Social Security Questions? Ask a Social Security Expert
Thank you for your question. Please permit me to assist you with your concerns.
Let m discuss the medical review first.
An insurer is permitted to have their own doctor review the party who is making a claim for disability.
However, your husband has the right to obtain his own medical evaluation and seek a second opinion if the disagnosis provided is not as he expected or as he claimed.
The medical review, if it was sub-par and potentially dirty and dangerous should be reported to the insurer.
If they refuse to do anything about it, it may even require a report to the state medical board since doctors are required to prove clean and adequate care and review, not 'shady' service as you described it.
Does that make sense so far?
So...although my husband has had his own medical surgeon for the last 6 years, along with an several independant doctors reviewing his file for SS & a final review from one for SS along - information with Hartford all received, they can do this review but as you said, he can get the file & request a second opinion?
We will report the doctor to the insured as they used a safety pin out of their pocket to do the sensitivity test - no sterilization, made him lay on the office table with no covers/protection & when asked him to undress for the exam, left the door open for outside traffic to see....just did not seem like a reputable doctor at all for someone like The Hartford
the reason is because it is ultimately their money that is going to cover his expenses, and they can demand reasonable oversight.
There is always a risk, from their perspective, that the doctor your husband found is too 'favorable' which may create additional expenses to them. Of course the flip side is that their doctor may be too 'favorable' to the company he gets compensated form.
That is why I suggested you report the doctor to them--as you said, the insurer here is fairly reputable and they may want to know whom they have on their payroll.
If I may ask, how old are the children in this instance? I am asking to figure out if they would be considered dependents or not, as that would tell me if the insurer can remove the funds from them, or if those funds are off limits. Please advise!
Okay - we will definitely report it - very unfortunate & scares us as to what kind of decision he is going to make based on the lack of knowledge of my husband's history
We have a 5 year old and 2 year old....
I definitely suggest reporting. It would only harm the insurer's reputation in this instance.
Please allow me just a few moments to research the children issue, I do believe they can get the payments back but I want to confirm.
Sorry for the delay, the insurer is able to take back benefits to cover their deficiency in this instance, even if those benefits were first sent to the children.
I apologize for the delay, I was hoping to find any language denying them that right, but it appears that in this instance the payments received are treated as one account.
Is there anything else I can check or clarify for you at this time?
That is what I was afraid of - thank you for your answer/time - I appreciate it.