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Thread: If I were never on long term disability

  1. #1

    If I were never on long term disability

    through my employer when I was acute, does an additional catastrophe
    have to befall me to seek it out now? Does a doctor have to claim that I am medically unable to work?

    If I decided I was no longer able to work, could my employer deny me?

    Anyone??

    Joe
    And the truth shall set you free.

  2. #2
    I ran this past an attorney, it depends on the policy. The policy is a contract, it may provide time frames, etc. Have the contract reviewed carefully. Get someone to review it for you if necessary.
    Every day I wake up is a good one

  3. #3
    one question i can safely answer , yes i doctor has to certify that you are no longer able to work, and probably every x number of months you will have to re certified
    cauda equina

  4. #4
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    Joe

    When I had to quit my job. I didnt have any luck with my long term or short term insurance policy. They both attributed my problems as pre existing. They denied both my claims. I had to go back to SSDI. Now if I had fell and broke both hips or legs my policies would have paid.
    Good luck
    T12-L2; Burst fracture L1: Incomplete walking with AFO's and cane since 1989

    My goal in life is to be as good of a person my dog already thinks I am. ~Author Unknown

  5. #5
    Senior Member zillazangel's Avatar
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    Chad is employed by the State of NC (not simply receiving benefits, he actually works there). He had to first exhaust his FMLA time - 3 months with no pay. Then exhaust 1 year, that kicked in after the FMLA time on short term disability which paid 50% of his income, but we had to pay 100% of the health premiums, our half and the state's half, which was over $1000/month. Let's just that there wasn't much to write how about what was left from his net pay after that bite! Then, he had to apply for long term disability. It took ALOT of medical paperwork, photos, doctors, etc to all certify that he will never be able to be gainfully employed again in any field. In his case, this is really the truth (for a variety of reasons I won't get into here). They would not consider the LTD claim until STD ran out, so we went with ZERO income from his job PLUS we had to pay $1100 month for our health insurance from MARCH to OCTOBER of this year!!! But, after taking their sweet time, and after a firm but polite call from a lawyer we hired (sad ... Chad's stepfather who died was a partner in a law firm and they had different last names ... it was so great for stuff like this), they approved him 2 weeks after the lawyers call.

    He is in the very unusual situation that they will not require periodic medical reevals until .. get this .. 2026! So, we're off the hook for 20 years, so I hope that means that will now pay us his back pay, the benefits they owe, etc. ANd in fact, we got a letter last week saying they were doing just that. WHEW!!!!!!!!!!!!

    Anyway, slightly rambling, but the point is that it is a long process and STD/LTD policies are determined by each company, not by any overarching body. Only FMLA time is mandated protected time for firms of over 50 people. You'll need a good advocate doctor to help you push it through.

    Not sure if you go on LTD if you can ever go back - I think you can, but it wasn't something we needed so I just glanced through that.

    Ami
    Wife of Chad (C4/5 since 1988), mom of a great teenager

  6. #6
    Suspended Andy's Avatar
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    Also keep in mind some LTD policys have a clause that they can discount any SSDI payment out of whatever they are on the hook for. So if you say, get 1/2 pay for LTD, whatever SSDI pays comes out of the LTD payment. Sweet, eh?

  7. #7
    I get it. So in most cases another event other than my SCI would need to occur to first find me exempt from working.
    I have been out several times this year due to complications from my injury:
    UTI, Torsion and surgery. would this present a stronger case?

    Also, it sound like LTD and SSDI is not a double bump.

    You can't get both?

    Should I get a lawyer first thing?

    J.
    And the truth shall set you free.

  8. #8
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    Quote Originally Posted by Andy
    Also keep in mind some LTD policys have a clause that they can discount any SSDI payment out of whatever they are on the hook for. So if you say, get 1/2 pay for LTD, whatever SSDI pays comes out of the LTD payment. Sweet, eh?
    This was the crappy kind of policy I had. It pays to really read your policy because some of them are complete rip offs.
    T12-L2; Burst fracture L1: Incomplete walking with AFO's and cane since 1989

    My goal in life is to be as good of a person my dog already thinks I am. ~Author Unknown

  9. #9
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    Quote Originally Posted by NoDecafPlz
    I get it. So in most cases another event other than my SCI would need to occur to first find me exempt from working.
    I have been out several times this year due to complications from my injury:
    UTI, Torsion and surgery. would this present a stronger case?

    Also, it sound like LTD and SSDI is not a double bump.

    You can't get both?

    Should I get a lawyer first thing?

    J.
    If you have only been working a year, I would just go back to social security and tell them of your recent extenuating health problems. You should be able to go through expedited reinstatement rather easy. I didnt have to have a doctor state that I was unable to work. I just had to prove that I had to quit my full time job. I was part time for a while at my employer but soon my health got the best of me for even part time.

    Getting that insurance money will take a while. At least with SSDI expedited reinstatement they will start your payments back immediately. SSDI gives themselves 6 months to review your case again which they know if you were permanently disabled before you are still disabled with SCI. They will pay you that 6 months regardless of whether they find you are still disabled or not. You will never have to pay that money back. I had to send in my recent doctors visits for expedited reinstatement but it was related to my sci in regards to urinary problems like you have been having. Plus the last year you have worked will more than likely up your payments from the original amount you were getting.
    T12-L2; Burst fracture L1: Incomplete walking with AFO's and cane since 1989

    My goal in life is to be as good of a person my dog already thinks I am. ~Author Unknown

  10. #10
    Suspended Andy's Avatar
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    Quote Originally Posted by NoDecafPlz
    Also, it sound like LTD and SSDI is not a double bump.

    You can't get both?
    J.
    It really depends, my company provided LTD had that provision when I talked to them, others may be different.

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