Dr refuses to complete paperwork

[Darkhlmt]

What is the name of your state (only U.S. law)? Illinois

I have been dealing with an illness for about three months now. I have been protected under FMLA during my time out of work. I recently was sent to a specialist who has now seen my twice. This specialist has now completed more FMLA paperwork continuing my time out of work. But, now he is refusing to complete any short-term disability paperwork. He stated that he can justify my time out of work but not the short-term disability.

Some history with the specialist. I have been a patient at the practice for two months. They have seen my twice in the office. But, we have talked over the phone about once a week to see if medications they have put me on are doing any good. At this point, nothing has helped. As of my last conversation with the doctor I was told, "I completed your FMLA paperwork and faxed it in. But I won't complete the STD paperwork because I don't think you need it." He also stated that he would no longer treat me and that I had to see another specialist.

I'm trying to figure this out. I don't see anything that requires a doctor to complete the STD paperwork. But, how can he just say "I don't think you need it" and refuse. He is taking money out of my pocket which is preventing me from paying my bills. I pay for the STD coverage incase I need it. If I qualify for FMLA, shouldn't I qualify for the STD coverage? Do you have any recourse. I don't know what to do. I feel like I've been dumped in the middle of nowhere with nothing to guide me back.

PLEASE HELP!!!

 

[TheGeekess]

What is the name of your state (only U.S. law)? Illinois

I have been dealing with an illness for about three months now. I have been protected under FMLA during my time out of work. I recently was sent to a specialist who has now seen my twice. This specialist has now completed more FMLA paperwork continuing my time out of work. But, now he is refusing to complete any short-term disability paperwork. He stated that he can justify my time out of work but not the short-term disability.

Some history with the specialist. I have been a patient at the practice for two months. They have seen my twice in the office. But, we have talked over the phone about once a week to see if medications they have put me on are doing any good. At this point, nothing has helped. As of my last conversation with the doctor I was told, "I completed your FMLA paperwork and faxed it in. But I won't complete the STD paperwork because I don't think you need it." He also stated that he would no longer treat me and that I had to see another specialist.

I'm trying to figure this out. I don't see anything that requires a doctor to complete the STD paperwork. But, how can he just say "I don't think you need it" and refuse. He is taking money out of my pocket which is preventing me from paying my bills. I pay for the STD coverage incase I need it. If I qualify for FMLA, shouldn't I qualify for the STD coverage? Do you have any recourse. I don't know what to do. I feel like I've been dumped in the middle of nowhere with nothing to guide me back.

PLEASE HELP!!!

What did your HR office/STD plan administrator say when you called them and asked your question?

 

[justalayman]

about 3 months?


Do you realize that FMLA is for a maximum of a 12 week absence? Have you surpassed that?

also understand that FMLA and STD are two totally separate issues.

I'm trying to figure this out. I don't see anything that requires a doctor to complete the STD paperwork.

that's because there isn't.

But, how can he just say "I don't think you need it" and refuse.

because this is not Soviet Russia or China. A doctor does not have to fill out any forms if they choose not to.


but the statement makes no sense.

If I qualify for FMLA, shouldn't I qualify for the STD coverage?

not necessarily. Your STD eligibility is based on the rules the insurance company imposes. FMLA is based in federal law.

Do you have any recourse. I don't know what to do.

1. contact the doctor and seek a clarification of why he refuses to fill out the forms. If he still refuses, go to 2.

2. contact the STD administrator to discuss the issue. You may have to go to 3

3. go to a different doctor, especially since this one has refused to treat you any longer. Once you are established there, ask them to fill out the STD forms.





so, why is he refusing to treat you any longer? Something in there may give you a clue as to why he has refused to fill out the paperwork.

 

[Darkhlmt]

What did your HR office/STD plan administrator say when you called them and asked your question?

The last time I spoke with them they said that I needed to have the doctor complete an additional form with more specific details about my illness. This is the form that the specialist is refusing to complete. I have not spoken with them about the doctors refusal to complete the paperwork due to that conversation taking place today.

 

[Darkhlmt]

about 3 months?


Do you realize that FMLA is for a maximum of a 12 week absence? Have you surpassed that?

also understand that FMLA and STD are two totally separate issues.


that's because there isn't.





because this is not Soviet Russia or China. A doctor does not have to fill out any forms if they choose not to.


but the statement makes no sense.

not necessarily. Your STD eligibility is based on the rules the insurance company imposes. FMLA is based in federal law.




1. contact the doctor and seek a clarification of why he refuses to fill out the forms. If he still refuses, go to 2.

2. contact the STD administrator to discuss the issue. You may have to go to 3

3. go to a different doctor, especially since this one has refused to treat you any longer. Once you are established there, ask them to fill out the STD forms.





so, why is he refusing to treat you any longer? Something in there may give you a clue as to why he has refused to fill out the paperwork.

First, I am aware that FMLA and STD are not one in the same. I am protected for about one more week under FMLA but my employer is working with me to obtain an extension under their policies. the STD is provided by a third party which my employer pays for.

to answer

#1, the specialist told me that he "can't help me" and that he doesn't know whats wrong.

#2 Planning on contacting them tomorrow

#3 I am going to my primary care doctor tomorrow to discuss finding someone that I can trust to help.

 

[justalayman]

there is no extension of FMLA. If the employer so chooses to allow more time off, that is entirely up to them. Along with that, they are then no longer bound by the same rules applicable to FMLA.

sounds like you are going in the correct direction

 

[Darkhlmt]

there is no extension of FMLA. If the employer so chooses to allow more time off, that is entirely up to them. Along with that, they are then no longer bound by the same rules applicable to FMLA.

sounds like you are going in the correct direction

I meant to say that my employer has their own policy in place for a "FMLA" extension. Even though I know there is no federal protection of my employment if the company denies the request. Thus far, my employer has been VERY good about my missed time.

 

[ecmst12]

Sounds like your doctor thinks you can go back to work.

 

[justalayman]

Sounds like your doctor thinks you can go back to work.

Then how could the doctor complete the fmla certification?

 

[ecmst12]

Much lower level of evidence needed.

 

[cbg]

Let's be clear here. FMLA is leave time. STD is income replacement. The two have different purposes and different eligiblity criteria; also different requirements.

While STD and FMLA can and often do run concurrently, they do not have to. It is possible to be eligible for one and not the other. As indicated above, the criteria are NOT the same.

Whether medical documentation is necessary for FMLA is complicated, and to a certain extent is fact specific. Whether medical documentation is necessary for STD depends on the wording of the STD policy.

FYI, STD does NOT provide job protection. FMLA does.

 

[justalayman]

Much lower level of evidence needed.

That is neither the doctors concern or place to make the determination. There is no reason to complete the fmla documents and refuse to complete the std documentsthe insurance company will make the determination on eligibility

 

[Zigner]

That is neither the doctors concern or place to make the determination. There is no reason to complete the fmla documents and refuse to complete the std documentsthe insurance company will make the determination on eligibility

What legal requirement is there for the doctor to fill out the paperwork?

 

[ecmst12]

We don't know what the paperwork looks like. Depending on what is being asked, the STD paperwork might very well require the doctor to be dishonest. FMLA paperwork doesn't ask for proof and there really isn't any particular standard of disability that has to be met, they just have to have a diagnosis. STD policies are a lot more specific about what constitutes disability, because there's money involved. FMLA is unpaid.

 

[cbg]

Well....the FMLA paperwork has to support a serious health condition as defined by the statute.

But I agree that it's less specific than most STD policies.