Posts Tagged ‘Unum SSDI Scam’

Friday Q & A

Why does Unum want SSA Form 831 so much? The company is hounding me to sign an Authorization to get my file. Do I need to do that?

There are quite a few really good posts on the Blog about Unum’s scam when it comes to obtaining SSDI Files. If you do a search from the Home Page I’m sure you may find more detailed information.

Although the company alleges it, “wants to give your claim every consideration”, the truth is Unum does not. In fact, Unum’s obsessive attempts to obtain SSA Form 831 are more related to denying mental and nervous claims limited to 24 months. Form 831 is a form that is kept in each recipient’s file at SSA and includes the listing codes benefits were awarded for as well as the name of the DDS (Disability Determination Specialist).

In the past, former employees describe Unum’s abuse of form SSA 831 by using the information to try to contact the DDS. Now you know why Unum’s SSA Authorization is valid for two years.

I’ve been asked by Unum to have a neuropsychological evaluation. Why?

Unum seems to have a focus project going on targeting mental health and cognitive impairment claims. I’ve heard from several people who tell me Unum’s on a neuropsyche test rampage. Although neuropsyche tests are considered “objective”, the test, administered by doctors paid by insurance defense, is actually as opinionated and biased as you can get.

The evaluator chooses a “battery of tests” not necessarily to evaluate impairment, but to evaluate the insured’s “intent, motive and secondary gain” issues more than anything else. This is particularly true for FMS claims where IME evaluators deliberately do not choose tests that diagnose the disease at all.

In any event, the IME evaluator compares the scores from the raw data (test) and compares the tests to population normative data. Then he/she writes an opinion report based on the results. How objective and non-biased is that?

In my opinion, neuropsyche tests are primarily insurance defense tools to provide employers and insurers with documentation to not hire employees or deny disability claims. It’s a multi-million dollar “gotcha” game paid for by the insurance industry.

Prudential neuropsyche tests – are they a put on?

In continuing with the above discussion, I haven’t had a chance to talk about Prudential all that much lately. Still, I consider the company #2 bad boy after Unum Group.

The company does not have its own mind; it has a Unum mind. Many ousted Unum employees wind up at Prudential. The company hires old “claim killer” Unum IME and peer reviewer doctors to review claims.

When it comes to neuropsyche tests Prudential retains IME facilities who “coach” its doctors on what tests to choose and how to write reports. Some of these organizations actually “grade” the IME reports written by its doctors. IME reports written by doctors who are coached as to what they should write remove all defenses of the insured to ever receive benefits. Prudential truly uses these facilities to “stack the deck” against claimants.

Prudential uses medical reviews written by non-specialized Registered Nurses to deny claims. The company insists on reviewing mental health records in order to pay claims even when therapists don’t want to provide them.

Next to Unum, Prudential is another company to stay clear of if you are an employer looking to spend employee benefit dollars wisely.  Prudential disability benefits wouldn’t be a benefit to employees, but a casualty soon or later.

Are disability insurance companies subject to HIPAA?

No, the aren’t. In fact, disability insurers are explicitly excluded as a defined entity in the law. However, the doctors who provide medical records to Unum ARE subject to Unum and need to abide by the law.

This is why doc-to-doc calls between insurance doctors and treating physicians should not take place. Using the phone is an electronic submission of health information. Treating physicians should make note of that.

Read Full Post »

%d bloggers like this: