Field Form Mistakes, P3 - The Mistakes Made during a Field Interview That Can Ruin Your Long-Term Disability Claim

Welcome to Season 4, Episode 20 of Winning Isn't Easy. In this episode, we'll dive into the complicated topic of "Field Form Mistakes, P3." 

Host Nancy L. Cavey, a seasoned attorney with extensive experience in disability claims, discusses the mistakes made during a field interview that can ruin your Long-Term Disability claim. Field interviews - where the disability carrier may send a representative in person to "interview" you about your disability claim - are common tactics used by disability carriers to ensnare or trap you. They are designed to be overwhelming, so policyholders make mistakes during the conversation that can be used to justify denying a claim. Today, host Nancy L. Cavey, will discuss more of the twenty-four common questions found in field interviews.

In this episode, we'll cover the following topics:

1 - Why Does the Disability Carrier Want My Statement? I Am Disabled, and My Doctors Say So

2 - Mistakes No. 13 - 15

3 - Mistakes No. 16 - 18

Whether you're a claimant, or simply seeking valuable insights into the disability claims landscape, this episode provides essential guidance to help you succeed in your journey. Don't miss it.


Resources Mentioned In This Episode:

LINK TO ROBBED OF YOUR PEACE OF MIND: https://caveylaw.com/get-free-reports/get-disability-book/

LINK TO THE DISABILITY INSURANCE CLAIM SURVIVAL GUIDE FOR PROFESSIONALS: https://caveylaw.com/get-free-reports/disability-insurance-claim-survival-guide-professionals/

FREE CONSULT LINK: https://caveylaw.com/contact-us/


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Need help with your Long-Term Disability or ERISA claim? Have questions? Please feel welcome to reach out to use for a FREE consultation. Just mention you listened to our podcast.

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Please remember that the content shared is for informational purposes only, and should not replace personalized legal advice or guidance from qualified professionals.

Transcript

Speaker A [00:00:11]:
 Hey, I'm Nancy Cavey, national risk of disability attorney. Welcome to winning isn't easy. Before we get started, I've got to give you a legal disclaimer. This podcast is not legal advice. The Florida Bar association says I have to say it, so now I've said it. But look, nothing prevents me from giving you an easy to understand overview of the disability insurance world, the games that carriers will play, and what you need to know to get the disability benefits you deserve. So let's get going. Look, disability insurance companies are not in the business of paying disability claims.
 
 Speaker A [00:00:47]:
 It doesn't help their bottom line. One of the most common tools that disability insurance carriers will use at all stages of a claim is what's called a field interview. Now, in my last episode, I talked about mistake number seven, restrictions and limitations, sitting mistake number eight, restrictions and limitations, standing mistake number nine, restrictions and limitations, walking mistake number ten, restrictions and limitations, lifting, carrying, bending, and twisting, mistake number eleven, restrictions and limitations, squatting and kneeling, and mistake number twelve, restrictions and limitations, use of your hands. Now, you would think that that should be the end of this whole series on mistakes that you can make in field interviews, but I'm sorry to say that there are even more mistakes that you can make. And in this episode, I'm going to cover the six types of questions that are commonly asked in a field interview. Now remember, a field interview is a tool that disability insurance carriers use when, in my opinion, they're trying to set you up for a claims denial. You need protection from yourself and from the carrier. So this is why I think this series of podcasts are important.
 
 Speaker A [00:02:04]:
 Now, before we get started, let's take a quick break because we've got a lot to cover. Stay tuned.
 
 Speaker B [00:02:12]:
 Have you been robbed of your peace of mind from your disability insurance carrier? You owe it to yourself to get a copy of robbed of your peace of mind, which provides you with everything you need to know about the long term disability claim process. Request your free copy of the Book@kvlaw.com today.
 
 Speaker A [00:02:33]:
 Welcome back to winning isn't easy. You're ready to go. So why does the disability carrier want your statement? I'm disabled. My doctor says I'm disabled. So what's this all about? Now, I've spent two whole episodes, with two more on the way talking about the field visit because I see so many claims denials based on the field statement. Now, many policyholders think that if they just talk with the insurance company representative or meet with them, that everything is going to be fine. I'm sorry to disappoint you, but your claim is in trouble if the long term disability carrier or the ERISA carrier calls you and asks to take your statement or they want to arrange a field visit. Now what's the purpose of the field visit? I think there are three purposes.
 
