09Nov2011
Derek Pulchinski
Author
Derek Pulchinski
Category
Disability Claims

Michael J. Fox an Inspiration

Just listened to Michael J. Fox this morning at the OHA Health Achieve Conference in Toronto.  His words were inspirational and very informative.  With a family member recently being diagnosed with Parkinsons' Disease, his presentation was well documented by the press as noted: THE CANADIAN PRESS TORONTO - Although Michael J. Fox turned 50 this year, the boyish actor who charmed audiences in "Family Ties" and "Back to the Future" says his battle to find a cure for Parkinson's disease keeps him young and too busy to feel ill. The Emmy Award-winning star told roughly 2,000 people gathered at a North American health conference Tuesday that his condition appears to have plateaued and that once-severe episodes of Dyskinesia — a movement disorder that causes him involuntary tremors

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21Oct2011
Derek Pulchinski
Author
Derek Pulchinski
Category
Disability Claims

Soft Skills of a Good Claim Manager

SOFT SKILLS ARE WHAT MAKES A FIRST-RATE DISABILITY CASE MANAGER. “I am very happy with the way my claim has been handled!” As an outside consultant who gets it straight from the claimant’s mouth, I often hear many comments like this about the people who are making the decisions on their claims. One interesting aspect of my job as a Field Representative is that I deal with many different adjudicators from various companies. Not only do I get some perspective on the adjudicators’ habits and abilities myself, I also quite frequently get unsolicited comments and feedback from the claimants. These comments are mostly positive ones. Negative comments (which I really don’t want to dwell upon) are usually as a result of poor contact and communication with the claimant. I

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20Oct2011
Elaine Hobbs
Author
Elaine Hobbs
Category
Disability Claims, Medical

Ask a Claims Expert – Rehabilitation Programs

Q) As a recent newcomer to the adjudication world, I would appreciate if you could share any advice you may have with respect to when you should request and/or initiate a Rehabilitation program. Answer from ELAINE HOBBS, CCRC, President of Hobbsability: Qualified vocational rehabilitation counsellors use established protocols and procedures to help their clients return-to-work. We always start with attempting to return clients to work with their pre-disability employers. If this is not an option, the counsellor then looks at helping clients return-to-work with new employers: working closely with the clients to help them see the skills and interests they have to offer new employers, combined with adjustment and vocational counselling. Most insurance clients are able to

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18Oct2011
Lynn Wilson
Author
Lynn Wilson
Category
Medical

Managing Psychiatric Disabilities

The week of September 30th was Focus on Mental Health Awareness Week and there was much discussion about both mental illness and mental wellness in the newspapers, internet and television. On September 21, 2010 Bell launched an unprecedented campaign called "Let's Talk" committing $50 million to help enhance awareness and understanding about mental illness and to help support community organizations across Canada. What Bell started is a positive step in the right direction. You can see what Bell`s doing by visiting their website http://letstalk.bell.ca/initiatives-anti-stigma/ Following Bell’s “Let’s Talk” initiative, we have dedicated part of our site to Mental Health where we will be sharing links to articles and information on mental illness and wellness. I

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18Oct2011
Author
Rudy Wietfeldt
Category
Medical

Ask a Medical Expert – Cognitive Behavioral Therapy (CBT)

Q) It seems like every claimant with Depression or Anxiety receives a standard approach to treatment: some combination of medications and psychotherapy, typically CBT. What is CBT? Are there different types of CBT? Are there times when one wouldn't use CBT? Answer from RUDY WIETFELDT of HappySolutions.net: This is a great question! There is no doubt that the current gold standard for either the treatment of major depressive disorder or an anxiety disorder is some combination of medication and psychotherapy. Research trial after research trial has shown that depression, for instance, is best treated when medications and psychotherapy are used concomitantly. Interestingly, brain imaging studies have shown that while medications work from the base of the brain upwards, psychotherapy

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18Oct2011
Author
Helen Sava
Category
Legal
Ask a Legal Expert – PIPEDA Thumbnail

Ask a Legal Expert – PIPEDA

One of the key tools to objectively assess claimants in the life and health industry is through the means of covert surveillance. Surveillance is a tool used both in the adjudication of the claim and after litigation in the defence strategy. Prior to PIPEDA coming into force I would go out on a limb and say surveillance was probably more widely and regularly used by insurers. With PIPEDA came a greater scrutiny of insurer’s internal adjudication practices and the start of a number of challenges faced by private investigators with the Privacy Commissioner. At the insurer level, more emphasis was placed on ensuring the file had conflicting medical evidence or some foundation to merit the level of intrusion into a person’s private affairs. Between 2004 and 2009, the Commissioner’s

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18Oct2011
Charles Deragon
Author
Charles Deragon
Category
Disability Claims

Do’s and Dont’s of Disability Case Management

Effective and proactive claims management is a critical aspect of an insurer's overall success. Here are some common mistakes to avoid and tips to stay ahead of the game.  1. Know you file! This might seem obvious to the reader but knowing your file’s information inside out is the key to proactive case management. In my years as a disability claims reviewer, I’ve come across numerous files where it was apparent the adjudicator either did not have the “big picture” or overlooked important medical and non-medical information that would lead to what became missed investigations. One tip, especially for complex claims or files with lots of information is to draw a “timeline” and chronologically document the milestone events of the claim such as: Date of first symptoms, last day

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