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Insurance Hell All insurance-related matters are here: Medicare, worker's compensation, appeals, denials, insights, wins, losses. PRICING is here too. Note: This forum has posts from 2006 forward. Older ones are in the Big File.


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Old 10-09-2010, 02:54 PM
beaverc beaverc is offline
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Default Ame exam

I'm treating on future med (lumbar spine injury). The IC arranged an AME exam. My PD rating was 45% before the exam and after was approx. 65%. Any way I believe the IC thought the exam would be in their favor, it wasn't, the AME Dr. gave me future surgery, meds, PT, pool PT,and on and on.I have been told the difference between the 45% and 65% increase in PD equals increased money in the form of stip payments. Haven't received nothing.Anybody know anything about ????
Also I am followed , cars sitting in front of my house, my neighbors have been spoken to etc.,etc., etc. Like something you have read about in a book. Anybody have any experience with this crap?????
THANKS
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Old 10-09-2010, 04:36 PM
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jss jss is offline
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Beaver,

That's got to be a ... weird feeling. I don't have any first hand experience with that, but I do have some second hand experience.

I have a friend that is an attorney that defends a medical insurance company against frivolous claims. After having heard some of the stories that he's had to tell, I don't blame insurance companies for covertly checking up on those collecting any kind of long term disability. He has access to investigators that check up on many claims.

I also have a cousin who was left quadriplegic after an accidental shooting in 2002. I worked for months to get her insurance company to cough up her long term disability and finally her lump sum disability payment. Her insurance company has tried for years to have her declared not disabled. She has not observed anyone investigating her, but her insurance company routinely sends her forms of proof to fill out and return with absurd deadlines; presumably to obtain an excuse to stop paying her???

If your disability is genuine, being photographed in a boat on an area lake, performing any kind of work for anyone for pay, or not returning a form to your insurance company by the absurdly short deadline could see your insurance company discontinuing your disability payments.

Good luck, Jeff
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