Medical Disability Durations & The Effect on Return to Work Guidelines

We have encountered several cases where claimants have been denied their benefits not because of incomplete or inconclusive evidence of their medical conditions but solely because their conditions kept them from working longer than the guidelines used by disability insurance claim departments. When evaluating disability claims, claims examiners rely on industry developed resources to determine the expected duration of the claim, regardless of the specific circumstances. Based on these claim management practices that have been put into place by most insurance companies, we’d like to shed some light on the process used to assign expected return to work dates for claims and the extra steps that claimants need to take to protect their benefits if they’re disabled beyond these arbitrary dates.   Continue reading

Protect Yourself Against A Functional Capacity Evaluation

In addition to IME’s (Independent Medical Examinations) insurance companies are also known to use Functional Capacity Evaluations, known as FCE’s, to analyze a claimant’s disability.  These evaluations assess the ability to perform a series of tasks which simulate customary job duties and determine the extent to which the claimant can complete these job duties on a regular basis.  FCE’s can have different focuses and purposes and be referred to as Physical Capacity Evaluations, Work Capacity Evaluations, or Disability Assessments, but they all mean the same thing: the insurance company is attempting to use a biased and flawed evaluation system to challenge the statements of you and your doctor about your ability to return to work.   Continue reading