Health Care Management Specialist

1.

After eight weeks from the date of disability, evaluate if the member’s file should be forwarded to the LTD department at Desjardins.

  • If it is very likely the member will safely return to work prior to the LTD effective date, defer sending the file and monitor to ensure the plan remains on track and expectations have not changed.

2.

At least six weeks in advance of the LTD effective date, send a copy of the member’s file to the Desjardins claims specialist to allow them enough time to review the file and request any further information required.

  • Once all the required information is on file (e.g., Member Authorization, Attending Physician Statement, Initial Employer Report), and a telephone interview with the LTD claims specialist is completed, an LTD claim decision will be provided within 10 business days.

  • Together with the claims specialist discuss the member’s file for ease of transition.

3.

For member rehabilitation programs that will continue for 2-4 weeks into the LTD period, remain involved to ensure the transition is smooth and the member continues to feel supported.