The rep from sedgwick stated his personal opinion of my claim and may denie my claim because he doesn’t agree with a medical professional, what gives him the right?
It maybe that your case manager is just bullying you so you go back to work or give up your claim or quit your job. It tends to work Don’t fall for it and follow your doctor’s recommendations.
If you get denied you can always appeal or sue your insurer.
And don’t quit your job!
They have the right to make a decision based on the information available. They are entitled to disagree with what your doctors are saying, but it should be based on them having an alternative medical opinion. They may have had your case reviewed by a doctor behind-the-scenes so you wouldn’t know about it.
You have the right to appeal. Also, if your disability ins ongoing, you should also apply for long-term disability benefits even though they have denied your STD claim. If they give you any problems with applying for LTD, then you can consider that a denial of the LTD claim and then have the right to take action against the STD and LTD providers. Sometimes legal action is the only way to cause them to approve your claims.
You should get a legal opinion on your specific situation because all LTD plans are unique and the strategy would be different depending on your situation.
Disability Lawyer with Resolute Legal
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