LT Disability Ins. Co. Want s to Interview Me. HELP ANYONE

Discussion in 'Fibromyalgia Main Forum' started by 1sweetie, Oct 13, 2006.

  1. 1sweetie

    1sweetie New Member

    Unum is my Long Term Disability carrier and was going to terminate my coverage after 24 months. I hired an ERISHA attorney & they have continued to pay.

    They now want to meet me in person and that will be done at the attorney's office.

    Has anyone else done this? What can I expect?
  2. findmind

    findmind New Member

    First, you cannot go to the atty's office for the appt!

    Have them visit you at home.

    Be where you usually are: in bed or on the couch or lounger.

    Let your brain GO...do not try to outwit them, teach them, etc. They already think CFS and FM are wastebasket dxs and they will do ANYTHING to say you can work: including videotape you leaving the house and following you. UNAM only goal is to have their drs declare you mentally ill so they only have to pay you for 24 mos.

    Cut the interview short....doze off right in front of the person. SHOW your pain in your eyes and posture. Do not try to be brave and do not argue with them in any manner; you do not have the energy to do so.

    Make your atty come to your home for the interview...that's what they are paid for, BTW.

    Have a written job description and scribbled notes why you cannot perform each duty.

    Cry, but do not scream, get angry or offer to get them water...make them get their own.

    Best of luck..let us know what happens...

    There's always hope!
    findmind
  3. bkayclark

    bkayclark New Member

    My doctors have sent so many letters to my LTD company and the medical records (140 pages) have been sent 3 times, they are delaying it for some reason I haven't been paid anything). I too am getting a lawyer as I can't handle the stress of it all and just don't have the energy.

    I agree they will have to come to me and see how my life is so messed up...that they wouldn't want what I have (CFS, FM and mono).
  4. 1sweetie

    1sweetie New Member

    Hello all and thanks for the responses. I am so scared of these people. It literally made me sick when I found that I had to be interviewed by them. I haven't had to talk with them since I hired an attorney several months ago.

    findmind: Per previous advice and that of my attorney, I have to meet them in a place other than my home. The attorney will be in charge and they can not see my home. It is a 4 hour round trip drive to this attorney's office and I will be wiped out by the time I get there, which is good I guess. The problem is that since I have been sick, I am the best that I have been. I am happy for me but I wish this interview had been 2 months ago. I will probably cry but I am afraid I will get angry. They make me so mad. Thanks for your advice and see you on The Porch soon I hope.


    bkayclark: I truly understand the stress these LTD companies cause. That is their intention. They want to trick us and we are easy prey since we do not think as well as we once did. Unum does not even consider CFS or FM as something they will pay for....say it is self-reporting and we can't prove we are sick because there is no test. The only reason I have been paid is because the neuropsych test that I had showed cognitive dysfunction but because the MRI did not show any abnormalities, it added it was probably caused by stress. They will only pay for 24 months for "mental illness". I was depressed because I was so sick and could not work...you understand.
    Good Luck to You!



    skeesix: Thank you for your advice. I am not letting them in my house. I have paid someone to clean my house and I do not want them here besides my dog would bite them. Hey, that's not a bad idea! Good advice on the clothes. I am so upset about this. I know that I will get angry. I just wonder if they have a picture of me doing something that I said I could not do. I have always been honest with them but I have made some improvement...far from being able to work..but I can do some things that I could not do. I rarely drive and on the CFS scale that Haleycole posted I have gone from a 10 or 15 to maybe a 25. I am just so scared of these people. It is so unfair. I paid in good faith and I expect the same from them.

    prickles: Thanks for your support as always.
  5. mezombie

    mezombie Member

    Is there someone who knows you well and truly cares about you that could come with you?

    If so, this person could provide moral support and also add to the interview if you forgot something or explain how bad this really is for you, how you really cannot function, etc.

    I agree with Skeesix that videotaping (or at least audiotaping) the interview might be a good idea. These insurance companies twist everything.

    I'd dress the way you normally would if you had an appointment with your lawyer, but would skip makeup.

