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Thursday, December 4, 2014

The Insurance Company’s Interview: The One Rule You Need to Follow to Make Sure You Don’t Let the Interviewer Push You to Overstate Your Disabilities

The Interview and Its Dangers

A danger area for long-term disability claimants is the in-person interview.  The interview is usually one part of the entire process of evaluating a claim, including an independent medical exam and surveillance.  It is sometimes done during an initial application for long-term disability benefits or while an appeal of a benefit denial is pending, but it is most common when the insurer is reevaluating the claim that it is currently paying.  As you can expect, it is a fraught area for claimants, but maybe not for the reasons you think.  

As you would expect, one part of the interview is to observe you and see if you do anything that is inconsistent with the limitations you claim, such as did you sit still for an hour when you claim you can only sit for fifteen minutes.

What you may not realize is that one purpose of the interview is to set you up for the surveillance.  In many of the interviews, the interviewer appears to push the claimant to claim greater impairments than the claimant has claimed in the past.  You may think that is helpful for you, since the more impairments you have, the less likely it is you can do your job.

It is not helpful, and it can scuttle your claim.  The insurance company will typically conduct surveillance after the interview.  If you do anything in the surveillance that is at all inconsistent with what you claim your disabilities to be, your claim is likely to be denied.  Even if the activity shown on the surveillance is consistent with you not being able to do your job, the insurer will use it to discount everything else you say.  For instance, if your job requires lifting 30 pounds, it shouldn’t make a difference if the surveillance shows you lifting 15 pounds.  But, if you claimed in the interview that you could only lift 5 pounds, the insurer will assert that you lied about not being able to lift 15 pounds, and that this discrepancy means that nothing you say about your impairments can be believed.  

The Rule

How do you avoid this?  By following the same rule that I give to my clients before testifying in court.  In both instances, you want to appear to be credible by answering the questions, but you do not want to be pushed around in making your responses.  So, here’s the rule:

  • Listen to the question.
  • Think about what you are being asked.  Don’t worry so much what your response will be.  If you have really understood the question, your will make a good response.
  • Answer the question, and only the question: when you have answered it, stop.  Don’t volunteer information.  Don’t start speaking again if the interviewer silently stares at you.  The interviewer is doing that to try to get you to start speaking again.

There are some corollaries to the Rule.  If you don’t understand a question, you can’t answer it.  It is the interviewer’s job to ask you a question you understand.  Ask for the question to be repeated or rephrased if you don’t fully understand it.  If you don’t know what to do, ask for the question to be repeated.  Make sure you are accurate with your level of recall or certainly.  If you are asked if you can do something specific, state accurately whether it is something you can do always, never, sometimes, occasionally, etc.  Hedging is fine, and will protect you against a charge of lying if the surveillance shows you doing something that you said you sometimes can’t.

Be particularly careful in responding to leading questions, that is, questions that can be answered by a yes or no answer.  Before answering, make sure your answer applies to each part of the question.  It is a good idea to always ask for leading questions to be repeated to make sure you understand them.  

Telling the truth is the most important thing.  Don’t let the interviewer push you or lead you into saying something that is not the absolute truth.  By following the Rule, you will have your best chance to avoid this.  So, during the interview, be calm, relaxed, focused, present in the moment, and listen to those questions!

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