Hi all, I was just wondering if someone here could offer info on this topic as I couldn’t find much online.
I’m on LTD almost 4 years and on CPPD almost 2 years. The LTD case managers on my file changed many times over the years, but they’ve all been very aggressive and, even after getting CPPD, they’ve never eased up on their very frequent “checkups”.
I’ve been told now that I will be getting a medical coordinator and that it’s to help me with services that may be needed. I’m ok with that and said so to my case manager who then went on to mention that I don’t have a choice but to comply with it. Now that it was put that way, it makes me think that maybe this isn’t something that’s a ‘good’ thing for me, but just more of their tactics to find some kind of fault with my claim.
Does anyone have any experience with a medical coordinator? What do I need to know? Am I looking at this all wrong?
thanks in advance
I think you instincts are correct. This is going to focus on coordinating treatment to try to improve your function with the goal of return to work. An insurer doesn’t invest money in something like this unless return to work is their go. The case manager is likely correct that you have an obligation under the insurance policy to comply with this request and to follow the recommendations of the medical coordinator. With that in mind, I recommend everyone go into this with good faith efforts. The medical coordinator may conclude that you are incapable of returning to work.
David Brannen
Disability Lawyer with Resolute Legal
The response posted above is based on the limited factual information made available and is not intended as a full and complete response to the question. The only reliable manner to obtain complete and adequate legal advice is to consult with a lawyer, fully explain your situation, and allow the lawyer enough time to research the applicable law and facts required to give an adequate opinion. The basic information provided above is intended as a public service only, a full one-on-one discussion with a lawyer should be done before taking any any action. The information posted on this forum is available to the viewing public and is not intended to create a lawyer client relationship with any person. If you want one-on-one advice, please click here to request a free consultation or call toll free 1-877-917-7050 to speak with a member with our disability claim support team.
Thanks for your reply David. It’s hard not to be suspicious when this medical coordinator was brought up after I made a request to communicate in writing. It’s the second time I’ve asked for something and it wasn’t acknowledged. The first time was last year when I asked for my case files and that was also ignored by the previous case manager.
What recourse do I have at this point? I know that insurance companies’ goal is to not pay out or not pay for a long period of time, but can they get away with treating people as if we’re criminals? This entire situation has added unnecessary stress to my life when I can barely get by through the day. I wouldn’t wish it on my worst enemy.
Sorry to hear this. With situations like this you have to review your group insurance policy to see what obligations you have. As I mentioned, you likely have the obligation to work with the medical coordinator as a condition under your policy. Even if it was specifically in your policy, I would recommend you work with the medical coordinator in good faith in any event. Sometimes professionals like this produce evidence and reports in YOUR favour.