If you have questions about a Medical Records Review, an experienced Long Term Disability claim lawyer can help. Herbert M. Hill, P.A. is here for you.
In the course of the years as a Long Term Disability claim lawyer, the undersigned has filed Administrative Appeals for Short Term Disability and Long Term Disability. In recent years, the federal regulations governing the process have changed. It used to be that an appeal would be submitted and a final adverse benefits determination rendered without the claimant ever getting a chance to review and comment upon any new information received by the insurance company, such as a “Medical Records Review” report. A Medical Records Review report is a report prepared by a doctor hired by the insurance company.
In appeals submitted by the undersigned, a specific comment was made to the effect that no valid denial could be rendered without our having
the chance to review the report their doctor rendered and on which they are now relying. So, after much hue and cry, the regulations were changed, requiring the insurance to allow review of a medical records reviewer’s report. Unfortunately, insurance companies are taking the opportunity to abuse that process.
Our Process
My experience is that the proposed denial letter is submitted with the report with an inadequate length of time allowed for comment. This process has driven many into my office because of the situation presented. There is a specific process we follow in responding to these reports. They come in response to appeals we have filed and we are prepared for the eventuality, even though we are successful on the majority of our appeals. When clients have submitted the appeal themselves and then come to us with these reports, we still have a process we follow but it involves some additional steps to get going on the file.
Your Next Steps
We have been on just about any horizon on which you may find your claim. It is because here at Herbert M. Hill, P.A., your Short Term Disability or Long Term Disability claim is just about all we do. Please give us a call if you have any questions. We are available by phone, or you may fill out our online contact form. If you have a pending medical records reviewer’s response due, please call us sooner rather than later!
