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Medical Evaluation Process for Disability


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We’re reviewing our medical evaluation process for assessing disability benefit applicants, and we would appreciate feedback from other jurisdictions regarding their practices. Does a third party manage the evaluation process or a panel of doctors? If a panel of doctors oversees the process, how many serve on your panel? What is your method of compensation (flat monthly amount, paid per case)?

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MEF, I will be interested in any responses you get. If you are asking in connection with a state or local government pension plan, you might also want to check with NAPPA, the National Association of Public Pension Attorneys. The issue of disability determinations for pension plans is a frequent topic at NAPPA meetings and on their listserv. Most private employers do not have special disability benefits for their retirement plans and have insured LTD plans, so the insurer makes the determination. In the private LTD arena, there is a plethora of ERISA case law.

Luke Bailey

Senior Counsel

Clark Hill PLC

214-651-4572 (O) | LBailey@clarkhill.com

2600 Dallas Parkway Suite 600

Frisco, TX 75034

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My suggestion would be if possible, to use the Social Security Definition of Disability.  It is an objective, third party standard.

Patricia Neal Jensen

Vice President and Nonprofit Practice Leader

| QBI, an Ascensus company

21031 Ventura Blvd., 12th Floor

Woodland Hills, CA 91364

E patricia.jensen@QBILLC.com

P 818-449-6096

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