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F that claims manager. I haven’t appealed before but you should. Their no isn’t final, always escalate.
You should be proud of yourself for taking time to care about your mental life. There are many jobs but only 1 you.
I bet Deloitte HR has the number for senior management at claims and would be happy to help you out
Your doctor has to sign a document explaining that you are incapable of working and the reasoning behind it. It sounds like you don't have the correct documentation in place.
Rising Star
This. Disability insurance needs note from your doctor.
Unfortunately, insurance needs notes from the doctors rather than from patient. I felt i needed another xray to confirm i didn’t have any hairline fracture in my ankle, but insurance said nothing in doctor’s notes suggested that i needed another Xray.
I am in the middle of an appeal as well. Some policies, you need to prove you can't work at all; others, you just need to prove you can't do your CURRENT ROLE. Look into that, because consulting is particularly demanding, so you can also make a case that you can't do YOUR job. Also, consider seeing a psychiatrist for a formal evaluation. Having a specialist helps your case. Also, ( and I mean this with care) if your depression/anxiety is so bad you can't work, you should probably be seeing a psychiatrist and not just getting care from your PCP. That was probably a red flag to their medical consultant.
Thank you, I hear you. I’ve known my pcp for several many years and trust her care. But I am now also seeing a psychiatrist for another opinion.
Since this is anonymous, would you mind sharing what you were prescribed recently and before and what are the doses? I may be able to elaborate on what you need given my past experiences. Also, frequent visits will matter - the expectation is that when you have depression and anxiety, you should use some sort of therapy, not just wait for meds to kick in. Also, you said you were on meds for a while. Did they change it by completely dropping to zero the previous one? Sorry to hear about your struggle
Thank you. I’m seeing my doctor every month. The change is medication and dosage was done appropriately under the doctors care. And no I didn’t drop to zero. I am also in therapy now but when I filed the claim, I was still looking for a therapist. My previous therapist had to drop me because she couldn’t accommodate my desired time slots.
As well as the 5 week gap between the latest pcp visit and the date leave was started. During these 5 weeks I had started medication and was waiting for it to hopefully work. Since it didn’t work I went on leave. Any thoughts on how to reverse denial would be greatly appreciated.
Wish I had more tangible advice based on actual experience… but keep in mind the claims manager has a vested interest in denying claims. Our so called healthcare system frequently requires people to relentlessly advocate for themselves when they are already sick or injured or struggling. Remember to be proud of yourself for taking the time you need, keep believing in yourself and advocating for yourself
since the claim was classified as mental health which insurance companies scrutinize, what you say has to be medically backed e.g you tell the agent you have panic attacks before/after client meetings, your doctor must document your panic attacks and emotional outbursts prevent you from participating in client-facing meetings or collaborative tasks under standard workplace pressure.
while it’s great you have your pcp supporting, the psychiatrist and/or therapist will be better to document your functional limitations to show you’re doing all you can to return to work. make sure it’s noted as a work-related capacity issue, having insomnia, panic attacks and emotional outbursts, etc it’s based on medical inability to perform, not a lack of desire to be in that specific environment. there should be no mention that you hate the job, colleagues or poor performance-related feedback.