weeks for several months was just a way to torture me. I don’t think it was necessary for the case. That’s all. I was so not knowledgeable in any insurance matters so I complied. If they do that to me now I will just tell them to deal with my doctor directly. Hope this helps to anyone who is in the same situation!