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peer reviewing physician

Important Shifts in Fibromyalgia Proof for LTD cases 2017

December 2, 2017 / By

Fibromyalgia Claims Fibromyalgia is a disease that does not offer any objective evidence or test results. It has been difficult to “prove” for long-term disability claims in the past. In 2017 there were two strong decisions which overturned long-term disability benefit denials. Disabled claimants were entitled to long-term disability benefits for fibromyalgia. The 2017 rulings represent important …

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Missing Pieces of the Administrative Record – Full & Fair Review under ERISA?

July 14, 2014 / By

ERISA “Full & Fair Review” & the Missing Pieces of the ADMINISTRATIVE RECORD One of the most important pieces in a long-term disability case is the “administrative record.” The administrative record is defined as: everything that the insurance company considered in the denial of your claim. It also includes any appeal that you might submit, …

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“Physician Peer Reviews” Lead to Wrongful Denial of Disability Insurance Claims

March 11, 2009 / By

“Physician Peer Reviews” Lead to Wrongful Denial of Disability Insurance Claims A Physician Peer Review is NOT the same as a second opinion or independent medical exam (IME). Essentially, a physician peer review is a tool used by the insurance company to review your Dr’s medical records. Physician Peer Reviews are problematic because the peer …

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