New ltd case manager not reading my file

Disability Insurance
1

I have been on std/ltd for 3 years. I had the same case manager for 2 1/2 years.

I passed the two year mark for any occupation. A couple of months later my worker asked for medical updates from my psychiatrist and my GP. My psychiatrist send her report in right away. My family doctor still hadn’t sent hers in after three months. My case manager asked me to follow up with my GP. She (insurance) also said her goal was to put me on maintenance once she received the report. This way only a yearly update would be required from my doctor.

By the time my GP sent in her form my case manager had moved on to another project and my file was given to someone else. The new worker clearly hasn’t read my file. She is asking the most basic questions and she asked if I talked to my doctor about returning to work. Then she said I’m approved for 3 more months and she’s going to call every 6-8 weeks.

I’m approved for CPP-D and a medical coordinator at my insurance agreed with my doctors that I’m not returning to work any time soon.

What should I do? I want to ask her to read my file, but I don’t want to aggravate her. Starting at the beginning is crazy!

2

When my case manager was being ridiculous in the requests from my doctor I switched to having my doctor write a brief letter stating that there were no changes to my condition or prognosis since the previous update. You are required to provide them medical updates to substantiate your claim to still be disabled, but you are not required to provide it in exactly the format they requested.

When she calls I would nicely and politely refer her to her case file for any questions that have been asked and answered.

Another forum member had some success with asking for an updated copy of the insurer’s file each time the insurer asked for her info. This cut it back to only requesting updates when it was truly necessary.

It’s very tough emotionally to deal with a case manager who is failing to do their job. I had one that screwed up my payments nearly every month for almost a year.

3

It really is so difficult emotionally. It definitely makes my anxiety worse.

Thanks for the ideas to try out. I have to work up the courage to tell her to actually read my file. I wish I had done that during our conversation but I was so shocked that she clearly hadn’t read my file. I’m thinking of asking for a copy of the last medical reports my doctors sent in. Maybe that will push her to read my file. It’s so frustrating.

4

Congrats on clearing Any Occ but IMHO if my insurer did that I’d just retain a lawyer and have them deal with it

5

Thanks. I’m not sure what I would ask a lawyer to do. My status hasn’t changed. I just want the new worker to read my file and pick up where the last one left off

6

At one point after having a new claims manager I just this wrote this email after an initial phone call where I answered their questions and highlighted that my answer is likely already in my file as my situation has not changed:

“Thank-you for reaching out to me. Prior to requesting any further phone calls please review my entire claim file. As mentioned multiple times during our call my medical status hasn’t changed and the answers to your questions were all already in my file. In the unlikely case you have any additional questions not already covered in my file please send them via email, and I’ll answer them as soon as possible”.

I never heard from them again, other than the yearly update 5 question questionnaire.

1 Like
7

I I found out what’s going on. This new worker is aware that my old worker was going to put me on maintenance. I guess she ended up reading my file.The new worker said when she received my file she thought she would give it to an internal consultant to evaluate my ongoing treatment. And so starts the anxiety of what’s to come next.

I really wish my situation was like the one you described. That would have been so much easier.

8

That sounds really frustrating, especially after being told you’d move to maintenance. Since the new case manager seems unfamiliar with your file, I’d politely remind her of your CPP-D approval and prior assessments, and ask that she review the existing documents. It’s reasonable to request continuity without sounding confrontational.

9

It is extremely frustrating. I contacted my worker to ask if she has certain documents and if she has read through my file.

She said she is aware that the previous worker was going to put me on maintenance, but she is going over my file with an internal consultant. She wants recommendations from this consultant for ongoing treatment.