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Disability Claim? You're Not Paranoid... They Really Are Watching You

  [ 60 votes ]   [ 6 Comments ]
By Jason Newfield & Justin Frankel, Attorneys at Law* • www.ProHealth.com • May 4, 2011


* Attorneys Justin Frankel and Jason Newfield head a disability insurance law firm (www.frankelnewfield.com) that: 1) Works with patients before they file long term disability benefit claims to negotiate medical, paperwork, and insurer minefields; and 2) Represents policyholders whose disability claims have been denied or delayed. They represent many claimants across the US with potentially disabling ‘invisible’ illnesses such as fibromyalgia (FM), and chronic fatigue syndrome (ME/CFS).
______________________

Disability Claims and SurveillanceSurveillance and Investigation Tactics Used by Disability Insurance Companies - The Importance of Knowing What to Expect

The great news is, you are having a good day. You got out of bed and went outside for the first time in weeks. The bad news is, you were having a good day and went outside and walked right into the field of a video camera being used by an investigator working for the disability insurance company. 

From the moment that you file a disability claim, information gathering begins, from reviewing medical records and interviewing your neighbors to videotaping your activities. They are gathering evidence in an effort to deny your claim.

Here’s what you need to know about surveillance and investigations of disability claims:

You’re Not Paranoid – They Really Are Watching You  

• Video surveillance is cheap and easy to conduct and open to a great deal of abuse.

• Surveillance is more frequently used by insurers in cases where claimants allege disability based on ‘invisible’ conditions like Fibromyalgia and Chronic Fatigue Syndrome (ME/CFS).

• And surveillance is commonly used in high benefit claims, where the insurer is motivated to terminate or deny a potentially expensive claim.

A “Good Morning America” investigative team reported on several cases of claimants whose benefits were cut off after the use of undercover surveillance videos. The investigators staked out one person’s doctor’s office.

Our own office has defended many claimants who were videotaped going to the doctor - and told these trips were proof that they were capable of working at highly physical jobs. Therefore:  

• Make note of your activities outside of your home.

• Note the day, date and time of all appointments.

• If you have been advised by your physician to have physical therapy or join a gym and exercise, make sure that your medical records reflect this.
 
In a published federal court decision, a major insurance company that routinely uses video surveillance acknowledged that surveillance is an aggressive tactic. This was one case where its videotaping would have supported a policyholder’s claim for disability benefits. However, the company instead chose to rely on a doctor’s vague assessment – a mistake on its part, as the findings were unclear and only based on a partial review of the medical records.

The Intrusive 'Field Visits'

We consider the Field Visit interview to be a cruel and unfair tactic. Patients who are ill and homebound are extremely vulnerable, and field visits take advantage of their weakness.

• An unannounced and seemingly friendly visitor knocks on your door. You are not expecting a visitor, so you are off guard. You are not well, making you highly vulnerable. 

• The seemingly friendly conversation, which takes hours and is exhausting, becomes confrontational when the interviewer suddenly opens up a monitor to show surveillance video of you going to the doctor’s office, walking outside of your home - and demands to know whether or not your visits to the doctor would be the same level of difficulty as 'going to work'

We recommend that our clients call us immediately if someone knocks at their door and wants to interview them without notice.

• Tell the person that you are not well enough for an interview, get a name and a phone number, and tell them you will call them to make an appointment.

• Have another person present when you meet with them. Depending on the language of your contract, you may be required to have such an interview, but you have the right to set the time and have a family member or friend present.

• You may also want to record the interview, with an audio device or video camera of your own, to make sure that the information is not distorted.  

Investigation in General

• A disability insurance claim immediately opens the possibility of surveillance and investigation.

• If your claim involves being unable to travel to get to work, you may be videotaped if an investigator sees you driving or traveling.

• If you call the insurance company from a phone not located in your home, Caller ID records can be used to prove that you are able to travel.

• Think like an adversary. BE CYNICAL and on the defense.

Your neighbors may be interviewed, family members may be called with seemingly innocent questions.

Claimants must be mindful of their activities while in the claims process and while benefits are being paid.   

In summary, disability insurance companies will use investigation techniques that present no-win situations, so it is important to know what to expect.

Being prepared for the investigation that is likely to follow filing a claim for a potentially disabling but ‘invisible’ condition like Chronic Fatigue Syndrome (ME/CFS) or Fibromyalgia can be helpful.

And if your claim has been denied based on the information gathered through an investigation, do not accept that the denial without a fight.

- Justin Frankel and Jason Newfield, Attorneys at Law, May  2011

[For insights regarding an earlier stage in the claims process, see Frankel & Newfield’s recent article “Avoiding the Disability Claim ‘Brush-Off’ – What You Need to Know.”]
____

* To learn more,
Visit www.frankelnewfield.com
Frankel & Newfield
585 Stewart Avenue
Garden City, New York 11530
Tel: 516-222-1600
Fax: 516-222-0513
jcf@frankelnewfield.com
jan@frankelnewfield.com

Note: This article is published with the intent to provide general information and is not intended, nor should it be used, as a substitute for legal advice rendered by a professional in the context of a specific situation.



Please Discuss This Article:   Post a Comment 

watching?
Posted by: damaquilts2
May 4, 2011
Is this private companies or SS that they are talking about?
Reply Reply

 
"watching?" Posted by: damaquilts2 May 4, 2011 "Is this private ins companies?"
Posted by: benami
May 5, 2011
YES!! Only private disability insurance companies would have the financial resources to go all out and spy on you especially when they have big $$ claims at stake. Social Security Disability claims don't pay out that much!

 


disability surveillance
Posted by: uxordepp
May 4, 2011
My God! This is truly horrible. I am on disability in Canada and I am not aware of any such thing happening here, but given the type of condition I'm dealing with, if it were happening, I would end up having some sort of nervous breakdown.
Reply Reply

sounds like pvt disability
Posted by: victoria
May 4, 2011
sounds like pvt disability- I don't think SS has the $$ to do this. I strongly recommend videotaping all visits to "their" doctors (from start to finish) and holding any "routine" interviews with disability ins. co. reps who want to visit you at your home even if scheduled ahead of time with your lawyer present if possible - or at least have an advocate with you plus also videotape it. Let them all know ahead of time that you plan on videotaping everything that is done with them, whether with their doctors or their interviewers. It makes a HUGE difference. Also, don't let them get you to describe what your diagnoses are -- that is your doctors' area.
Reply Reply

Disability Claim? They Really Are Watching You...
Posted by: nl2
May 25, 2011
Yes! This has happened to me a couple years ago with Foundation Health Systems, Inc. now known as HEALTH NET Life Insurance Company in Hartford, CT. For years I was collecting disability income for CFS and Fibromyalgia from them. Then they (HEALTH NET) hired a private investigator and followed me for 3 days which only showed me out and about 1 day with little activity. They interrogated me for 4 - 5 hours (no attorney @ that time)with my mother here @ my house. I had no idea HEALTH NET would cancel my long-term disability benefits. That is when I hired an attorney in California because I couldn't locate a Colorado long-term disability attorney. We appealed their decision and my benefits were reinstated plus backpay. Then after sometime HEALTH NET cancelled my benefits again this time for the "24-month Limitation on "Mental Illness". I had many doctors and medical evidence to support my Chronic Fatigue Syndrome and Fibromyalgia disability claim and that it was "NOT" mental illness. My attorney in California told me I had to hire an attorney here in Colorado to file a lawsuit against HEALTH NET under ERISA to go to court. After all of this traumatic roller coaster ride and stress (physically, emotionally, financially, etc.) I didn't and couldn't pursue it any further!!! I could continue enduring the extreme physical and emotional exhaustion! Because it was going to escalade the extreme amount of stress in all aspects of my life (physically, emotionally, financially, etc.) and my miserable physical symptoms would only increase and also the extreme injustices were going to continue. I couldn't and didn't want to deal with one of my worst nightmares, HEALTH NET, any longer. I wasn't strong and well enough to endure additional extreme false accusations and abuse from Health Net even though it was my income. I hope "nobody" has to or ever endure these types of injustices! It is totally wrong any way you view it and should be against the law!!! "CHRONIC FATIGUE SYNDROME" and "FIBROMYALGIA" is extremely real! Research is continuing to prove the reality of these monsterous diseases. And it's about time disability companies learn the absolute truth!!!!!!
Reply Reply

It is worse than you know
Posted by: Gottabekiddin
Dec 2, 2014
In the US they intercept all your calls and know where you will be. They use the cameras on your tablets and mobile phones to listen in and film you; in the US it isn't specifically illegal. They can use pictures snapped from a video and practice 'selective sampling' and give it to your own doctor to turn him against you. The rules of evidence don't apply because it is all done with huffing and puffing long before the courts are involved. They know most can't afford a protracted legal battle so they play hardball right from the start. They have the money to break the keys on your wireless networks and grab your documents before you even turn them in. They track your mobile signal. This is so much worse than the surveillance described above. They even make my Sony PlayStation tell them how much it is used. I have samples posted in DropBox if anyone is interested. They don't assign individuals to follow you because they do handoffs between areas. Keeps their mileage down. My best friend died and two of them I had gotten to know sat in the front row starIng at me as I stood by my friends body.b I am fatal and don't really need to be treated this way after a long and successful career making over 6 figures. I have a reason to keep going now though. Until sealed into the mandatory concrete vault and penniless I will fight to change the laws that allow us to be harassed like common criminals. I confronted the guys hanging their camera in my back yard and they just lied for five solid minutes said they were Google and were running a line to my backyard only. Trust me. It is much worse than you can imagine.
Reply Reply


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