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Q&A26Do I have to resign when I go out on disability?

This is the #1 question asked on Lindanee’s Blog and I have several good articles about the subject. Therefore, please do a “Search” from the Home Page for Resignations and read the other articles.

In brief:

  • Never resign, or give a written resignation when leaving work because of a disability.
  • HR can be informed with a written statement, “My treating physician has provided me with medical restrictions precluding me from working at this time. I will be filing for STD and LTD if necessary. My physician has recommended a period of total disability.”
  • “Resigning” means “I quit”, and that’s not what happens when an employee leaves work because of a disability.

What does IDI mean?

IDI stands for “Individual Disability Income” and is usually used to describe disability contracts called, “Disability Income Replacement”, which are non-ERISA, subject to state jurisdiction, are underwritten individually and paid for by the insured.

Why is my insurance company so mean and violating my policy?

While this is a very important question I’m having to be considerably careful in answering it. Perhaps my readers can read through the lines a bit here. Insurance companies tend to “behave”, or “follow” the social mores of any culture or society. If you live in a society where there is no “rule of law” or adherence to an objective, common justice system applied to everyone equally, insurance companies will tend to follow.

What I’m observing right now is that insurers have no fear about violating ERISA Plans or IDI policy contracts. For example, Unum recently violated ERISA Plan provisions by estimating SSDI even when the claimant “kept the process going” by immediately making application for dependent benefits. Not only that, but Unum reduced the claimant’s benefit to $0 for an overpayment that did not as yet exist. When challenged, Unum refused to correct the error.

Disability insurance is an area well rooted with medical impairment and therefore insurers will behave as society behaves. I have been seeing blatant violation of Plan and policy provisions in the last year. Those of you who are aware of what’s happening around you will understand what I’m taking about.

My doctor gave my insurer a prescription for an FCE behind my back. What now?

“Behind you back” might be a little harsh if you did not discuss the possibility of an IME (FCE or Functional Capacity Evaluation is a type of IME), with your doctor in advance. Those who have back/neck impairments should always discuss whether an FCE, if requested, would cause further pain and injury. Doctors aren’t mind readers and patients should always make it known to the physician that IMEs are possible and how they should be handled.

The next issue is why your doctor gave an insurance company a requested prescription for an FCE without letting you know first. As a Consultant, I have a a policy, in my opinion, that the physician cannot be trusted to act in your best interests, and patients need to move on to other doctors who are more willing to support their patients’ rather than hinder them.

Having said all of the above, insurers are very “sneaky” about obtaining FCE prescriptions and often contact physicians who are no longer treating to obtain them. I had a claim sometime ago where the insurance company representative actually “forged” a prescription the treating physician said he never wrote.

It is always a good idea to talk to your doctor and agree on a plan of action should your insurer request a prescription for an FCE. Physicians are more likely to sign them if the request comes unexpectedly.