 Speaker A [00:03:27]:
 First, they want to prove that there's no objective evidence of your disability because your actions contradict what you say you can do or what you're telling your doctor. Number two, they want to attack your doctor's reliance on your statements because if the doctor is relying on your statement about your restrictions and limitations or your functionality, and that's incorrect information, then the whole basis of the doctor's statement that you're disabled fails. And of course then they want to argue that there's no evidence of a causal relationship between your disability and or your inability to engage in your own occupation or any other occupation. They don't like the restrictions and limitations that your doctor's assigned and they want to punch holes in those restrictions and limitations. Now I want you to remember that you have to prove at your own occupation stage that you can't do the material and substantial duties of your own occupation as defined by the very terms of your policy. Not your job, but your occupation. Now at the any occupation stage, you have to prove that you can't do the material and substantial duties of any occupation by virtue of your training, experience, education and the skills that you have learned. Different standards of disability and different games just depending on where you're at in your disability insurance claim.
 
 Speaker A [00:04:50]:
 Now unfortunately, by the time that the long term disability carrier or the ERISA carrier has asked to take your statement or have a field visit with you, they have probably done surveillance on you and they've had your doctor's records reviewed by their medical experts. The carrier, the adjuster who's handling your cases, come up with a laundry list of questions that they want to ask you that are going to help them justify a claims denial or termination. Once they've taken your statement, the carrier is then going to take that information to your treating physician and say, aha, you relied on statements made by your patient about their activity level or doctor. We've got some surveillance that we really want you to look at and we want you to sign off on a letter that says you're capable of doing your own occupation or if you're at the any occupation stage, at least sedentary work. And the whole purpose of this field statement is to spring a trap on you, to portray you as a liar, a malingerer or a fraud. And they want to use that to deny or terminate your benefits. I'm going to give you some time to digest what I just said because we're going to come back and talk about the next six mistakes. So let's get our head wrapped around the purpose of a field statement or an interview.
 
 Speaker A [00:06:31]:
 Welcome back. Welcome back to. Winning isn't easy. All right, let's talk about mistake number 13, restrictions and limitations, pushing and pooling. Now, I really think that this is a bit of a dumb question, and when I get that in the course of a field statement, I'm thinking they must have surveillance on my client. You're going to be asked questions on the activity of the other living form about your ability to push and pull, and you might be asked to give examples. And you may be asked if pushing and pulling increases your pain level and how it increases your pain level. Now if you say that you don't push or pull and the carrier's got pictures of you in the grocery store pushing a grocery cart without difficulty or pushing a lawnmower, then that's a problem.
 
 Speaker A [00:07:24]:
 They may have pictures of you pushing a broom while sweeping off your driveway, and you can bethe that that's going to be used against you. And I know that sounds, you know, innocuous and minor, but that's the way they start attacking and tripping at your credibility. Now, if your statement is taken, you want to be able to explain that you have good days and bad days and that you attempt to work within or do activity within the restrictions and limitations assigned by your doctor, but that there are days that you can do more and days that you can do less. That's sort of a way to get around some of these broad questions about things like pushing and pulling and bending and stooping. How about mistake number 14, concentration. Now, I know that it's a pain to fill out these activity of daily living forms, and they seem to come on a weekly basis. But one of the trap questions are problems with concentration. So the issue is, do you have problems with concentration because of your pain, because of the nature of your medical condition or the side effects of medication? And are you claiming that you are disabled because of these problems? Many jobs or occupations require a high level of concentration.
 
 Speaker A [00:08:41]:
 And you may not be able to do your activities, particularly those requiring mental activities, repetitive activities or cognitive things. Things if you're having problems with concentration. But the question becomes how do you determine or how do you prove that you're having problems with concentration? So you're going to be asked questions like, do you concentrate well, whether you can focus, whether you're having problems with your short or long term memory, how often you experience these concentration or focus problems. I tell you, I hate these questions because they're all open ended questions. Now, I think that when you're filling out the activity of daily living form, you should be thinking about what you've told the doctor about the problems you have with concentration because of pain or side effects of medication. Because if it's not documented in your medical records and you're talking about these problems in your field statement, the carrier is going to be scratching their head saying, look, somebody's lying, and it's got to be the policyholder. It would be helpful if you give doctors specific examples and make sure that those medical records are consistent with what you're putting down on your activity of daily living form. So again, that's another reason why I think it's important that you have your medical records while you're completing these activity of daily living forms.
 
