For many disability insurance companies, 2020 was a year of adjustment, while 2021 marks the first full year of the “new normal.” Disability insurance companies have begun to adjust to some major changes in how they do business, from an increase in the number of employees working remotely to corporate mergers of some of the country’s largest insurance providers. Below, learn more about what Dell & Schaefer’s attorneys observed in 2020 and what we expect to see from disability insurance carriers in 2021.
Disability Benefit Denials are Likely to Increase
Although there were still plenty of long term disability claim benefit denials in 2020, many claimants were also given a bit more leniency when it came to things like in-person doctor visits. Going forward in 2021, insurance carriers have begun to step up their scrutiny of claims, ordering independent medical examinations and asking for more documentation at the outset of claims.
More Claimants Will Be Required to Undergo Compulsory Medical Exams
The independent medical exam, or IME, is a medical exam the disability insurance carrier will order certain claimants to undergo as part of the claim review process. In most cases, the IME isn’t an actual examination at all, but simply a review of your medical file by another physician the insurance carrier selects. Your long term disability policy will often contain language stating that refusing the IME will result in the automatic denial of your claim, which unfortunately means that this is more of a compulsory examination than an independent one.
Because the physician who performs your IME is relying on a paper record to determine whether you qualify for disability benefits, it’s crucial for your claim file to be as complete as possible. This means your physician’s notes must connect the dots between your medical ailments and how they impact your ability to work. At Dell & Schaefer, we frequently work with physicians to ensure that they’re noting each of the factors and elements the insurance company is going to look for.
Telehealth Visits May Draw More Scrutiny
In 2020, with many hospitals and physician’s offices overrun by COVID concerns, it could be hard to even get an in-person appointment. Others opted for telemedicine as a way to reduce their exposure to those outside their household. But now that the vaccine is being rolled out throughout 2021, disability insurance carriers are less likely to accept telehealth visits as equivalent to an in-person doctor’s visit. Though those who are already on claim may be able to get by with telehealth notes – as the claim file is more likely to have notes from prior in-person doctor visits – those who are just starting the disability claims process are encouraged to seek in-person appointments if it is safe to do so.
Video Surveillance is Back
Another change in 2020 was a decrease in video surveillance of disability claimants. To put it bluntly, paying disability insurance carrier employees to keep an eye on disability claimants was a money-losing proposition at a time when few claimants were ever venturing outside the house. But now that things are beginning to reopen in 2021, claimants can expect a return to frequent video surveillance. If you’re leaving your house while on claim in 2021, or while your application for benefits is pending, there’s a good chance that your disability insurance carrier is watching you.
Many Disability Companies Have Merged, Increasing Claims Oversight
Along with its many other changes, 2020 brought about quite a few mergers for some of the country’s largest disability insurance carriers. These companies have restructured their operations and have put more protocols and processes in place to review claims. In most cases, this means more oversight of claims and more layers of review before a disability claim may be approved.
At Dell & Schaefer, we’ve never stopped fighting the disability insurance carriers to secure for our clients all the benefits to which they’re entitled. No matter where you are in the claims process, you can benefit from a thorough review of your claim file that will help fill in any gaps that the insurance carriers are likely to focus on. To get started with a FREE consultation with one of our experienced attorneys, just give us a call today.