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Surveillance Not Enough To Terminate Benefits

Sunday, August 9th, 2009

A recent case has offered excellent guidance to claimants with orthopedic disability claims, and is well transferable to other impairments. A claimant was being paid for several years, when CIGNA conducted surveillance, revealing activities which exceeded the levels that the claimant had advised he had capacity for.

After securing the surveillance, depicting the claimant active on each day, and engaging in some level of activity, CIGNA terminated the claim, finding the activity level inconsistent with the claimed impairment. The Court determined that while the surveillance raised some questions about functionality, there was an abundant amount of evidence showing that he was impaired, and that the activity did not translate into the ability to work full time. One component of the claimant’s evidence was a diary showing typical daily activity and pain. The Court found this evidence compelling, along with the support from treating physicians.

The claimant take away point is that a diary or symptom log could well provide an additional level of claim support, to rebut an insurer’s efforts to rely upon surveillance. Linck v. Arrow Electronics (D. Mary. 2009).

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