I have been on LTD for just over 2 years now and doing a gradual return to work for the last 6 months. I went off for mental health reasons. Going back has been VERY difficult. I lost a significant amount of hair, I have panic attacks at work. My rib cage has been inflamed for the last 6 months and I have migraines 4-5 times a week.
I had a workplace violence situation and my ER was not happy I reported it and retaliated against me on several occasions. They even said what happened wasn’t a big deal because I was friends with him at the time. Now being back I am being treated very poorly, they are also refusing to meet my accommodations and it has greatly affected my ability to work. I am not able to always work the hours that my dr has stated but my accommodations state that I require flexibility with my schedule. My ER has told me that they don’t think my return to work is successful. I am pretty sure they are getting ready to fire me.
Recently my ER reached out to my LTD provider and I was contacted by my case manager. They were very aggressive on the phone telling me that my ER reached out to them with concerns over my RTW and they had a conference call. They stated that my ER was putting pressure on them. I didn’t understand what they meant by that. My case manager said that I need to find a different therapist, try different treatments and start riding out side effects from medication because everyone is sick at first. I have had significant side effects from medication beyond the typical side effects. I have made LTD well aware of the side effects I have been experiencing and it would not have been safe for me to continue the medications.
In October my psychologist sent a lengthy report to them and my benefits were extended past the 2 year mark. I recently sent them 2 reports from a neurologist and psychiatrist. Together these reports were over 15 pages. There was a lot of detail and treatment plan and alternative plans listed and support my disability.
Now LTD is requesting full reports from all doctors including the psychiatrist again. The psychiatrist told me they do not fill out forms or write doctor’s notes. I let my case manager know this when we last spoke but they still are requesting the psychiatrist fills out forms. The information they are requesting is all included in the consult notes that I sent them. They cover everything and they were from a month ago. Now LTD is requesting the EXACT same information just sent to them. Why do they need duplicate information???
I understand they have to continue to determine my eligibility and periodically request information but when does this become harassing behaviour? They currently have all the information they are requesting and it was from a month ago. The psychiatrist spent 3 hours with me. The report is incredibly detailed.
I am getting better, just not at the pace they would prefer me to. I put in a lot of effort and these situations really set me back. Part of the reason is, my workplace is so toxic that it makes it hard to get better. HR was fine with my return to work until my manager made an issue with it and now I am dealing with LTD hounding me. I am terrified that I am slipping back to a place where I will have to go off work again. I hated being off work. I can’t do that again. It was such a horrible time in my life. Their tactics are counterproductive. As much as my workplace is toxic, not going to work at all also negatively affects my mental health and will cause a decline in my health.
When I spoke with my case manager it also sounded like they were aware that my ER was getting ready to dismiss me because of an unsuccessful return to work. What happens to my LTD if I do get let go?
I am also concerned with them asking for the exact same medical documentation that I just sent them. I feel like this is harassment. They have the information and now they want it again. The information will be the same. It was written a month ago. Have you experienced this before?
My family dr was monitoring my medication. I have not been on long term meds for 1.5 years. In my area it is difficult to get into a psychiatrist. Family drs are supposed to manage the medication first and only refer if meds are not working. Since I have been having such a hard time with finding a med that doesn’t make me seriously ill my family dr agreed to send me to a psychiatrist. I am only allowed 6 visits with her.
Working in this environment is not worth it. I don’t feel like I am able to work elsewhere at the moment. My plan was to get to full-time and then find something else.
I have never stopped treatment. I see a psychologist twice a month and I do go to support groups. I am not sure if LTD will support me leaving work and going to volunteer. I am not comfortable bringing this up to my case manager. I find they tend to twist what I say and often give me incorrect information.
My biggest concern is I sent them a lot of documentation and now they are requesting the same documentation that I just sent them. It is incredibly frustrating which I feel is what they are trying to do. How can they ask for the exact same information that I just gave them.
