Timing is everything.

Sometimes you need to take a step back to see the big picture...

The Time-line File: 

The time-line file can give you actually three really cool bits of intel and in most cases open up brand new and unexpected avenues of attack. If you follow the sequence of events from the claim being examined through everyones input, you can start to put together an idea of the work flow, or at least how your claim went.  More, the close observers will start to pick up who reports to who so an Org chart can be developed.

The timing of events themselves can be as important as what actually happened. If you recall we had you gather all records for the period concerning the handling of your claim and 90 days prior. What started as boring or depressing (What the hell? The doctor only spent 4 minutes on my case??? ) soon become interesting and quicker than that became a new avenue of attack.  Consider our story before we started analysis:

First, let us introduce the latest entry into our rogues gallery of enemy combatants, a claims manager whom we will save embarrassment by calling him, oh Richard "Louie" DePalma:

Our hero, the Claims Manager

In December of 2013, Richard took a claim that had already been approved by the enemy for LTD for over a year and began steps designed to overturn it. No new information was to be had, no changes in the case (that we could yet see) but out of nowhere Richard begins the process. Not even getting into the deceptive tactics Richard used, the fact that he took a completed settled claim and took it on himself to overturn on based on no new information made his move seem shady. When we looked at the rest of the record we found that the claim was overturned in record time (87 days).

Curiouser and curiouser as they say. So we start going back 90 days (hint hint) and what do we find? That for the three weeks prior to commencing overturning the claim, Richard was using his contacts to get an early determination from the federal government on Jeff's disability award through them. Within three days of getting confirmation (before we even knew) Richard put the wheels in motion to overturn their own decision and re-deny his LTD. Three days.

So why would this happen? If you look back at the BIG big picture from a time-line perspective it all starts to make sense: the motivations, actions, everything:

2010-2012: We fight long and hard with the enemy on both long and short term disability. STD is only partially approved and LTD is not after two appeals. At this point we gave up and through the rest of 2012 heard nothing.

Late 2012: The enemy suddenly approves LTD out of the blue, pays back wages and continues through 2013.

At the same time, the enemy hires another company to work with the government to push Jeff's federal disability through.

Literally the minute that works, the Richard reverses the last determination, provides himself with what he foolishly thinks is cover and tosses the claim back out. From then until now, the status is closed.

So when we looked at it like this, we find that the enemy delayed paying anything until they were just about to get the government involved. Then by "approving" the LTD during the governments determination process, it sends the message to the government that this claim is valid. When the government takes a 10th of the time to say "yes" where CDIS took two years to say "no", CDIS overturns the claim, essentially saying they are lying to the government.

Now suddenly the motivations and actions of Mr. DePalma make a whole lot of sense and now that we see what is really going on, we have a new weapon with which to attack the enemy.  Remember what Sun Tzu said about knowing the enemy and knowing yourself.

Conclusion:
Just from the time-line of events we have learned a number of useful things. We know for fact (further I guess) that not only was the original claim not decided upon based on facts, neither was this most recent overturning of their own decision. Greed pure and simple. Easy to see and easy to predict. They are indeed the scorpion of the fox and scorpion fable. As long as you trust them to do what is best for them and worst for you, you will not be disappointed.

The good news is, their predictability can also be their downfall. Everything is a weapon, everything they throw at you an opportunity.

Here endeth the lesson...

The Tactical Team
CignaWarJournal at Gmail dot com.