Disability policies generally require policy holders who apply for disability benefits to undergo an Independent Medical Evaluation or even a Functional Capacity Evaluation. If your policy allows for these and you’ve been requested to undergo such an examination, you have the duty to cooperate.
What Happens if you Refuse to Perform Tasks Requested or Don’t try Hard Enough During the FCE?
Your claim can potentially be denied for “lack of cooperation.” In the case of Ortega-Candelaria v. Johnson & Johnson, 2014 WL 2696725 (1st Cir. June 16, 2014), Mr. Ortega-Candelaria applied for disability benefits and was asked to undergo a Functional Capacity Evaluation.
He refused to do lifting, carrying, pushing, pulling and climbing during the FCE and didn’t give his best efforts on tasks. Johnson & Johnson’s Plan discontinued his benefits, based on a lack of cooperation. The trial court ruled against him finding that the Plan terms required him to cooperate. Without such cooperation, Johnson & Johnson could legally reduce or terminate his benefits.
What Should I do if I’m Scheduled for an IME or an FCE?
You should immediately contact Long Term Disability attorney Nancy Cavey, who can explain to you your rights and obligations under your disability policy, what steps can be taken to safeguard the legitimacy of the evaluation, and how to be properly prepared for an IME or an FCE.
Remember, the IME or FCE is scheduled but for one purpose. That’s to deny your benefits! You need to protect yourself before your claim is denied. Call today at 727-477-3263.