Short & Long Term Disability
Disability policies are purchased by individuals as an added layer of protection in the event of a non-work-related medical condition that prevents them from continuing to perform the essential duties of their job. TPN’s 30 years of experience, comprehensive services and extensive network of experts ensures that problem claims like pregnancy, stress, concentration issues, fatigue and other medical symptoms are properly evaluated before indemnity costs escalate further, helping clients resolve claims quickly and equitably.
TPN bridges the knowledge gap between medical, legal and claim coverages, leading to sound medical opinions with respect to function and its role in the analysis of a disability, as well as identifying how specific medical conditions impact specific physical activities and the impact these have on the claim.
- Short-Term Disability
- Transition Short-Term to Long-Term
- Long-Term Disability
- Medical (physical) claims
- Mental and nervous disorder claims
- Co-morbid physical combined with mental and nervous claims
- Claim audit, including our document discovery and analysis
- Review or exam by appropriate medical and investigative professionals from TPN’s extensive network of experts (if necessary) with an evidence-based medical report provided
The medical reports provided can be substantiated by our experts to help clients successfully negotiate resolution with the claimant or their attorney and avoiding costly trials
An insurance carrier received a long-term disability claim that reported the claimant could not continue to work because of fatigue symptoms. The patient had been sent to the insurer’s IME, and they found no objective evidence of a cause for fatigue and opined that he should return to work. However, the IME’s multiple treating physicians all agreed with the patient’s reports of inability to work due to fatigue. The client felt strongly that the patient was able to work, however, the multiple IME reports did not support the insurer’s opinion, preventing closure of the claim.
TPN performed a claim audit including an in-depth document analysis and found that the treating doctors did not have a good understanding of the claimant’s essential job duties. Despite the medical reports indicating their collective opinions that the claimant could not work because of fatigue, TPN’s review of the essential job duties substantiated that the claimant’s work would not be impacted by fatigue. To further substantiate our client’s position, TPN had the claim reviewed by one of its highly experienced medical experts that had disability claim knowledge.
Upon review of all the claim documentation, TPN’s medical expert contacted all five treating physicians to discuss the patient’s issue, his work capabilities and necessary work restrictions. All five physicians agreed with our medical expert that the patient was fully capable of full-time sedentary work and each signed a letter from TPN’s medical expert stating so, which were included in the final medical report delivered to the client. The insurer was able to end disability payments using TPN’s evidence-based medical report, since the claimant was able to return to work full-time.
If you have complex disability claims that continue to escalate in costs and time to resolution, get a FREE consultation from TPN with recommendations on services to resolve the claim.