While receiving disability benefits, an insurer has the authority to conduct an assessment.
Regardless of how long you’ve been receiving long-term disability benefits or how recently you’ve started receiving them, your insurer has the right to periodically check and evaluate your claim. You may be required to provide extra documentation or submit to medical examinations as part of these evaluations. In order for these examinations to be acceptable, they must be reasonable, relevant to your condition and treatment plan, and not contradict what your doctor believes you are able to handle.
It’s not uncommon for people to disagree on what’s important and reasonable. Because of a failure to cooperate by a disabled insured to follow a prescribed treatment plan, an insurer may withhold benefits on the grounds of noncooperation with policy conditions. Legally, these denials may or may not be enforceable. An experienced disability insurance attorney can help you understand the difference.
As part of a return to work program, you have been requested to participate
A return-to-work or work-hardening program will be set up for a handicapped insured who has been on disability benefits and receiving disability income for more than two years with the explicit goal of rehabilitating the insured and returning them to work. However, the insurer can utilize these tools to acquire evidence of a disabled person’s functional abilities. For example, the insurer may use these programs to stop paying benefits to a disabled person if the person has shown that they are capable of working.
For example, a disability insurance lawyer can help you determine if a work-hardening program is fair to comply with in order to protect your long-term benefit claim from being terminated.
However, you must comply with an insurance company’s reasonable attempts to rehabilitate and return you to work, but only if these attempts do not run counter to the recommendation of your own medical professional and only if the attempts meet your impairment and working conditions.
If your insurance company has determined that you are capable of performing other occupations, they have located them for you.
As stated above, an insurer has the right to periodically examine and investigate your continued disability while you are receiving disability benefits. This necessitates an in-depth examination of your medical condition. An insurance policy’s exact definition of “disability” (which varies from policy to policy) is also taken into consideration during these examinations, as well as your educational and employment record.
Insurers often employ a two-pronged strategy. A functional abilities evaluation is the first step in the process. Determine what “transferable talents” you have, so that you can find what other careers are available if your former employer accepts that you will never return to your old job.
There’s a good chance that none of these alternate careers are a perfect fit for your collection of abilities. For one thing, they may be unable to provide a full-time salary that equals your previous one, or they may be unduly enthusiastic about what you can do with your residual handicap level. An experienced disability insurance lawyer can assist you in making sure that the insurer’s analysis of your transferable skills and list of possible alternate occupations is fair and accurate and assist you in defending yourself if the insurer uses this analysis as a basis for denying you the benefits.