 Speaker A [00:10:01]:
 Now, if you're having problems concentrating, I suggest that you have somebody help you fill out the information and have it noted on the activity of daily living form, because the carrier is going to scratch their head and say, well, she's having problems with concentration, but she was able to fill out these forms and answer these questions. That really doesn't seem. That seems contradictory to me. Now, in some instances, it may be necessary for you to have psychological or neuropsychological testing to document the problems you're having with concentration. And if that happens, it's really time for you to consult with an experienced or risked disability attorney, because there are some neuropsychologists who are not in the business of helping people like you, and that the selection of the right neuropsychologist to do the testing is important because we just don't want testing done. We want testing that addresses the issues that you say you have. And more importantly, we want the testing to address the issues that you would have doing your occupational duties. So, for example, if you're having problems with executive functioning, gathering information, analyzing it, then spitting it back out, we want the neuropsychologist to do specialized testing on that executive functioning so that we can correlate your complaints with the results of the neuropsychological testing.
 
 Speaker A [00:11:25]:
 Now, again, that will play also ultimately into the question of the vocational evidence, because we want to be able to establish, excuse me, that there's a causal relationship between your concentration problems and your inability to do the maternal and substantial duties of your occupation or any other occupation involving concentration. So we want our vocational counselor to be weighing in on how your concentration or cognitive issues impact your ability to do your own occupation or any occupation. So these kinds of issues are really important if we're dealing with cognitive or concentration issues. We just don't want to gloss over these answers and say, I have short term memory problems. You know, I lose my keys, you know, I leave my truck running, things like that. We've got to prove it. And it all has to be consistent with your medical records. All right, mistake number 15, restrictions and limitations.
 
 Speaker A [00:12:28]:
 Shopping. Now I hope you're not the kind of person that shops till you drop, because that, again, can be a problem with inconsistency. The activity of daily living form is going to ask questions like, are you able to go shopping, a grocery store, a mall, a big box type of store such as Walmart? How long do you shop at one time? Do you take breaks? How long are your breaks? Do you visit more than one store in a single shopping trip? Do you have to break up your shopping trip into multiple short errands? Now, look, there's no absolute answers here. You probably have good days and bad days. And what you can do depends on your pain level, the side effects of medication, or what you did the day before. And again, these are open ended questions. Now, you might go shopping, but you might hang onto the shopping cart, or you actually may use an electric card in the grocery store. You may have to stop and sit down.
 
 Speaker A [00:13:21]:
 You may have to break up your trip. You may have to just run in and do something on your grocery list, like running in and getting milk, but ignore everything else on your list. On a good day, you may be able to visit more than one store, but then you pay for it with increased pain the next day. Look, we all have to shop, but because you shop doesn't mean you're disabled. The problem that we have is if you're not telling the truth about what you're doing and they've got surveillance on you, that can be a problem. If you say, look, I can only go to one shop a day, and they've got you running from Publix to Walgreens to Home Depot to your child's school all in one day. That is not really consistent with what you've put on your activity of daily living forms. It may not even be consistent with what you've told your doctor.
 
 Speaker A [00:14:08]:
 You know that carriers are going to twist what you say about your activities of daily living. To inflate, conflate that to an ability to work at your own occupation, or at least a sedentary occupation when you're in the any occupation stage. So I don't want you to make a fatal mistake with these activity of daily living forms. Again, that's why I think we need to be consistent with what's in your medical records. And certainly if you're being scheduled for a statement that tells you that there's a problem with your case. Let's take a break. Wow. We're covering a lot of information.
 
 Speaker A [00:15:08]:
 We've got more to cover, though. So welcome back to winning isn't easy. Mistake number 16, restrictions and limitations driving. Now, there are going to be a lot of questions about driving on that activity of daily living form. How long can you drive? Why do you have to stop? Is it because of fatigue, medication, concentration? How long can you ride in the car as a passenger? Can you do short distances? Can you run errands? Can you go to your doctor's appointments? Do you pump your own gas? Do you rely on others to drive you around? Now, they're also going to ask you questions about, do you own a car? How often do you drive it? Do you have problems getting in and out of the car? Do you have problems putting things in your trunk? Again, all of these are open ended questions designed to trap you. Now, you have to be truthful and not exaggerate your difficulties. But again, we want to talk about good days, bad days, your ability to drive as it's impacted by your pain, your fatigue and your medication. You might want to explain that you pace yourself.
 
