Disability Insurance Question and Thanks

Discussion in 'Fibromyalgia Main Forum' started by mompain, Jul 23, 2008.

  1. mompain

    mompain Guest

    First of al, I want to thank all of you who have been thinking of me and offering encouragement when my insurance company refused to pay for my Provigil. They are still refusing to pay without a sleep study, (I have an appointment for this in early August), but my WONDERFUL, CARING doctor searched high and low and came up with enough samples for me to have enough for the next month. Now that is the kind of doctor that I have said many prayers in search of. This pain institute that I am going to now takes the comprehensive approach and cares for the whole me. I love them and how they care and truly want to help patients work through their pain and problems.

    Now to my disability claim question. I recently received an answer to my long term disability insurance claim and they said that they were going to have to do a "Behaviorial Medical Intervention" in order to reach a conclusion about whether or not they could pay my claim of disability. My Sjogren's doctor has sent them all of my medical files and a letter stating that I am not able to work because of numerous health problems. What is going on with this "BMI" thing? I have never heard of it and neither had my doctor when I called her. I don't mind the insurance company doing whatever they need to do because everything I have sent and stated is true concerning my disability but I feel as if they are just trying every way they can to get out of paying my claim. I have had this insurance for over 15 years and have only used it 3 times, so I am not one to take advantage and overuse. Can anyone offer a thought on this deal? I can't quite figure out what is going on.

    By the way, I did contact them today and told them about my pain institute doctors that I was not seeing when I actually stopped working due to disability but started seeing very soon afterward. I told them I would like for them to get those records if they had any problems backing up anything that I or my doctor has sent them. I thought maybe they thought this was only these few doctors sticking together and that is why they did not approve my claim.

    Any advice??? I would truly appreciate it.
  2. dc1980

    dc1980 New Member

    I read your post and was curious about what the heck was "BMI" too. I just googled "Behaviorial Medical Intervention" and found this website:

    One of the statements I saw on the website was: "AEP has partnered with BMI to better manage claims under our sick pay and workers' compensation programs. BMI has helped numerous employees get proper treatment and successfully return to work!"

    In my opinion, if the "BMI" your work is talking about is the same as the website then it looks like you just might be in for an uphill battle to get your LTD payments. I am not trying to scare you but any time a 3rd party comes in and you have no choice over the type of "medical treatment" you are going to receive and their main goal is to get you back to work instead of managing your illness with your best interest in mind instead of the company's best interest, especially if it is not a work related injury - then I personally question their motives.

    I have been fighting to get my LTD benefits for 2 1/2 yrs now. It gets frustrating but hang in there and get you a good attorney if necessary.

    Best of Luck,