std claim denied

[s2112h]

state of florida
my wife went on std for one week due to work-related stress. she was prescribed the usual anti-depressants, etc. by her pcp. we filed a claim for std with her insurance company. a licensed social worker initially denied the claim, and her physician convinced them to reconsider. the claim was denied because "the provider did not provide an axis one diagnosis, do a mental status exam, pyschological testing, global assessment, or observation that would document the intensity of the symptoms. based upon careful <yeah, right> review of the medical information received, we have concluded that the objective data received does not support you being disabled."

we are in the process of appealing. any advice?

 

[ALawyer]

Unlike the way it worked in high school, a "note from the doctor" is NOT sufficient for an insurance company, nor should it be, unless the doctor is highly qualified -- and most pcp's are not psychiatrists -- and/or provides sufficient support for the diagnosis (such as with standard tests or other measures another professional could review).