While You’re On LTD–Who’s Who?

When you’re on LTD, you will deal with a variety of people who work in different positions at (or are hired by) the insurance company. We’ve talked about the importance of documenting all your communications with the insurer, but it can be overwhelming keeping track of all the various people and positions who you may have contact with. It’s helpful to know who’s who.

Here’s a primer on some of the key people involved in an LTD claim.

Case Manager (also known as a Claims Specialist or Claims Manager)

This is your key contact at the insurer company. Their job is to keep tabs on you and whether you still meet the eligibility criteria for LTD benefits. They talk to you and to your doctors and are the central point within the insurer for everything related to your claim.

Sometimes your claim will be assigned different types of case managers, depending on what stage of the claim you’re at. For instance, when it’s time to think about returning to work, you may be assigned a rehabilitation case manager.

Treating Doctor(s) (also known as the Attending Physician)

These are the doctor(s) you are already seeing. They could be your family doctor (GP), specialists you’ve been referred to, or that you are seeing as part of your treatment.

IME (Independent Medical Examiner)

This is a doctor that the insurance company has hired to get an additional opinion on your condition. The IME does not treat you, but can examine you, review your health records, and give the insurer their opinion on whether you’re disabled. Although the IME is working for the insurer, they are supposed to be unbiased and neutral.

Consulting Physician

A doctor employed by or paid by the insurer to help the insurer understand your medical situation. This physician will not examine you directly, but has access to the medical information you’ve provided the insurer, and can also contact your treating doctor directly.

Vocational Rehabilitation Consultant (also known as Rehabilitation Consultant, Specialist, or Professional)

This person’s job is focused on your eventual return to work. The rehab consultant is hired by the insurer to develop a plan for your safe and successful return to work. That includes planning for accommodations and managing the psychological aspects of your return to work. This person will have training in a related field (such as occupational therapy). Because your job duties and physical working conditions may need to change, they also educate and work with your employer. If you can’t return to your old job or workplace, the consultant might identify retraining opportunities.

If you’re unsure about the person you’re being asked to speak to or work with, always ask for their name and position, and for an explanation of their role–and write those things down in your ongoing notes.