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...
SSDI Overpayments – The Right Thing
Most people who read Lindnee’s Blog contact me because they know I will always tell them the truth about their claim situations and because I have the knowledge and experience to provide accurate answers. This is one of those siutations. I seem to be hearing a...
Unum – Financial Reserves And Reservation Of Rights – Editorial by Linda Nee
Disability financial reserves are generally defined as “a monetary estimate of what a claim will cost.” The reserve represents money set aside for the eventual payment of claims and is not otherwise available to pay operating costs such as salaries, expenses and other...
Insurance “Robber Barons” – Deliberate Strategies White Paper
Statistics published by the Health Insurance Association of America (HIAA) report three out of ten American workers file disability claims before retirement. Of the thousands of disability claims filed in the United States, excluding Social Security, approximately 20%...
Fibromyalgia And Unum – A Sunday Editorial by Linda Nee
Unum’s Fibromyalgia Position Statements and Guidelines (7/29/2002) Just before leaving Unum in 2002 one of its physician consultants handed me a copy of Unum’s “position statement” regarding Unum’s handling, review, and philosophy in administering fibromyalgia claims....
Unum – Talk About Scary, Spooky And Shady…
I think it is exactly the appropriate time of year to talk about Unum’s “scary, spooky and shady” claims practices that are heralding 4th quarter profitability and causing insureds a great deal of grief. Unum’s investigations appear to be over...
