LTD case manager bullying

Disability Insurance
1

I am having an issue with my long term disability insurer and I believe they are not acting in good faith.

I am a Heavy Equipment Technician. Went off work back in June due to degenerative disc disease and spondylosis in my spine and tendonosis and chronic sprains in my elbows. This trade is extremely physical and hard on your body.

After dragging things out before giving me any compensation at all they finally sent me for a functional assessment in the city 1.5hrs away from my home town. It took 2 months before finally being put on short term disability and receiving compensation.

It was deemed that in a month and a half I could attempt a gradual return to work with limitations and restrictions which my employer said they could not accommodate.

They then had me do a 8 week program in my home town with a physio therapist that afterward said I could attempt a gradual return to work with strict restriction and limitations because I was still struggling badly with pain and inflammation. My work said they could not accommodate me into my proper role and could bring me back as a plus 1.

The insurer then cut off the program in my home town and sent me for another functional assessment in the city 1.5 hours away where they want me to start a gym plan with a kinesiologist to get me stronger.

This drive alone goes against the 15 mins sitting restriction laid out by my current physio therapist. My doctor and current physio therapist recommended against this program due to the physical travel strain and toll it could take on my mental health. They both provided reports recommending against it. My doctor recommended that I stay with the physiotherapist in my home town to avoid the long drives.

The insurance company said that because my doctor didn’t say there was anything medically contraindicating me from doing the program that they are proceeding with it.

The insurer has now said that if I don’t attend that my benefits would be cancelled.

This new assessment was an hour long assessment and I explained that usually my symptoms present after activity and can last for days so not sure how a 1 hour assessment could be even close to accurate.

They now want me to complete a 3 day a week work hardening program which is a 3 hour drive away from home there and back.

I pushed back and they agreed that they would pay for food, fuel and one hotel stay a week to reduce the amount of driving. All of this I would need to pay upfront and then they would reimburse me. They said they can only issue these reimbursements by mail. So who knows how long each payment could take to get to me.

I felt forced into it so I gave it a try and could not handle the drive and also cannot afford the upfront costs. I have explained all this to the insurance company and they are still pushing for me to attend it and threatening to cut benefits even though my doctor has recommended against it and that I continue with treatment in my home town.

2

Based on what you have shared, you should reach out to a lawyer. It doesn’t appear to me they are acting in good faith; however, your account is, respectfully, one sided. If it were me, I’d push back on their asks, wait for them to stop paying me, and then sue for breach of contract, bad faith, various HRTO damages, etc.

3

I have been speaking with a lawyer and they are willing to fight them on it but they need a denial letter first. The only thing is these things can take time to settle. So how do you afford to live and pay bills if you get cut off while it gets settled.

4

I have pushed back on the fact that driving completely goes against my restrictions and that paying these costs upfront is not possible for me to afford. They are trying to say that because I sat in the assessment for 40 mins I should be able to do the drives. They are also basically saying that it is my responsibility to pay for my own treatment aswell. I put a pause on the program because of these issues and said I need to get more clarification from my doctor.

5

This is all very triggering for me to read. I feel for what you are going through and have dealt with similar issues. These companies are brutal to say the least! Long story short, I was cut off and forced back to work. If I didn’t comply, I could appeal and wait for an answer. That wait would have left me with no income for that time. I chose to attempt the return, which failed. I stayed long enough to be able to return to short term sickness plan (it was difficult) however I then applied for wsib (as deemed workplace ptsd among other health issues) I was approved and remain on wsib at this time. My dealings with LTIP deteriorated my mental health even more.

6

Yes they are definitely brutal! I am so fed up with my case manager that I have requested that all further communication be done through email. The fact that they think they can disregard actual medical scans backed by a doctor is outrageous. If only there was a lawyer in my family​:disappointed_face: