DCS CLIENT SERVICES
Initial Applications for Benefits
As an experienced Consultant, I will provide clients with all the necessary assistance they need to prepare and submit the initial application disability forms in a manner that best places their unique medical circumstances in the official files. Initial applications are extremely important in that they represent the insurer’s “first look” for eligibility as well as whether or not the definition of disability is met. The application process is often very difficult for those who are impaired and DCS clients receive the help they need.
Medical Communications and Proof of Claim
It is extremely important for physicians to report accurate medical restrictions and limitations to insurers who then use the information to make claim decisions. Personal and direct assistance will be given to treating physicians to insure all medical forms are completed with specific supporting medical information needed and expected by insurers.
Independent Medical Examinations (IMEs)
DCS also provides insureds with expert consulting advice, preparation and management if they are asked to submit to an IME. Information will be provided concerning how to prepare, and how to present oneself during the examination. Learning how to prepare for an IME and remaining in control of the process is very important to a successful outcome. Written resources are also available.
Field Visits
DCS provides clients with written resources that are comprehensive in preparing clients for field interviews. In addition, Linda will verbally prepare each client several days before the interview to insure clients have a clear understanding of the purpose and process of meeting with an insurance investigator.
Contract Policy Reviews
It is extremely important for insureds to have an in-depth knowledge of their disability policy or Plan and completely understand what you and the insurance company are entitled to. Disability insurers often attempt to misrepresent policy provisions to their customers in an effort to deny claims with out-of-contract requirements. As a contract specialist, Linda conducts policy reviews as a part of the insured’s management strategy.
Subjective and Self-Reported Claims
Disability insurers often attempt to deny claims with allegations of “self-reported” impairments such as chronic pain, depression, migraines, and Lyme disease. It is extremely important for insureds and their treating physicians to understand the importance of documenting these impairments in ways consistent with the provisions in Plans and policies. I will assist you in obtaining the necessary and/or required medical information to support subjective and self-reported claims.
Working Part-Time
Is your claim paid correctly? Or, has your disability insurer arbitrarily decided to pay you only 50% of your scheduled benefit? Those insureds who are able to return to work in limited capacities may need assistance in determining whether their benefits are calculated correctly and “indexing” has been applied. It is also helpful to insureds when Linda takes care of the administrative work of faxing information to insurers.
Any Occupation Investigations
As an experienced claims expert managing ERISA group disability Plans, I will be able to assist you in managing the 24-month change in definition in ways that updates current medical restrictions and limitations, and accurately computes “gainful” occupation wages. This is an area of claims management claims reps aren’t good at, and the process is more successful if managed by the claimant and someone who understands the process.
Surveillance and Field Investigations
Surveillance and field investigation requests are very profitable to disability insurers. Linda’s accumulation of written information concerning surveillance and the investigator’s interview is a very powerful information base for clients. In addition, Linda will prepare you for the field interview, and/or provide a strategy to survive surveillance.
Specialty Impairments
Linda’s twenty-five years of disability claims experience allowed her to accumulate additional expertise in managing claims with the following impairments: HIV (AIDS), Chronic back pain and failed back surgery claims, Fibromyalgia, Chronic Fatigue, and Migraines. Insureds who come on board with these impairments receive the full value of Linda’s medical knowledge in these areas, acquired over many years of experience.
Long-Term Care Claims
Long-Term Care claims have unfortunately become problematic because this coverage involves a wide array of medical, social, personal, supportive and specialized services required by individuals who have lost capacity of self-care due to chronic illness.
Although Long-Term Care is made up of many different services aimed at helping people with chronic conditions, insurers of LTC products use many of the same “risk management” strategies such as surveillance, field visits and medical misrepresentation to determine whether claims should be paid or not. DCS, Inc. will assist those receiving LTC benefits with their reporting needs to insurance companies as well as provide valuable information about the LTC process and ongoing evaluations.