I had to stop communicating with my case managers over the phone. It was by email only. It cut down on some of the stress I experienced once there was a paper trail in black and white. I also told them to make requests through the treating doctor directly. It eased my having to run around in a panic for reports.
Toward the last few months I have been cc’ing their ombudsman department in correspondence. My doctors would also repeatedly address the ongoing duplicate requests in their reports and letters.
As long as you have a medical diagnosis from your ongoing doctor(s) that support your inability to work due to illness, the insurance company cannot terminate you. They might, but not legally. There will be lots of “if you or your doctors don’t complete x then your benefits will be terminated”
The contract you have is between you and the insurance company. If you are fired, there may be legal recourse for that aspect against your employer (it could be you are not truly ready for return to work)
They will ask for multiple forms, reports and updates. They are looking for any glimmer of hope to get you off the plan.
I tried 7 medications over 2.5 years. In 18 months I dealt with 5 therapists, 3 psychiatrists, 1 psychologist and an MD. If you are doing everything they ask, attending regular care appointments and continue medication changes under the care of your doctors then you are doing all you can on your end.
In my province (NB) there is no limit to psychiatry visits - you may want to check on this.
That is a good idea. I am going to ask them to make requests through the treating doctors. My family dr is part of the problem. He only filled out forms when I first applied. Every time I have asked him to fill out forms he never did. They have been using my psychologists reports. Maybe I will also reach out to the ombudsman and speak with them. It just makes me so angry. I just sent them pages and pages of documents and now they are requesting the same thing.
The psychiatrist gave me 5 diagnosis and the neurologist has wrote a lengthy report stating I have chronic migraines due to the PTSD. The psychiatrist notes were very detailed and listed every symptom I was experiencing.
In my area there is a shortage of psychiatrists. They are now telling drs they are no longer accepting patients even for their wait lists. We do have an psychiatry urgent care department which is where I see my psychiatrist but you get a limited number of appointments so they can continue to see new patients. Dr’s who still accept patients have 1-2 year wait lists. When I was working with a rehab specialist with LTD they were saying they don’t even have any drs they work with in my area. I think this is why they haven’t sent me to see one of their drs for an evaluation. When I requested my file last time, a dr from 4 hrs away reviewed it. Their report basically said this is going to be long term and I may never and probably would not be a good idea to go back to my original ER.
I wish there was a way to start holding insurance companies accountable for undue stress. I want to just focus on my health instead of being in a constant state of stress. I hope you finally found a med that works. I think that is probably the toughest part. Thank you for all the info!
I have recently started the new med and so far so good.
My husband says the same thing! He thinks I should start a movement for insurance company accountability but eh…not today LOL (it’s something the old me would have done)
At the beginning, I would have a therapy appointment Monday where the therapist would say I was not approved for work. The caseworker would call me Tuesday and Friday and ask if I was ready to return to work because “the notes I have from the therapist say you are ok to return to work”. I would then be in a panic for another week until I could see the therapist again. It undid the few steps of improvement each time. Turns out, there weren’t any notes from the therapist. No updated calls. Nothing. They were messing with me over the phone.
I am not sure why they are harassing you for updated info if you are approved beyond the 24 month mark. It should only be occasional check ins with your treating medical team.
Have your Doctor write a letter saying no change since the last reports sent on (put date)
Ask for a copy of your full and complete claim file, maybe something is missing?
All consult notes are typically sent to your primary doctor–you could ask for a copy of the notes since the last month.
But do ask for a full and complete copy of your claim file.
Insurance Companies are not human, they are a business. What needs to happen is consumers and claimants to put pressure on politicians and regulators to change the laws and to start holding Insurance Companies accountable for unfair practices.
The courts do not award fair damages for the hell people are put through. Consumer protection in Canada is very poor. B.C. has the best record and some of the best court awards.
Insurers are litigation power houses, but also still a business.
Lawyering up and fighting poor denials is also a great way to not be part of the scam. If more folks sued it would send a message.
But not worth your health if you do not have the energy to fight back.
