Typically insurance companies hire Medical Services Companies to have one of their physicians review a disability claimant’s medical records to confirm that the claimant can work.
MLS, MES, PDA, PRN, UDC, BMI, PsyBar are some of the Medical Service Companies frequently used by insurance companies to perform a “record review” to bolster a denial of benefits. These third party vendors claim to be independent but in truth are anything but. In fact, many of these vendors have been formed by prior employees of insurance companies. To try to support their claim of independence they produce Websites that claim their impartiality and fairness. Sometimes this can be used to the claimant’s advantage.
To secure disability benefits for a client who had a history of rheumatoid arthritis and was now disabled by fibromyalgia, we used information off the MLS website to support the claim. (Even though MLS doctors reported that our client was not disabled.)
The MLS website not only confirmed fibromyalgia syndrome as a potentially disabling diagnosis but also defined the symptoms and possible causes. According to the MLS website:
Fibromyalgia syndrome is a widespread musculoskeletal pain and fatigue disorder for which the cause is still unknown. The term fibromyalgia means pain in the muscles, ligaments, and tendons – the fibrous tissues in the body.
The symptoms of fibromyalgia include:
- Pain – The pain of fibromyalgia has no boundaries. People describe the pain as deep muscle aching, burning, throbbing, shooting and stabbing…
- Fatigue – This symptom can be mild in some patients and yet incapacitating in others. The fatigue has been described as ‘brain fatigue” in which patients feel totally drained of energy. Many patients depict this situation by saying that they feel as though their arms and legs are tied to concrete blocks, and they have difficulty concentrating.
- Other common symptoms – Include chest pain, morning stiffness, cognitive or memory impairment, numbness and tingling sensations, …..dizziness, and impaired coordination.
The website further defined one of the possible causes to be rheumatoid arthritis which “may awaken an underlying physiological abnormality that’s already present in the form of genetic predisposition”.
Our client was in a mentally challenging career which was adversely impacted by the symptoms described in the MLS website and which caused him to be disabled from his occupation. Using the information contained in the website of the medical services reviewing agency hired by Prudential, we were able to impeach MLS’s own physicians and secure his disability benefits.