It never ceases to amaze me what insurance companies can come up with to coerce claimants to give up their SSDI files. And, unfortunately, claimants believe what they are told, and do as they are commanded, sometimes to their own demise.
First of all, let me say that SSA. SSDI and private disability insurance are two very different things. Neither one is accountable to the other, nor do they communicate as part of the review process; and, no where does it say claimants MUST provide copies of their SSDI files to private insurers as proof of claim, not even Plans or policies require that.
You wouldn’t know that, though, if you listened to the untruths and misrepresentations some insurers communicate in order to get their hands on SSDI files. One of the latest communications I’ve read from Reliance Standard, makes a statement alleging ERISA REQUIRES them to review SSDI files. WTH?
Upon checking I have it on good authority that there is no such ERISA statute requiring Reliance, or any other insurance company, to review SSDI files.They lied. Most claimants may recall that there is an aggressive push by insurers to obtain SSDI files, but not for reasons that are advantageous to them. Insurers actually hire “third-party paper chasers” to get claimants to sign SSA Authorizations so they can get the SSDI files. The question is why.
In SSDI files, there is a SSA Form called Form 831 that describes the SSA listings under which claimants are awarded, as well as the DDS (“Disability Determination Specialist”) who made the approval. Insurers are looking exclusively for listing codes for mental and nervous awards in order to use that information to limit benefits to 24 months. Even if the mental health listing is given as “secondary” to the primary approval listing, insurers like Reliance Standard could use the information to their own advantage.
At one time, Unum even arranged conference calls with the claimant and DDS, which is another tragic story for a different article. For this article today though, it is sufficient to understand that SSDI and private insurance are two different things; they are not associated with one another, and have no communication. It takes a specialized Authorization to obtain a copy of someone’s SSDI file, and claimants are not forced, or compelled to provide it, if they don’t want to.
Having said that, claimants are required to provide insurers with a copy of the initial award letter so that an overpayment can be calculated. Once, the award letter is received no further information needs to be provided to insurers. There are exceptions that include changes in SSDI benefits due to increases in earnings, but in the long run very few people have to submit any additional SSDI file information.
For the time being, it is important for claimants to be able to sift through insurance BS when they see it. If you don’t want your insurers to have copies of SSDI files, don’t sign the Authorizations. And, there is no ERISA regulation that requires insurers to examine SSDI files. Shame on you, Reliance Standard.
