Oct 28 2011

SURVEILLANCE AND THE FUNCTIONAL CAPACITY EVALUATION

This has been on my mind for some time and I have been trying to let my clients and perspective clients know about this so they can respond appropriately.  Many insurance companies use vendors to conduct video surveillance while the disability claimant is at their home.  There is simply no way to tell which files will be selected for video surveillance.  The choice to perform video surveillance is usually placed within the discretion of the claim manager or claim supervisor.  Some insurance companies coordinate their surveillance in a way that creates some unique opportunities for the insurer. 

            If your insurer has set up an Independent Medical Examination or scheduled you for a Functional Capacity Evaluation or some other type of examination (which would occur outside of your home), chances are, you are going to be surveilled on the day before the examination, the day of the examination, and the day after the examination.

            We recently had the opportunity to evaluate several surveillance tapes to determine what possible use they had to the insurance company.  The insurance company is not interested in surveilling you on days when it does not know your schedule.  Therefore, when you are scheduled for any type of examination by a long-term disability insurer, YOU SHOULD ASSUME THAT YOU ARE BEING WATCHED.

            For most people this does not present a problem.  For some people, any opportunity to get out of their house translates into a desire to stop by their doctor’s office or a pharmacy or a bank.  It is a well-known fact that many individuals who are on disability frequently combine their trips outside so they don’t have to expend more energy than is necessary and they can recover in the days following these activities.

            Many insurers interpret these “extra stops” as hidden capacity for work.  Most of the surveillance that we see, frankly, is useless in the demonstrating or determining excess capacity.  We recently watched a video of our client who was standing out in front of his house with his dog on a leash.  We also witnessed a client stepping outside with his cane for a cigarette.

            To the insurance industry, these activities are demonstrative of working capacity.  In reality any reasonable vocational or medical expert will tell you that these small activities do not contain enough information that would translate into full-time, part-time, or even volunteer work.

            The thing to remember is that if you think you are being watched by your long-term disability carrier, you probably are!