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Beware of Insurance Peer Reviews

covered under the defense base act and the longshore act Hi I’m Brian Wiklendt with Garfinkel Schwartz I’m coming to you from our Cocoa Beach Florida office today on the space coast of Florida.

We also have offices in Maitland Florida which is a suburb of Orlando. But we also travel all across the country helping people that are civilian contractors and longshoremen across the country.

You may watch this information on the Garfinkel Schwartz YouTube Channel in a video called “Beware of Insurance Peer Reviews.” 

Insurers’ Ammunition vs. YOU

I’m coming to you today to discuss the ammunition that the insurance companies have when you’re involved in a claim on an injury under the Defense Base Act or the Longshore Act. The weapons that they employ without your knowledge are several and very powerful things that they use to try to deny your claims or deny your benefits as soon as they can.

No. 1 What are Peer Reviews?

Number one is that they establish insurance peer reviews. A peer review is giving your medical information to a doctor that they hire to review to determine whether you should be getting the benefits that your treating physicians are asking for you to get.

Insurers Pay Doctors to Get You Back to Work

And those peer reviews are obviously bought and paid for. The doctor that does the peer review for the insurance company never sees you never interviews you never talks to you and you have no idea that they’re actually working and analyzing your medical records. They have the right to do that and they use that against you to cut you off.

Labor Market Surveys Can Cut You Off

Another type of situation that have is that they do labor market surveys on you without your knowledge they try to find jobs based on what they think you’re capable of doing so that they can reduce your earning capacity benefits.

And they use federal computers they use the Department of Labor and they find jobs in your area that they think you’re qualified to do.

Insurers Prove You CAN Work

Now the problem is that they don’t have to prove to the judge that you actually will get the job and that you’re not taking it. All they have to do is prove that you’re physically able to do this job and that you’re technically capable through your education and experience to do the job. And what do they do they tell you this do they explain it to you?

Benefits Cut With NO Warning

Do they say, “hey we want to help you. Do you want to go and apply for these jobs? We’re here to help you?” No, they don’t do that. All of a sudden your check that’s supposed to be for twelve hundred dollars a week and its all of a sudden six hundred dollars a week. With no explanation. Using their silent weapons that they have against you. What do you have to say about that?

You hire a lawyer, hopefully you already have a lawyer, you get the lawyer and you have to go through a formal hearing process to finally have them give you and show you why they’re reducing your benefits and where these jobs come from to make their unilateral decision to start cutting your benefits or cutting your medical benefits off.

Garfinkel Schwartz Fights for Your Benefits

And it’s unfair but that’s the playing field that we have to play in. And if you don’t have a lawyer when you’re dealing with things like this you’d better really rethink what you’re doing. It is not easy fighting insurance companies, especially when you’re not familiar with the things that they might try.

And if you don’t hire me, please hire a lawyer and make sure you vet out that lawyer and they understand and know these Federal laws because these laws are very, very uncommon even to most of my lawyer friends they have no idea what I do for a living they’ve never heard of it.

So please get help somewhere. Hopefully you’ll call me and have trust in me and I just urge you to understand the weapons that are being used against you as we speak. And if they’re not doing it now, they certainly will later because they don’t want to be paying you for years and years and years I’ll tell you that.

Insurers Use a Lot of Weapons Against You

And those are the weapons they have. They have other weapons that can be combatted as well. But please don’t go it alone it’s too complicated for you to worry about on your own to try to defeat these types of unilateral decisions that are made by insurance companies that hurt you and your family.

Again thank you very much, I’m Brian Wiklendt with Garfinkel Schwartz signing off today from the Cocoa Beach Florida office. I hope to hear from you soon and thank you for your time.