disability insurance legalities

[marymrt]

My son was diagnosed with hydro nephrosis (kidney failure) due to a birth defect. He was on disability at work and the first urologist said he could go back to work. His kidney has atrophied and he only had 7 percent usage about 2 months ago. My son was having severe back pain which is associated with the disease he has. He asked to have a second opinion which the doctor stated he needed to have the kidney come out. They then took him off disability about 5 to 6 weeks ago. My son has to climb towers in his work and he feels he cannot do this. The second doctor told him he could go to work but no climbing or lifting. Which is about 80 percent of his job. His work says they do not have light duty for him to come to work before he has his surgery Oct. 6. The disability insurance company is saying they see no reason he cannot work. Is it not a law that a person is entiltled to a second opinion. what are the disability insurance responsibility in this particular situation? My son is very stressed out as he is financially in dire straights due to not being paid. What are our rights and what can we do about this. HELP!!!

 

[cbg]

Whether or not your son has an automatic right to a second opinion is a matter of state law. He is free to obtain one at his own expense if your state does not mandate it.

The disability carrier is responsible for paying any claims that fall under the terms of the policy. They have a right to investigate to be certain that all claims they paid are, in fact, covered by the policy. They are not required to pay any claims that do not meet the criteria for disability as set down in the policy language. Medicine is not an exact science; it is not impossible that two different doctors may have differing opinions as to what he is capable of doing.

 

[marymrt]

Thank you for your reply very much... I appreciate it...

 

[TxMsLady]

Your son might also consider applying for Social Security Disability. Best wishes to him during this difficult time.

 

[marymrt]

Thank you we had not even considered that avenue!! Thank you for your kindness.