Should I Let My Doctor Be Interviewed by the Disability Insurance Company?

Hi, I'm attorney Greg Dell here with attorney Victor Pena and we're going to discuss a situation that we see a lot that unfortunately results in many claim denials and the issue is can a disability insurance company decide to go ahead and call a claimant's treating doctor and discuss the claim with them without the claimant even knowing about it? Well the short answer is usually yes and the reason is because when you get those initial claim forms from the insurance company in that packet they usually include a whole bunch of authorizations one of which requires you to sign off and give them authorization to contact your doctors directly so then they can request medical records they can reach out to the doctors and get additional information things like that. Okay so let's talk about the problems we see with this phone call we know that they can do it and when we're representing a claimant what we often try to do is to say to the disability insurance company send them a letter and say look if you want to speak to our claimant's doctors please let us know because we don't want to hear that you weren't able to speak to them or we also don't want it to be done you know behind our back you know without the doctor being prepared so that segues into if we know this is going to happen how do we protect our clients from this situation? Well one of the things is what you just mentioned you let the insurance company know if they need to get in contact with the doctor to let you know and then so you can make sure that the doctor is responding which is one of the biggest you know one of the biggest problems with doctors some you know they're busy sometimes they don't get the message and oftentimes they don't respond at all and then you know causes a problem for the claim so the biggest struggle that I see is that the doctors either two things happen one is the treating the the insurance company doctor usually an in-house doctor an outside doctor will write some report or something and send it over to the to the doctor the treating doctor the treating doctor will have some it will be like do you agree or disagree and the treating doctor might be in a tons of stuff and just says I agree and that almost always results in a claim denial because they're obviously agreeing with something that's counter to the benefit of the of the claimant right the other thing is they'll have this phone call and then the treating doc the the hired doctor will send a summary to the treating doctor and say um what do you do you agree or disagree with what was said in this phone call if you disagree if you don't respond then you agree right and how often do you see the doctors don't respond really often a lot more often than you'd think in fact you know you can say sometimes they they don't respond more often than they do especially where they get those letters you know kind of summarizing the contents of the conversation and then what they'll do is just pick and choose and you know summarize the conversation just pick out little things from the conversation and and make it hard for the doctor to respond okay so here's my tip for what the claimants have to do you should tell your doctor that on no circumstances should they speak to the insurance company or anybody about your claim until such time that they have been you have given them approval the reason for that is because if we get involved with your claim what we want to do is we want to prepare the doctor for the phone call we want to have a conference with that doctor we want to go see that doctor we want to show them all the other medical records let them know the total picture about what's going on with you we want them to understand the definition of disability in the occupation because really that's what it's about the other doctors from in-house aren't going to tell them about the definition of disability or what your occupation is so you have to have your doctor prepped bottom line if they're not prepped eight out of ten times you're going to get screwed because the doctor your your in-house doctor is going to one way or the other agree with the other doctor unfortunately so very common problem we see we recommend that you take our advice on you know how to avoid this situation that if you do believe your doctor is going to be contacted please contact us so that we can help you this is just one of the services that we offer in terms of whether we're helping you apply managing your claim or working during an appeal we're going to provide you with a free review of your claim we're going to let you know further how we think we can help you we're available anywhere in the country and we always offer a free initial consultation we look forward to speaking with you.