I sued Reliance Standard and my plan for disability benefits based on severe degenerative disease, fibromyalgia and disordered sleep. Reliance's defense after 10 years of paying benefits was that I suffered from OCD, and was not disabled and had not been for years. Not one of my doctors (in my administrative record of 1200+ pages) ever mentioned OCD. They also tried to use my husband's therapy as my own, and even dragged in my debt to the IRS as evidence of my poor character. RSL's file reviewer who diagnosed my mental illness was a gastroenterologist -- who, when deposed, admitted that "he finds some element of physical disability in about 10% of the files."

Yes, I suffer from depression and anxiety. Chronic pain and disordered sleep are common causes of a varied array of psychological disturbances. And -- Who wouldn't upon realizing that you cannot support your children, that you are suddenly isolated and feel alone, and cannot enjoy your career or hobbies. It's a severe gut kick! We lost our house, our vacation condo, our whole lives came apart in the first few years. Even after 17 years, I miss my job, my marriage and my friends. When my children were young, we went from a decent life with vacations to using food stamps, 2nd hand clothing, and a 17 year old car. I can't travel, play golf, garden, or even enjoy a movie in a theater and haven't for a long time. My wonderful children did not run far and fast as so many others have, and I am so proud of them.

As it turned out, about a year into the suit, I discovered I had a congenitally deformed hip and pelvis which was the cause of so much pain and physical side effects. As it was not in the official record, the judge refused our multiple attempts to supplement the record with this info. The laws should be viewed as guidelines and not written in concrete, especially when the goal is a complete and fair review of all pertinent info by a competent medical panel -- not one doctor who has no real training in understanding the paradigm of chronic pain, or a judge without any medical training at all. Fortunately, the judge decided that a claimant with a physical disability can also suffer from some mental issues without it shifting to a mental disorder. It's a good case for others with a blend of medical disabilities - just because you are crazy doesn't mean you're not also disabled. See Gemmel v Systemhouse Long-term Disability, MCI and Reliance Standard, CV04-00198-TUC-CKJ.

Thanks for commenting. Is there any means by which a file reviewer that is diagnosing without performing the exam themselves can be disallowed and/or even when his subject of review diagnosis is why out of keeping with his specialty? These are obviously more tactics of delay to win a battle of attrition and should not be entertained as having legitimacy. Not being part of the original record, no exceptions? or was this up to the discretion of the judge? Thanks again.

When a claimant is examined, or has their file reviewed, by someone who is not qualified to diagnose and treat the cause(s) of disability, it's up to the claimant to point this out. Each statement made by one of these pro-insurance clones should be carefully reviewed and disqualified by an expert witness, so the judge can easily follow the real medical issue, and why it keeps the claimant from working.

The claimant's documents should also show the history of the relationship between the reviewers and the insurer. Many reviewers make mil$lions from just one insurer in a few short years. Other doctors have views that are not in line with the rest of the medical establishment, and this should be detailed too. It's tedious and long, but necessary.

Unless you convince the judge that these medical issues are real, AND substantially interfere with employment, you are lost.