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Medical Evidence

by Lawrence Pierce

Can you expect your disability insurance company to be honest with you? In my experience, the answer is : "NO."

Here are some examples of ways in which the insurance company will try to discourage you from pursuing your claim by giving you false information.

After going to see their doctor for what is called an ' independent medical exam,' you will receive a letter "declining" your claim , or any further payments on your claim, because there is ' no evidence' of disability. Often this letter is an outright lie. Demand to see a copy of the report prepared by their doctor ( the 'independent' one )to see for yourself what was written about you.

You may be asked to attend a functional capacity exam, which is a test of your ability to do certain physical things. You will not be shown the test results, and they may reveal that you are truly disabled. After your insurance company gets the results they will often write to you and "decline" the claim, or further payments on your claim based on their interpretation of the test results. You should demand to see a copy of the test report, and discuss it with your doctor or lawyer.

Finally the most pervasive lie told by the disability insurance companies is that you must "prove your disability on the basis of objective medical evidence."

I rarely see insurance policies that require anything other than "written proof of disability," or "due written proof..." and in either case that is generally accepted to mean a letter from your doctor confirming your disability.

The request for 'objective medical evidence' ( something that can be seen on an x-ray, or in a lab test ) is designed to discourage you from pursuing benefits that you are entitled to.

Some insurance companies pay bonuses to their employees to close files, so they have a direct interest in discouraging you. Furthermore, these people that write to you may call themselves, 'Disability Specialists' or some such title, but, in reality they rarely have any formal training or education, and no written materials supplied by the insurance company to help them make a fair decision. They are just winging it, in my experience.

Lawrence Pierce is a Vancouver lawyer, with Pierce Law Group, specializing in disability insurance cases. He has recently won judgments against Sun Life, Great West Life, and Unum Life for aggravated damages.

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