Many are wondering if their disability insurance company can require them to go to a medical examination, or IME, during coronavirus. The simple answer is probably not.
Our disability insurance attorneys have successfully stopped insurance companies from sending our clients to medical evaluations during the coronavirus pandemic. But what types of tests could the insurance company want and who cannot be required to go?
There are several types of tests that your insurance company may send you to while reviewing your disability claim. Typically, the disability insurance policy gives the insurance company the right to have you physically examined as often as reasonably necessary. Insurance companies often use these in-person examinations to support a termination or denial of long term disability benefits.
Types of In-Person Evaluations for Disability Insurance Claims
If you have a long term disability claim, here is a list of some of the evaluations your disability insurance company may want to send you for:
- Independent medical evaluations;
- Functional capacity evaluations;
- Neuropsychological evaluations; and
- Psychiatric evaluations.
An independent medical evaluation, or IME, is performed by a medical doctor who likely specializes in the type of condition from which you suffer. A functional capacity evaluation (FCE), on the other hand, is performed by a physical therapist. A neuropsychological evaluation is performed by a neuropsychologist, who assesses your cognitive abilities. A psychiatric evaluation is conducted by a psychiatrist and assesses your mental health.
All these examinations are done by a doctor chosen by the insurance company. The doctor is also paid by the insurance company.
Reasons Your Disability Insurance Company Cannot Send You to a Medical Examination
During the coronavirus pandemic, in-person evaluations may not be feasible. Here are some reasons why:
- Many facilities are closed and several doctors have reduced or stopped performing evaluations.
- If you are immunocompromised or vulnerable to infection as a result of your medical condition, it may not be reasonable for the insurance company to require you to submit to an evaluation even if the insurance policy allows it.
- People who suffer from a chronic respiratory disease, such as COPD, are at an increased risk of becoming severely ill if they contract coronavirus.
For those at an increased risk, an insurance company cannot force you to be evaluated or examined by one of their doctors as part of the disability claim process. That would unreasonably put you at risk.
How Will Insurance Companies Review Disability Claims During Coronavirus
Insurance companies will likely start conducting medical reviews instead of requiring in-person examinations. In this scenario, a physician reviews all of the medical records in the insurance company’s file and decides whether the disability claimant has any restrictions and limitations. The insurance company then evaluates the opinion from their doctor to decide if the disability claimant meets the definition of disability in the disability insurance policy.
The reviewing doctor never meets or examines you. Instead, he or she simply reads your medical records and writes a report concluding whether or not you are disabled. If your medical records are not detailed enough and your doctors do not properly communicate the reasons you are disabled, a medical review can result in a denial or termination of benefits.
We Can Help You
We understand these are difficult and uncertain times. At Dabdoub Law Firm, we are fighting even harder to ensure our clients’ disability claims are approved. We are also fighting to make sure our clients continued to receive their disability benefits. Our attorneys can handle your disability case from claim initiation to appeal to lawsuit.
If you have questions or concerns about your disability claim, give us a call and speak with one of our experienced disability attorneys about:
- Submitting a disability insurance claim;
- Appealing a long-term disability denial;
- Negotiating a lump-sum settlement; or
- Filing a lawsuit against your disability insurance company.
We represent clients nationwide with disability claims governed by federal law. Even if we are not located in your state, we can help you.
Call (800) 969-0488 to speak with an experienced disability attorney. Pay no fees or costs unless you get paid.
