Recently applied for CPP-D based on demand by insurance company - too early for any outcome.
A new situation has cropped up with my LTD insurance company, as follows:
My case manager is telling me to ask my psychotherapist to perform “return to work focused CBT”.
I don’t feel I am ready to start planning my return to work yet.
I am still undergoing medical treatment, and at the last doctor’s appointment, my medication dosage was increased.
In the Medical Report filled out by my doctor as part of CPP-D, he indicated that I am not ready to return to work anytime soon (selected “Unknown” for Section 6, Question 2).
Can the insurance company force me to initiate RTW CBT therapy?
Will they send me for IME if I don’t?
What should I be asking my psychotherapist, and how should I respond to the insurance case manager?
The contractual agreement says you are required to participate in return to work activities such as physiotherapy or CBT or whatever. It does have to be medically reasonable and the only person who realistically can stop it is your doctor. I would reach out to your doctor as soon as possible
Your insurer can’t force you, but if you refuse, they can cut off your benefits for not cooperating.
Early in my LTD, my insurer put me on a CBT program for insomnia. It made me much worse after a week. My psychotherapist for the CBT program contacted my insurer about my deterioration and that I was probably not fit for the program. I also told my insurer that the advice from my CBT psychotherapist conflicted with my sleep specialist. My insurer immediately took me off the program.
I would at least show you are cooperating, and try the program. If it makes you worse, tell your therapist. Also have your doctor write a note to your insurer to take you off the program.
I don’t think they will send you for an IME yet. They may send you for an IME about 3-6 months before your COD. I had an IME at my COD. It turned out to be in my favor.
I would and trying to get your doctor to say something specific because your doctor notes are shared with the insurer. Just bring it up with them and advise them what’s happening. They have to come up with it themselves re opinion
Personally I would try the program and then if it makes you worse, I would tell the psychotherapist that your health has deteriorated because of the program. If you continue telling them each time you meet with them, I think they will either notify your insurer that you should be removed from the program, or give them feedback after the program is finished that you’re not ready to return to work.
At the same time, I would update your doctor with your deterioration and say something like "My insurer has enrolled me in a return to work focused CBT and it has made me worse. My symptoms of such and such have increased. Would you be open to writing a note to my insurer that the program is aggravating my condition? " I would also ask “Do you think this program is a good idea since I am still trialing some medications?” Something along those lines. This way you’re giving subtle suggestions to your doctor about what you would like written, whilst also leaving it up to your doctor’s discretion.