ASK A LAWYER: Independent Medical Examinations

What should I do if my employer is pressuring me to return to work but my doctor says I should not?

You should provide a further medical note to your employer from your doctor explaining that you are not able to return to work.

Can you refuse to see the doctor the insurer has chosen for a functional capacity assessment or independent medical examination and request a different one?

You can refuse, but the consequences of refusing must be understood. Where the insurance company continues to pay benefits, a refusal to attend an assessment would be construed as non-cooperation, which would likely result in suspension or termination of disability benefits. If there is a specific reason that you are refusing to attend the assessment, you should provide reasons, as if there is an acceptable reason, the insurer may agree to arrange an assessment with another assessor. Where your benefits have been cut-off or your claim has been denied, we would urge you to contact a lawyer to discuss your options before attending any such assessment.

I underwent an independent medical exam at the request of my insurance company. Their doctor reported

that I had no symptoms of chronic pain and was fit to work. It just so happens that on that particular day, I was feeling better than usual. Now my benefits have been cut off. Do I have any hope of overturning this decision?

Entitlement to disability benefits is not frozen in time, and if you were having a better than usual day on the day of an assessment, that doesn’t mean you have no chance trying to recover further benefits. If your own doctors support your ongoing inability to work and your condition generally waxes and wanes, i.e., you have some good days and some bad days, this one-time snapshot of your health does not mean your case is over. The particular circumstances of your claim need to be thoroughly discussed with a disability lawyer to assess your chances of success.

Will my LTD benefits be affected if I make an out-of-province or out-of-country move?

Most LTD policies include a residency provision that may restrict or exclude benefits if you are outside the country. This would not usually encompass a period away for a brief duration, such as one to two weeks, but if you intend to be away for an extended period of time, you must check the policy provisions before making any travel plans. If you are on claim and must travel for a valid reason, you can discuss this with your insurance company, as if they approve the absence, you should not have a problem. These comments are general in nature and cannot replace actually reviewing the specific provisions of your particular policy.SP

“Perseverance is a great element of success. If you only knock long enough and loud enough at the gate, you are sure to wake up somebody.”

- Henry Wadsworth Longfellow