    I feel for you. Good luck!
  6. 1sweetie

    1sweetie New Member

    My husband will take me. I rarely drive and not for long distances. I hope they will allow him in the interview with me. I will request it. I will also ask the attorney about videoing the interview.

    These attorneys have dealt with Unum before. I guess I have to trust them. They will meet with me 1 hour before I meet with Unum. I'm just afraid of what I may say. I get so confused now and under these type of circumstances I don't know how I will react.

    I just wonder what they will ask? Maybe the attornies can anwser most of the questions.

    Thank you so much for helping me.

  7. victoria

    victoria New Member

    But notify them of your intention to do so.

    When my husband was on pvt disability ins initially, he made the mistake of letting some rep come by to talk to him; and of course the meeting was totally misrepresented in the rep's letter/report.

    They later asked for a second meeting; this time he did it at our lawyer's office and notified them we were going to videotape it for their protection and ours; so they then hired their own videographer to record it as well. The interview went very well as a result.

    I then also videorecorded his physical exam by an orthopedic MD paid by the insurance company. It definitely makes a difference in attitudes, sad to say;

    As we later also saw an orthopedic doctor on our own, and he treated my DH like dirt until my husband got mad and said he wasn't paying him to be treated like that - turns out the MD thought he was a worker's comp case! When the MD realized we were paying him, he suddenly got nice!

    Taking them on in an adversarial approach after they have given you problems is better than being meek and mild about it... not that you have to speak up about it, just be matter of fact about what you've gone thru and are going thru physically.

    Also, do not try to make yourself "look good" by doing such things as putting on makeup etc, ... let it all hang out, so to speak, as you would be normally at home... the fact that you may have made extra effort will not be appreciated, they will assume that is what you can do, ie, if you haven't been able to wash your clothes etc., wear what you have...

    hope this helps! good luck!
    Victoria
  8. rockgor

    rockgor Well-Known Member

    I don't know of any reason why your husband can't be present at the meeting. Is there a state statute that says he can't? Of course not.

    Does the insurance policy say a husband can't be present at a meeting? I seriously doubt it. Your atty may need to put his foot down.

    "I'm very sorry, but my client is quite fragile. We won't be able to proceed if Mr. Sweetie can not be present."

    Do you know if there will be more than one representative from the insurance co. at the meeting? Is this person a doctor? How can he/she determine your disability state?

    Do you or your attorney have a copy of the policy? If not , demand one. Your rights and obligations are spelled out in the policy which is a contract.

    The general rule the courts follow is that if the contract is ambiguous, a court interpretation will favor the policy holder (you) rather than the insurance carrier.

    This is a matter of public policy. A company can not write ambiguous policies and they have them interpreted in a way favorable to the company.

    I don't know, but I suspect this is just someone who will report a general impression to the carrier. Based on that the carrier will decide if he wants to go thru more costly tests or not.

    (I just had an emg at the request of an insurance company. The bill for that one test was $1400.)

    One thing to avoid is saying I can't do something (shopping, laundry, carrying my grandchild) if you can do it sometimes.

    Better to say something like, "Yes, I had a good day last week and was able to go to the maket and fix dinner. But most days I lie on the sofa and don't do anything pysical."

    Don't think the company is giving you anything. They took money (premiums) and they have a contractual obligation to pay benefits.

    And you are not a welfare case. You have a long history of work and accomplishment behind you and nothing in this world can change that.
  9. kirschbaum26

    kirschbaum26 New Member

    Hi:

    I just started my LTD with UNUM. They have approved me for my RA at this point, and only for the first month...so I will have to continue to send them forms...what a pain. I had only a phone interview...so cannot give you any advice, but I was very interested in all the comments you received.

    I hope that your interview goes well.

    Good luck.

    Ingrid
  10. 1sweetie

    1sweetie New Member

    Thanks for coming to my rescue with good information. Who better to help me than a friend that is also an attorney!

    I have made copies of these emails and will take them with me when I speak with my attorney. He is supposed to be well experienced with dealing with both CFS and Unum. He is an ERISHA attorney and works with the national CFIDS organization that is based in Charlotte, NC. He explained to me previously that this law actually protected the insurance company not me. I don't know why but that was a surprise to me.

    You asked an excellent question and I will call my attorney to contact the insurance company for the answer. Who is this person or persons that I am meeting and what it their intent?

    We did demand a copy of the policy before we agreed to meet with them. My attorney declined the meeting until they presented us with a copy.

    You brought me one issue that I have already messed up and so have my doctors. I learned about this from someone on the board but it was too late for what I had already said but my doctor's continued to write up my visits wrong. The word "I can't" has already been said. It's was a habit for me but my CFS specialist wrote a nearly word for word dialogue and even after saying we should not use "She can't" it would still be in her notes.

    Who is required to pay for test and who chooses the person testing? Originally I had a well respected, well known individual from Duke that did my cognitive testing. Later it was done by Social Security and cognitive dysfunction was the reason for receiving SS disabilities.

    When I actually talked to the insurance company, the "I cant's" at the time were true but I have made improvements and some of what I could not do then, I can do now. On the CFS scale, I was probably a 10 to 15 and now a 25 to 30.

    They do not even consider CFS, FM, or any self reporting disease. They added it to their policy after the large suit they lost. I consider this bad faith. I truly though that since I had paid premiums for 32 years for disability and was told if I could not work I would be covered until I was 67, that I would be paid. The only thing we saw or was told was that for the first 60 months we would get 60% or our income if we could not do our job, after that any job. I did know if it was "mental" the limit was 24 months and that is what they are trying to use.

    They have paid to date because of the cognitive test which they and the testers elude to depression because of no physical findings on my brain MRI's. The brain fog is not considered since they do not believe in our self reporting diseases. I also have test that show I am totally exercise intolerant and doctor's showing severe swings with orthostatic hypo-tension (which is now sporadic).

    I agree, I trusted them and they owe me and I am sure I told them that when I was speaking with them. I do wish I had never spoke to them. I was so sick that I had no idea that anyone would think of not paying me.

    Thanks for the info.




  11. 1sweetie

    1sweetie New Member

    Thank you also for great info. You speak from experience and I understand how a video could keep everyone on their best behavior.

    I will go there "natural" as I have to do most of the time now. I had always dressed nice and always wore makeup but until things have changed.

    I have been able to put on a "little" make up on recently. My husband bought me a mirror and I have to sit down to try to do it. I rest before and after. I am using the Bare Minerals makeup on occassion if I am able. That would be approximately 5 times now. I hope they do not have a picture on one of those rare occasions that I took hours to get ready and did get on some makeup and clothes. If they see me like I am daily, it would be in PJ's since clothes hurt my skin.

    Thank you so much. I will keep you informed.
  12. rockgor

    rockgor Well-Known Member

    If the insurance co. wants you tested, it will choose the dr. and pay for the tests. (If you are asked to travel too long a distance, discuss w/ your atty.)

    Are you talking about showing your atty e mails from this board? Probably not a good idea. Most attys are delicate w/ feelings easily wounded. They don't like other people, especially other attys, giving advice from the sidelines.

    But you can certainly discuss w/ him the ideas presented here.

    And it is certainly reaonable for you to say that previously you couldn't do such and such, but you have improved a little. You now can do it once a week or whatever.

    Or maybe you tried to do something last month, but then were stuck in bed recuperating for 2 days after. The truth usually sounds reasonable.

    It's too bad we have to deal w/ aggravation like this in addition to the disease, but as my 12 step friend Michael says, "Things are what they are, even when we don't like it."

    Good luck.
  13. 1sweetie

    1sweetie New Member

    No, I would not show it to another attorney. I have to take it with me to remind me what to do or not do.

    I worked with many attorneys while I was a banker and yes, you are right, he would be offended. I know you were not that kind of lawyer and I wasn't that kind of banker, right?

    I have to travel that far because I want to meet at a neutral spot and this attorney thanks highly of his time. He charged a nice fee just to read my file and send letters to the insurance although they have earned the money for me so far. I have received 4 months of pay that they told me they were not going to pay me because of the letters.

