Mistreatment of ltd case


I have really been struggling as of late with my ltd claim. I have mental health issues which make it impossible for me to work.

Recently I had to request a new worker after being lied to/manipulated by my old one (she implied my givingthem a sample of my dna to give to a pharmaceutical company was normal, my Doctor assured me it was not normal and under no circumstances should I achquiesce)…the new one is literally the person who played a part in cutting my benefits prior to this. When I asked why they were being assigned to my case, I was told this person is their best in mental health caseworker available…they also mentioned wanting to get me back to a level of functioning that would allow me to return to either my old vocation (which is impossible because they literally contacted my former employer to tell them my definition had changed and I would not be returning at all) or a similar vocation…I’m very confused at this point because if my change of definition was approved, and my former employer was notified (and yes, I was let go, so I don’t have that position to go back to even if I could), how can they say I would return to said role?

Also, with COVID, how am I expected to magically just get back out there and find a job when we are supposed to be safe at home? Not to mention none of my care providers are recommending this course of action…I’m so confused. Any insights would be great.

Insurance companies are not there for your health and wellness. They care about the almighty dollar. They can say anything they want when they make their own rules.

My advice would be:
Stop taking telephone calls. Communicate only in writing. Point out your mental illness and their harassing/bullying/contradictory behaviour as a factor. This took stress off me and I was able to process information instead of being put on the spot. Don’t panic when every communication has the tagline of “if such and such is not completed we have the right to terminate benefits” It is a standard form letter phrase.

Stop being the middleperson and request direct contact with your medical professionals because of your mental illness. I would get a report request for my doctor a day after my regularly scheduled appointment and it would be expected back within a week. I would stress and panic over getting into town, dropping off the form, picking it up and sending it. It was a game they played. They cut down on their requests once they had to deal directly with the doctor.

Stay compliant. Although I had a difficult time adjusting to meds, I tried whatever I could on my doctor’s advice. This added to my conditions worsening as we could not control symptoms or symptoms added to the mental health deterioration.
Although I did attempt one return to work plan with a variety of treatments through the insurer, it was against my doctor’s advice and I didn’t end up completing it. I had a meltdown and did not return. She veto’d it every time after that, preferring I receive treatment from a licensed psychologist or psychiatrist before physical/occupational therapy and whatever other bs they offered.

Go to regular medical professional appointments. I was on a provincial waitlist for over a year but ended up paying out of pocket for therapy. Psychiatrists are free here in NB so I did manage after a few months after a referral from my family doctor. I still saw my family doctor on a regular basis during the time I was waiting for other treatment.

Request your disability insurance file. My file held A LOT of information I was not aware of (like revealing private details of my illness in communication with my employer, the internal request for DNA testing that most likely did not make it past their legal department in my case, ignoring of medical professionals, confirmation they did not get me the care I needed right away but waited 7 months into my claim to start and all sorts of other things)

Ensure your medical professionals are supporting you. It took so many letters from my family doctor to the insurance company I thought she would drop me as a patient. She had my back. Same for the psychiatrists and psychologist I saw outside of the insurance company. Ultimately, the therapists and IME professional reported I was worse off because of the insurance company and my employer firing me. The IME was never mentioned when my benefits were terminated “for appearing happy at a doctor’s appointment 5 months prior”

Your insurance company notified your employer you couldn’t return? That could be in your favour moving forward (i.e. if you are in customer service and have a mental health condition, crowds, telephone ringing, dealing with irate customers, dealing with people in general, concentration completing forms or transactions, memory loss, insomnia/hypersomnia, fatigue, irritability, nausea from meds - it could impede you from doing any job)

I took advice from forum members and managed my way through the insurance company’s game. It was tough, but you have supporting medical professionals so it’s a great start!

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Thank you so so much, I just spoke with my Doctor now, and he mentioned it was no problem to help me with this, and that he agreed they have mistreated me. I am so grateful for your response…it helped so much! I am going to ask that they only email me from now on, as letters can get lost in the mail.

I never thought my life would look like this, but sure am glad for this safe haven to talk to others who understand.

Much peace for you!

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If you don’t have a copy of your disability plan, request that as well.

When you apply for CPPD let us know and we can help there too!

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Hi Marilyn, thanks for your response! Who should I ask for that information (the copy of my disability plan I mean)?

I was able to also put off talking to my worker while my G.P writes a letter for me, as my Specialist wasn’t able to make the appointment, so that is a huge relief.

I still worry a bit about being pushed to pursue other forms of treatment my Doctors and counselor don’t agree with, or that I am uncomfortable with, but I have also been advised to have my Doctor write a letter of support if that does happen (it hasn’t come to that just yet, but I can see hints of it already).

Thanks again.

It will come to that.
I sent an email to the insurer and they sent me a form to complete. I asked for everything - financial account, internal notes, copies of communications from others, my medical information medical professionals sent, phone call logs etc. They had 30 days to comply.
It was over 500 pages the first time, another 100 the next.

I absolutely attempted the vocab they offered. They are offering something to attempt to ‘help’ you. My doctor wrote a letter saying it was against her advice, and when I was worse off after the attempt, she reminded them she recommended licensed psychological treatments only to start.
Each time they attempted a plan besides psychological sessions she would recommend licensed psychological sessions to continue. They weren’t even sending me to a licensed therapist. She would write a letter each attempt saying no I wasn’t medically approved and that each request made me worse off with anxiety and agoraphobia. She finally got me into a psychiatrist and eventually I was able to pay for private licensed psychology sessions.

The psychiatrist the insurer hired for my IME wrote a scathing report of how the insurer mistreated my case. They had sent selected reports to her, while I brought the rest of the story. I brought in documents and reports that were the before and after of what they had given her. She included and referenced them in her report.

Honestly, it has taken a walk through hell to get to the other side of this. I would not have made it this far without this forum. Other people have been through it.

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I will speak to my Doctor today to make sure the letter was sent on my behalf to request written communications only I can recall asking for all the medical files and have never had them sent over to me. I hesitate to ask my caseworker for this information, as I feel very nervous dealing with him for anything, as I feel my case is already being actively managed, I was once told that they had me on a month to month approval system where my worker had to literally ‘hit a button’ in order for me to be paid. That was prior to my 2yr mark, most people say they are being left alone during covid or after being approved past the 2yr mark, but it seems that isn’t the case for me.

Would I just contact the help service (their website number?). I feel very overwhelmed with all of this.

Thank you so much.

You don’t have to ask her anything.
You send an email requesting that further communication be in writing due to the stress and anxiety they are causing your recovery and request a copy of your file in the same email.
They may return a formal form for you to complete in order to get your signature for the privacy request on the files.
Mine tried calling a few times, and even attempted a few attempts at recorded call appointments but I responded by email each time “As per my email of date to directly to you, I no longer take telephone calls from insurance company”

Have you had an independent medical exam from them yet?

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Well, I was awaiting my Doctors letter which he is drafting up this week…but definitely after he does that, I will do just as you mentioned.

Yes, I have had an IME, it went well, they agreed with my Doctors.

My trouble now may be that their specialists are pushing me to take meds where my practitioners support my holistic path…in fact I was told by a practicing Psychiatrist that she wouldn’t see me because she felt it best I see a Psychologist…she too supported my path. I’m a bit nervous about all of this as it’s COVID, and even if I was ready to return to work, I have immunity concerns…I’m just beyond confused by their pushing me at this point, and am definitely feeling scared.

Thanks for your response, it’s very helpful.

Much peace.