I’ll be at my 2 year mark in November. I was just advised by my case worker that she will be sending papers to apply for CPPD. Does this mean that they are accepting that i am disabled but they just don’t want to pay in full so get me to apply for CPPD?
Yes and no. If you are on disability they have already accepted that you are disabled. LTD insurance is priced as an add-on to CPPD. So you will be required to apply for it as part of your LTD contract. So it’s pretty standard practice for the insurance companies to get everyone who might qualify to apply for CPPD.
If you are not approved for CPP-D then the insurance company might decide to cut you off BUT if your doctor says you can’t work then you could sue the insurance company.
It takes 4+ months to get a decision on CPP-D and I think the insurance company will keep paying you while you’re applying.
If you get approved then you won’t be “low hanging fruit” (cases the insurance company look to cut off).
There are many factors: your medical condition, the type of work you did, the size of your employer, the size of the insurance company, etc.
Your individual situation will be unique.
Just do a good job applying (there are some good articles on this site) but don’t be discouraged if you get denied CPP-D at first (it is fairly common).
I see thank you. What can be done if your specialist doesn’t have time to fill out papers for insurance regarding your care?
I don’t know.
Does your GP have access to records from the specialist?
Maybe as long as they refer to the specialist.
Maybe you can get another specialist to fill out the forms.
It is only a brief 4 pages for the medical report.
I did the rest myself and some of the questions I referred to my attached sheets.
My insurance sent a form to my specialist by fax requesting mediation dosage ect. But specialist is to busy to fill them out. This is the second time the case worker sends it. I ask myGP if i can sign an authorization for her to get my file.
If your GP will respond to the insurance company then I would that satisfies them.
My advise is you read David’s book on How to apply for CPPD. It worked for me. It’s very detailed and outlines all the necessary steps. Key works to meet CPPD’s criteria are severe and prolonged. If you can justify and meet these requirements then you shouldn’t have any problems. What your Dr documents is very important and supports what you outline for the case manager whom Reviews your file.
All of my specialists send reporting letters to my GP, then she reports to the insurance company on their forms and includes the information they gave her. It has worked out well so far.
I also filled out all the parts of the form that I knew the answer to so that it would be faster for her to review and finish the parts I didn’t know.
I don’t know if it would help but maybe you could send them a printout of your current pharmacy prescriptions with the doses from your pharmacy?
Currently rheumatologist took me off humira as it has caused issues. So i am waiting to see a hematologist so we can decide what i will be taking next. So no meds right now. I have told the insurance company about this.
Thats the way they do it. Then cppd will pay around half your payment then your ltd insurer has less to pay .Any money owing you will have to send to ltd.
I only get 1/3 from CPP-D so it varies.
This is a huge problem with lazy doctors. The specialist must fill out the forms (as in my case ) before CPP-D and the insurance company pays you. This system needs to change.
My family dr is sending in a request for my file so she can send info to my insurance.
That’s what I did. Pharmacy printed it out and even faxed it for me