I am awaiting a decision and the insurer is stalling… my specialist filled out the forms with diagnosis, limitations, treatment plan, prognosis and that I am compliant with treatment. The insurer’s case mgr (CM)is insisting on more information and chart notes. The CM is not a dr, is not involved in my treatment… since the relevant info about ailment is already provided what or why would they require chart notes. This to me is a breach of confidentiality or just plan nosiness… I understand they need medical info to make decision but how much as I feel this is intrusive and unnecessary given what was provided… please advise
The insurance companies have doctors or nurses who review all the medical records and give opinions to the claim managers. This is not a situation of nosiness – medical records provide better context to a person’s situation and quite frankly are often the key to success. When we represent a person in an appeal, one of the first thing we do is require the full medical files going back many years.
Disability Lawyer with Resolute Legal
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