 Speaker A [00:16:12]:
 You might break up your errands over the course of several days, if in fact, that's true. Now, you may also say, look, I don't take my medication as scheduled to allow myself to run these errands. So you want to use ranges and not absolutes. I assure you that if they've got surveillance on you, they're going to be tailing you to wherever you're driving to. And that includes your doctor's offices. That includes going to the grocery store, pumping gas. And once again, they are going to try to conflate all that activity with an activity level such that you could work. And of course, they're going to attack your doctor's opinions regarding your restrictions and limitations if you are doing more than either in the 20 year activity of daily living form or what you're telling the doctor.
 
 Speaker A [00:17:01]:
 Mistake number 17, computer skills. So what on earth does computer skills have to do with the activity of daily living form? Well, two things. The first involves the use of your time. Can you sit at a computer for how long? Is this consistent with what you put on the form about your ability to sit or your need to change positions? Or is it consistent with what you put on the form about problems concentrating? Now, of course, they may even ask you, are you doing medical research about your condition online? And if you are, that's great, but that's not something I would suggest that you disclose because then it looks like you're trying to become an expert on your medical condition and how to fool the insurance company and the doctor. I know that sounds crazy, but I've seen disability carriers draw that kind of conclusion based on a person's research about their medical condition. Now remember, they are going to be trolling the Internet looking at social websites to see what you're posting, how often you post, and what it is you're doing. And I've told you before that you need to shut down all of your accounts and don't post anything and ask your relatives and friends not to post anything about you. Now, of course, the fact that you might be on the computer on social websites can be inconsistent with your activity level, but it also can be inconsistent with the time that you say that you're spending on the computer and they check.
 
 Speaker A [00:18:36]:
 Now, the second reason you're being asked questions about your computer skills is to determine whether or not you have what's called transferable skills. In other words, if you have a level of computer skills such as word processing or using email, then they're going to, at the any occupation stage, ask their vocational evaluator whether or not those computer skills would transfer to other occupations that you could do in view of your education and your prior work experience and your restrictions and limitations. Now the other issue with computer skill issues or the use of the computer is it can be inconsistent with what you said you could do in terms of your ability to sit and stand, reach, bend, alternate positions, the use of your hands or the posturing of your neck and concentration. So again, be careful with these open ended questions, restrictions and limitations hygiene number 18 now, does the carrier really care how many times you take a shower? How often you wash your hair, or how often you change your clothes? The answer, of course, is no, they don't really care. But again, what they're doing is looking for inconsistencies between what you report on the ADL forms and what you've told the doctor. So you're going to get questions like, do you need help dressing? How often? How long does it take you to get dressed? Do you need help showering how long does it take you to take a shower? Do you shower every day? Who helps you? What time do you get up? What time do you take a shower? Are there any accommodations that are being made to assist you with your hygiene in terms of the bathroom, the shower, or even getting dressed? Now, if your disability does not impact your hygiene, simply say so. But if you have difficulty bending, stooping, twisting, then questions about your hygiene might be relevant. So let's say you need help putting on your socks or shoes if you've got a back injury, or you may have trouble getting in and out of a shower because of a back injury or a stroke.
 
 Speaker A [00:20:45]:
 Don't be afraid to document in detail the problems you're having with dressing, showering, sleeping, or accommodations. Cause nobody should be coming into your home, much less your bathroom, to check it out. But I would also suggest that you tell the doctor all of the accommodations that are being made with bathing and dressing. That way there aren't gonna be any inconsistencies between what you put on the activity of daily living form and what you're telling your doctor. So, again, before you are completing the activity of daily living forms, get your records. Look at your medical records. Make sure that they're consistent. If they're not, you need to make sure that you're giving the doctor the information so that your activity of daily living form is consistent with what you're reporting to your physician.
 
 Speaker A [00:21:30]:
 And if you feel it's appropriate, give your doctor the completed ADL form. Now, I tell you, if I'm representing you, you're not going to be doing any of this until I review the ADL forms. I'm reviewing your medical records because I want to make sure that there is some consistency. And of course, I'll be dealing with your doctor and with the insurance company. All right, we have covered a lot of stuff, but you can see how important these activity of daily living forms can be and how they can be a trap that can result in a a denial or termination of your benefits. So in the next episode, I'm going to talk about mistakes 19 through 24. If you like this podcast, consider liking our page, leaving a review, or sharing it with your friends and family. Remember, this podcast comes out weekly, so stay tuned next week for another insightful episode of Winning isn't easy.