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Originally Posted by larbec7
They are asking me to do a FCE. I am not sure why.
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The insurance carrier is asking you to get a functional capacity exam in order to provide them with an update. You've been on disability for a while, and they want to see if you've improved, and where you stand overall.
I wouldn't get too worked up over it. As much as we don't want to provide these updates periodically, it's a prudent request by the carrier. We really can't expect a company to pay claims out for years and years, without any type of periodic update(s). I don't mean to be crass, but in some cases where a person has been on disability for a long time, they may want to make sure the person is still alive and that someone else isn't cashing their checks. Believe it or not, these type of things do happen.
The primary reason is that they want to ensure that you haven't improved, or if there have been any positive changes overall. An exam 18-24 months into disability is fairly normal. I'm sure if you just go to the exam and be honest, all will work out.
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Someone told me that the disability company can make me have surgery and or make my doctor reduce my medication and force me to go back into the work force...is this true?
I am in constant pain and take 4 soma 350, 4 4mg zanaflex, 3 darvacets and 8 oxycotin a day for my spasms and pain.
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No, this is not accurate. An insurance company cannot require you to have surgery or change your medication. They can suggest it, or put pressure on you / your Doc, but your medical Doc's judgment comes first. The foremost oath in medicine is "do no harm." As long as you have a qualified Doc in your corner, that's what matters. An insurance carrier Doc can disagree all he wants, but the bottom line is you're not his patient and he's being paid by the carrier to render an opinion. Additionally, Docs don't like to disagree with other Docs...It creates possible issues for them in a number of ways. Thus, the firmer your Doc is, the better your case will go. Conversely, carrier Docs have more power in cases where the applicant's Docs isn't that committed, or doesn't want to render an opinion and just sends in appointment notes & etc.
Additionally, you're on some major meds....Especially the Oxycontin. It in itself suggests you have major issues. Most companies would never permit someone to work at their company with the meds you're taking, especially the amts. Until you were able to find some alternative treatment that provided excellent relief and you could then cut way back on narcotics, you could never go back to work....Unless of course you ran your own business. No offense, but no business in their right mind would let an employee work on their property taking 8 OCs per day.
I wouldn't worry about any of this unless you've done something you shouldn't be doing....Like heavy labor & etc. where you've been caught or observed doing it. In those rare cases, things can get a bit touchy, for the obvious reasons. However, it sounds to me that the carrier just wants an update to see where you are physically. It's probably nothing more than a routine, random audit, and your case number came up. Your reaction is normal, but please know that it's just the company being prudent with how it's spending it's money. You haven't provided details about your age, claim amt & etc. but it's possible that you're a large claim.....The larger the claim, the more attention your case gets.
Take care, and best of luck.
Regards,
Ex
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