LTD "Update form" questions - new super detailed forms

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I’ve been on LTD with Industrial Alliance since 2010. I’m nearing the end of my claim (age 65, I’m 61). Every year they’ve sent a simple 2 page update form with general health and treatment questions. I fill out my portion and my doctor fills out the rest.

Last Friday, I received a letter from IA instructing me to fill out a “mandatory” form on a Claim Lab website. I was unable to log in to the website, so I sent an email to let them know.

They called me this morning at 7 am (!). I missed the call, so they sent me an email with the update form in PDF format, and told me they’re sending me a hard copy in the mail. It’s a much more detailed form than the previous updates, and I’m afraid they’re looking for excuses to cut off my benefits, since I’m near the end of my claim.

I read the article on the Resolute Legal website about the traps in claim update forms, and I have some concerns and questions:

The form asks both me and my doctor to sign a waiver giving them permission to disclose my health/file information to the insurer “and/or third parties” and “authorized agents”. Should I avoid giving them this blanket authorization?

My disability is related to an incurable mental health diagnosis. The update form includes a checkbox “Detailed Questionnaire about Autonomy and Activities”. I also have osteoarthritis, which is causing difficulties with some physical activities. When I fill out this questionnaire, should I include the limitations caused by my osteoarthritis, or only the mental health related issues? I was planning to add a letter with details for some of my mental health limitations, since they don’t provide space and my symptoms fluctuate.

“Surveillance trap” - What kinds of surveillance can an insurance company use? I don’t go out much, only for doctor appointments and tests, and the occasional (once a month?) errand. I get groceries etc delivered. Can they monitor online or phone activity? Or enter common areas of apartment buildings?

Is there anything I should discuss with my doctor when I ask her to fill out the medical questionnaire? The new form asks for detailed information like dates of appointments, medication doses, tests, treatment plans with dates, frequency of visits etc. I’m afraid the insurance company might deny my claim if the info on the new form doesn’t match what she has written on previous forms. Also, I’ve been on the same medication regimen for many years, with no other therapy or psychiatrist (not available), I only see the doctor a few times a year, and I’m afraid the insurance company will decide I’m not being treated properly and use that as an excuse to deny my claim.

I’m waiting until I receive the hard copy update forms in the mail before I book an appointment to fill them out. In the meantime, I’d like to prepare to fill out my portions. I’m seeing my doctor in a couple of days for a checkup, and I’ll discuss the form with her as well.

I’m thinking of filling out a draft copy of the “Detailed Questionnaire” and giving it to her in advance, because her portion contains many of the same questions and I want to make sure the answers match.

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I’ll try and reply when I have a bit more time but the topic of surveillance is well covered by many disability lawyers. To make a very very long story short they can surveil you but only through the lens of public spaces both physically and online.

So if you make a public Facebook post of you swinging upside down at the local McDonald’s playpen then that’s fair game. They cannot install spyware on your computer. They can surveil you from a public Street but they can’t go on to private property to film you.

They can use a very long lens to peer through a window although that is questionable as long as they are standing on public grounds

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I’m not too worried about surveillance, since I get everything delivered and mainly go out for medical appointments (doctors, regular blood work). I have X and Facebook accounts, but not under my real name. I live in a highrise on the 16th floor and my windows are covered, so I don’t have to worry about “peeping” into my windows.

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I think you just work your way through it like the old form. I personally would not consent to ClaimLab because I don’t think tech companies are trustworthy. You can also decline to provide the generic consent and tell them to request consent for anything specific that they have. Make sure to include qualifiers like sometimes, to the best of my recollection, often, usually, I struggle to…, etc.

I often fill out the form with the basics with “see attached sheet” for anything involved. Then on my computer I type out the detailed answers and it’s easy for me to change and add things as they come back to me.

I also fill out as much of my doctor’s section as possible because I think it’s a waste of the doctor’s time to be sitting there typing in historical stuff that the insurer already has. I use post-it notes to flag the sections that I need the doctor’s help completing.

From what you’ve said I think it’s unlikely that they will try to cut you off. I think it’s more likely that they’re trying to launch some new internal systems and you just got caught in the net because you exist. You are under a physician’s regular care and if the field of medicine doesn’t have anything more to offer for your condition that’s just the way it is.

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Good advice re filling out the form. I’ve kept the completed update forms from previous years and I use them as a sort of template if I’m asked to fill out my own info. Unfortunately my doctor flatly refuses to fill out forms electronically and always hand writes them, so I can’t fill out the written parts of the medical form for her, only the check boxes.

I’m concerned about being cut off because of my age. A few years ago my LTD deposit was late and I was panicking. It turned out to be just a bank issue with the insurer. Before I knew what the problem was, I did some research and found out that LTD insurers often look for an excuse to cut people off when their policy is a few years away from expiring. I’m 4 years away from turning 65. Since my disability is mental, it’s harder to prove. In the 15+ years I’ve been on LTD, they’ve NEVER asked me all of these detailed questions before. That’s why I’m concerned.

But you could be right and it’s just because they’re switching to Claim Lab. Re giving them permission, I think they’ve probably already shared my file with Claim Lab without my express consent.

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It’s stressful and very easy to spiral with fear since the impact to you would be so large. But the closer you get to age 65 the less incentive they have to cut you off since the number of future payments are counting down. It would be pretty tough for them to make that argument after 15 years and as you accumulate age-related issues like arthritis. The one exception is if an effective new treatment for your condition emerges. But even then it would take a long time to get you on the new treatment and give the treatment time to work. The real payoff for them is if they can get a young person off of disability and not have to pay 15 or 20 years of payments. Very, very few people your age who were disabled are ever able to return to work so I would look at it more as hoops that you have to jump through for their due diligence rather than a realistic hope that you will be able to return to work.

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There is another angle they might be going for…and that’s a lump sum payout.

Since you are so close to your end date it might make financial/accounting sense for the insurer to offer you a lump sum payout to get you off their books. If so, they will definitely want to confirm that your doctor maintains that you are permanently disabled before they offer you any type of lump sum payout.

I know of one person this has happened to. They offered about 70% lump sum payout for the last 5 years and the person accepted the offer.

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I thought of that possibility as well. But when I was doing research on LTD cutoffs close to retirement age, I read of cases where the insurance company only offered 25% or a similar lowball offer, and it ended up going to court. All I can do at this point is fill out and submit the forms, wait and see what happens. I know David doesn’t negotiate lump sum payouts, but I think that’s just for situations where the insured asks for the payout, as opposed to the insurer.