IDI Insureds – You Can’t Just Stop Working………
One of the most common mistakes among IDI insureds is that they take themselves out of work on their own volition without having a documented treating physician’s buy-in. If this were possible most insureds with IDI policies could stop working whenever they...
Daily Buzz – 4th Qtr. “What’s Going On?”
The Standard just denied a ME/CFS claim using the age old argument of “subjective and self-report.” The recommendation to deny was made by a sole internal medical reviewer who stated, “there was no testing or objective evidence to prove the...
Unum’s Christmas Grinch
The beginning of December is hell month for Unum’s claims handlers as managers push the stress overload buttons to deny more claims. Anyone who has ever worked as a Unum claims handler will tell you it’s best to quit on October 1st and come back after the...
No Resignations – Ever….Ever….Ever….Ever
The most popular posts on Lindanee’s Blog are the articles I wrote dealing with “Resignations”. I know I must have published at least 5 articles about the subject and yet people seem to continue to ask questions about “resigning to go out on...
The Internet – “Relying On Worst Case Scenarios?”
Does anyone remember when information was presumed to be accurate when it “was written in a newspaper?” I know my father used to say, “Of course it’s true, it’s right here in the paper.” Clearly, that’s not true today, and...
December DCS Report Newsletter
December’s DCS Report will focus on SSDI, SSI, offsets and repayments. For those readers still not subscribed, you may process your $25 yearly fee using Pay Pal and my email address: DCS@metrocast.net Happy Holiday!
2019 DCS Update
Wow! This year seemed to go by really fast. It’s time for DCS, Inc’s statistical and activities update. Lindanee’s Blog has 215 subscribed site members and 225 members for Comments. there are 2,179 articles in 183 categories. DCS receives on average...
Unum Thanksgiving Checks May Be Late
This is just a reminder that Unum’s checks are usually late around the holidays. Unum staff celebrates both Thursday and Friday as holidays so information that’s due won’t be seen or processed until the Monday after Thanksgiving. Not having checks...
Only Physicians Can Take An Insured Out Of Work
This is an issue primarily for those with IDI policies such as doctors, dentists, surgeons and highly paid executives. There seems to be a misconception among these insureds that they can decrease their hours, stop doing certain procedures, sell their businesses, and...
“I don’t get it…………”
Yesterday I was speaking to a DCS caller about a claim situation in which Unum denied her claim twice, finally overturning the appeal and paying the claim “because she was awarded SSDI.” In the course of the conversation, I inquired about why this claimant...
What Everyone Should Know About ERISA Appeals – Part III
WHAT IS AN APPEAL? An appeal is a claims process whereby insurers are asked to review their previous denial decisions to determine if the original denials were correct. Through supplementation of the Administrative Record or claim file insureds and claimants have...
What Everyone Should Know About ERISA Appeals – Part II
FIDUCIARY DUTY The U.S. Department of Labor defines “fiduciary duty” as a responsibility of employers (Plan Administrators) to administer disability Plans solely in the best interests of the participants and to decide indeterminable issues in favor of the claimant....
Pre-Existing Conditions by Linda Nee
Nearly all group LTD polices contain some type of pre-existing condition provision. These provisions protect the disability insurer from paying claims for conditions that existed before insureds became effective on the current policies. There are many types of...
What Everyone Should Know About ERISA Appeals – Part I
The purpose of this article is to be an educational and informative resource to private disability insureds interested in obtaining basic information concerning “Appeals”. It is not intended to be legal advice. DCS, Inc. refers all of our clients with disability claim...
Merry…..Surveillance In The Everygreens?
Just a quick reminder that surveillance teams are out in full swing trying to locate early shoppers carrying parcels, walking malls, and putting grandkids on Santa’s lap. Remember, the new normal of disability claims investigation includes activities checks with...
“Targeting” Claims For Year-End Denial -What Does “Targeting” Mean?
Articles appear everywhere on the Internet accusing disability insurers of “targeting” claims. “Do insurers really do that?”, I’m frequently asked. Sadly, the answer is, “Yes, they do, and they’ve nailed it down to a...
ERISA “Any Occupation” Investigations
Employer sponsored group Plans nearly always contain a definition of disability which includes the following: “After 24 months claimants must be unable to perform the material and substantial duties of ANY occupationfor which he has training education and experience.”...
Chronic Pain In The “New Normal” Disability Claims Process
By far one of the most frequently abused impairments by disability insurers is “chronic pain.” Classified as self-reported and “subjective”, insurers tend to reject claims with a primary diagnosis of “chronic pain”, ICD-10 code...
Holiday Hungry Vulture Denials From Insurers Strike Down Medical Information
Insurers’ end-of-the-year claim denials are in full swing, and desvastating to those who have no financial assistance for the holidays. Reasons for the denials appear to be first and foremost “not persuasive medical information”, or mental and...
Insurance Physicians Practice Voodoo Medicine by Linda Nee
There’s an old saying, “If someone can’t do their job, they should teach.” Insurance companies typically hire physicians, who for whatever reason, can no longer perform clinically but want plush jobs paying big money. Insurance medicine, including IME physicians is a...
