The claims process may be very stressful and confusing for some people, especially when health or well-being is already compromised. One way to help clarify what is required of you in the claims process, is to call your insurance company case manager or claims examiner and ask them to help you understand. If you are not well enough to engage in this type of conversation, provide the insurance company consent to communicate with a trusted friend or family member who can make calls for you. This and help you review any written communications from the insurer.
Don’t ignore the insurers’ requests for information as this can lead to the claim being delayed or denied due to a lack of information. While the information collected for your claim can seem very personal, it is standard procedure to gather enough details about your condition to validate the payment of the claim. But you have a right to know why it is being collected and how it is being used.
Find out which benefits you have access to including disability, health, drug and employee assistance program benefits as well as any benefits through workers compensation or government sponsored plans such as Employment Insurance or Social Assistance. If you need help understanding or accessing these benefits managers, union reps, occupational health professionals, human resources, benefit provider, or counsellors available through an employee assistance plan may be able to help you.
Once you are ready to return to work, your employer has a legal duty to accommodate if you have a disability, including a mental disability such as depression. This means they need to explore how your work could be modified so that you can successfully do your job. They will need to talk with you about this and will also rely on the information provided to them by your insurance company and/or doctor. Information on creating a return to work plan as well as other resources to help you transition back into the workplace, are available at no charge at Supporting return to work success.
If you are returning to work from a leave of absence, you may be concerned about the confidentiality of your medical information. Many employees wonder what information might be shared with their employer during return to work planning. Knowing more about the process can help alleviate some concerns.
Legislation is in effect that prohibits an insurance company from sharing medical information with an employer without your consent. If there is no consent, what is shared, for the purpose of return to work planning, is an individual’s limitations and restrictions – not their diagnosis and not the kind of treatment they’re receiving. This legislation protects employee privacy and can help guard against potential discrimination related to a medical condition.
At a time when you are not well, the claims process may seem daunting and yet it can allow you the time and financial support necessary to access the help you need for recovery. Get the support you need to complete the claims process successfully so that you can focus on getting well.