I was lied to by my case managers for my short and long term disability. They advised they hired a psychotherapist for my health, however, when an issue came up that red flagged me not being able to return to work, my psychotherapist advised after submitting her recommendation that she was actually not able to submit a medical recommendation.
I am still trying to sort this out, but reading between the lines the therapist is telling me that she was hired not with me as her client, but my employer as her client, so she cannot provide medical recommendations. It is like she was hired as a coach and sold to me as a mental health professional because of her official title.
Has anyone else run into this, where you have had mental health counselling, but the service provider was actually not serving me, instead serving the company in my return to work. I feel the therapist was even not aware of her limitations as she only seemed to know that she couldn’t submit her recommendations after they were submitted.
The final discharge letter from the provider is full of untruths, and that was forwarded to my family doctor, who will surely be looking for the advice of the mental health professional.
There is a lot more to this story, but, has anyone else run into this?
My insurer hired someone who I would meet once every 1-2 weeks. They tried to understand my issues, made me account for my time (what I did during the day, gave suggestions of other things I should be doing (e.g volunteering). This person also tried to do mental health counselling, but they were not really qualified and also gave different advice than my psychologist.
The intent of the insurer in hiring this person was 100% to get me ready to return to work.
It doesn’t sound like my experience was as bad as yours.
Good luck in sorting this out.
I was fully on board and we did similar progress charting.
My case manager was absent for the last 2 months and then when pressed for assistance the file was passed to someone else. This was after 3 months of not showing up to meetings (on the phone) not returning emails, no updates on extensions of my disability coverage.
The therapist did assist and was actually doing the work of the case manager by times. During my time off work, I suffered a ptsd episode related to work, and it was her recommendation that I not return to that role. She supported this with sending her recommendation to the Case manager and requesting modified work duties or a new role. This was interpreted as me not wanting to return to work, and my claim was cancelled because of it.
The therapist advised me that if I had my family doctor write the same recommendation it would be considered a medical recommendation but she was not able to submit the same as she was not hired for me, but hired for my employer.
Additionally by the last meeting with the therapist because of how this had all been handled my symptoms had returned and I had lost the gains I had made. I told her this had become all encompassing and i was overwhelmed because I was not well enough to return to work, but was being forced to because the claim had been cancelled. This does not appear in her discharge report, it quite falsely states that I am ready for a return to work.
The company this therapist works for boasts about their ability to get their clients employees back to work quickly… but, it’s not in truths. I would be forced back to work unwell because at this point I don’t have any income.
to get a letter from your doctor asap saying that you are not ready to return to work, and also that your condition has worsened;
to get your version of the facts on the written record - as unemotionally as you can, laying out what you were told, what happened, how hard you tried to complete the process and return to work, the failed efforts to contact your case manager over a period of months, what the psychotherapist advised you that she was reporting to the insurance company, what the psychotherapist came back and told you, and the effect all of this added stress had on your condition; and
request a copy of your file from the insurance company. Check to see if anything is missing, like the reports from your psychotherapist.
Thank you for that. I have a Doctors note from my family doctor, and she is supporting my continuous leave from work. The problem is though, she is going to see this letter from a psychotherapist and think that I am just being non compliant or difficult. I will need to advocate for myself in a big way in my next appointment to continue on my leave.
I have written down a record of the events, (two copies, one highlighting just straight facts, the second with an explanation. ie, symptoms started to increase when case manager set an appointment, then didn’t call for or email until two days after the appointment). I started taking notes when things started going sideways in January, so it is very conscious. After reading your reply, I requested a copy of my file from the insurance company… for the second time… I asked this through my HR rep, but she hasn’t gotten back to me about it yet.
I have had a number of health professionals encourage me to look into this with a lawyer, but I’m not sure lil ole me is ready to fight against a health insurance company.
I think you may need to make a written request directly to the insurance company to make it official and trigger their obligation to comply. If you search around the forum was some advice from someone who did it about how to request it.