    He had just won a LARGE settlement against this company the week before I retained his services. He said the company knows him well. After listening to us and before reviewing the case he said we had only had a "fair" shot of winning and if we did it would be a one time settlement.
    His takes a large percentage if he wins in negotiations and an even larger percentage if it goes to court.

    It should not have to be this way.

  14. JenniferAnn539

    JenniferAnn539 New Member

    Sweetie,

    Do you have CFIDS? If so, have you considered having a RNase L test done? I would think that would pretty much spell it out in black and white proving an immune disorder. If the numbers are high it would reflect your level of disability and inability to function on a "normal" level.

    Best of luck.

    Jennifer
  15. 1sweetie

    1sweetie New Member

    I do not remember all the names of the blood work but I do remember that most were in the normal ranges or were showing inactive. There have been some that would be out of range but they would correct themselves.

    I have had most of the symptoms of CFS and later FM but like a lot of people with CFS my blood work is rather normal. I wish it would show something. I have enlarged nodes, sore throat, edema, and so many things but I would have slightly elevated WBC only.

    I will try to find my first paper work and check for that test.

    Thanks for your suggestion.
  16. carebelle

    carebelle New Member

    I posted to you with your name on another post today will you look for it and help me please with a question I have?
    Thank you
  17. sdown

    sdown New Member

    Hi, I had a meeting with my lawyer and Clarica's lawyer in my lawyer's office. They interviewed me for I cant remember but it seemed like days. It was for a few hours. I felt like I had done a crime. I thought this is what its like to be a criminal and be investigated. I finally said "I can't do this anymore and walked out. My lawyer said you have to come back tomorrow. I said call me. My lawyer called me the next day and said "You dont have to go for a second interview they want to settle". Its almost like they want to push you to your limits to what will happen". They asked all kinds of questions "Do you do any of the cooking, cleaning? "Who looks after your son" Who looks after the garden, Do you cut the grass... & on & on. I was so flushed when I left there Im sure my blood pressure was thru the roof at a dangerous level. I kept interrupting them before they finished alot of sentences because I sometimes have a very short attention span and I told them that. Be honest with them and tell them all your symptoms and how much you are suffering. Good luck
  18. sdown

    sdown New Member

    I had a Physical Therapist who worked for Clarica Insurance come to my home. Big Mistake! She analysed everyhing in the house. It had nothing to do with physical therapy. She was a paid snoop by Clarica. I had plants in the window. She wanted to know if I planted them and if I watered them. give me a break. I should have never consented to her visit in the privacy of my home. She examined my floor and my counter, my dishes, my fridge, my stove. I should have told her to leave on the spot. They really prey on the sick as I was so lonely and any company I could get I fell into their trap. the other times i was with the therapist we actually did therapy. We went for a walk and that day I was only able to walk 1 block as I was very weak and another day we went to the pool for 15 minutes.
  19. 1sweetie

    1sweetie New Member

    You don't know how much it means to me for you to take your time to let me know what to expect.

    This type of information is what I need. I want to know what they want from me. I did not know how to prepare myself mentally.

    I hope my attorney can limit the interview time. The attorney and his assistant think that there time is very valuable. I will wilt if they grill me like that. I am just afraid to say the wrong thing.

    Was your attorney with you and did he tell you what to answer or were you on your own?
  20. mezombie

    mezombie Member

    Your attorney will no doubt "prep" you. You're paying him, so by all means ask him what to do if you feel uncomfortable with the questions. Ask him about scenarios that particularly frighten you. Maybe you can work out some signalling system, where he can let you know with body language if you should stop talking, or expand, or whatever. Most attorneys will speak up quite clearly to the insurance rep when a question is irrelevant before you have a chance to respond.

    Remember, the issue is <b>are you able to work</b>.

    I know this will be hard, but try to take a deep breath, look at your DH, then your attorney, and then answer.

    Don't give them more information than they are asking for!

    I know you've said you're feeling better now than you did when they first approved you. That's great! For purposes of this interview, however, keep in mind that this illness is unpredictable. For purposes of working, that makes you unreliable. How would you know if you could meet a deadline, for example?