Disability Ins

[dpike13]

Im in Virginia and was in an auto accident. I applied for my short term disibility and it was granted. I sent them the results of my MRI which showed 3 bulging disks in my neck and 2 in my back. Im still under a Drs care and going to therapy weekly and they want to do injections into my spine. I received a notice that they terminated my benefits after 1 check which covered 2 weeks. I have been out of work sence 10/9 and the Dr says I will be out at least 6 mths. They said they consider the bulging disk the same as a sprain or strain. I dont see how they can stop the disability when my Dr wont release me to work due to my condition. How can they decide what my condiditon is when they dont treat me or see the pain Im in. There are times I cant get out of bed with out assistance. I have migraines to the point I dont dare drive and my left leg will go numb at times to the point it goes out from under me. I also have a lump on my left leg the size of a football and we dont even know whats causing that problem.Can I do anything about this??? Do they have the right to stop my disability??

 

[ALawyer]

The insurance company owes you a duty of fairness. While they are not bound by your doctor's opinion (let's face it, a doctor is more likely to be sympatheitc to and thus write a report favorable to his or her patient, especially when his money is not at stake) they, and you, ARE BOUND by the policy.

If they are acting in an arbitrary or capricious manner, or in bad faith, then they are liable not only for the policy benefits they failed to pay, but also for bad faith damages.

Make sure you comply with the terms of the policy and get any second opinions that are required. Then "sue the *******s" if they are playing games with you.

 

[ellencee]

My opinion of the insurance company's denying benefits is this--more than likely the medical records and/or notes do not provide information that meets the insurance company's criteria for short term disability benefits. There are many people with buldging discs at work today. Your doctor needs to provide more thorough documentation as to why you can't work. Ask your insurance company to send the forms either to you or to your doctor and have your doctor send specific information to the insurance company.