For all, but especially those who may be lucky enough to have LTD (Long Term
Disability) insurance.
Come of you may have heard this before and for that I apologize, but not all
have, so I will repeat this story. I worked for a company for 13 years
prior to my TM, almost all of my time in Human Resources. I started my time
there working in the Benefits department, and one of my responsibilities was
to
do the new hire benefits orientations. I learned about our plans, and sat in
on a couple of orientations done by another employee and when she got to the
LTD section I was really surprised by what she would say. She said "it is
much more expensive to become disabled than to die" and encouraged them to
seriously consider applying for the coverage, as well as the medical and life,
etc. I worked for a retail clothing chain and this was not easy to get our
young population to understand in those days, unless they knew somebody with
AIDS, which was just starting to really surface.
Of course I applied for LTD, as I saw the benefit in it. I was 37 at the
time, and knew that if something happened to me, I had children to provide
for.
I am so glad that I did, as it did come in handy.
The disability company can ask about whether or not you are getting SSDI,
and if you are recently approved and your plan allows them to recover it from
you, they will ask you to repay it to them. If you have been getting SSDI for
some time, they are only asking for informational purposes, as it cannot
have any bearing on your case. Your LTD benefits are based on your earnings
while you were working and is not reflective on any SSDI money that you
receive,
whether increased or not.
The LTD companies try to get people to just back down and not fight for
their rights. They hope that those who aren't really disabled will back down
as
the may not be able to prove their case. They hope that the sick don't have
the energy to fight. They count on this. This is why we have to fight so
hard to get and keep the benefits that we have. It's not easy when the meds
scramble our brains and make it hard to concentrate.
I was actually very careful during my appeal when I was out of the house, in
my yard, in front of the house and shopping, etc. as I was afraid that
there may be somebody trying to film me doing something that could be used
against me. Sometimes I am able to do more than other times and didn't want
to
have to fight about that too.
When my claim was reinstated, I got all pay retroactive to the date it had
been denied. They have to do that, and it was a nice chunk, but it was a
drastic cut in our money until then. My husband had still been working so it
wasn't as bad as it could have been. The bad part is that we got it in
December
for 18 months worth and all taxable for that year. Bummer to be all taxable
without no where near enough taxes taken. But, nice to be able to catch up
on everything and have a nice Christmas then.
So far for medical insurance we are in good shape as we still have with
Pete's ex-employer until he turns 65. The good thing is that the coverage
stays
the same, which was good coverage, and we pay less than we could get for good
coverage on our own, if we could get good coverage with my pre-existing.
Take care all and hope you are able to stay warm as well.
Hugs, Barbara A
\ssage dated 12/8/2008 3:16:39 P.M. Pacific Standard Time,
[EMAIL PROTECTED] writes:
Barbara,
Thank you for your kind words and advice.
I have hired a lawyer to handle the case. I worked for the county
government and ERISA laws don't apply to government employees so I will be
able to sue
the company for her fees which under ERISA you can't do.
I know that I will win eventually. I hae gone through the small savings I
had, maxed out 2 credit cards and now, when the stock market is down 60%, I
sell stocks from time to time. I talked to my lawyer and she said that we
could bring a civil suit against the LTD compnay for the total amount that I
have
lost as well as mental and physcial anquish. SO guess what, they should
have continued to pay me because they have really ticked me off! Too many
companies do this and it is not humanly nor morally correct.
Yes, I know there are people that take advantage of insurance companies but
those people that really need LTD should not be punished - aren't we suppose
to be innocent untl proven quilty - OH THAT"S FOR THE RICH - I keep forgetting
that!
What really gets me is the way the insurance company went around everything
and basically tricked me and my neuro - there should be laws against that. I
always thought that ERSIA was suppose to protect employees BUT in reality
ERSIA protects employers and insurance companies and allow lawyers to make
more
money!
I don't know if you noticed but I really get upset regarding this problem.
I thought before TM that I was doing everything correct financially to
protect my future but I didn't count on insurance companies bucking their
responsibilities!
I know that I am so much luckier than most. I do have a home that's paid
for along with an older car that's paid for. But there's the doctor bills,
meds, food, electricity, taxes, insurance and everything else adds up to
greater
dollars than SSDI. I'm in the class that I'm too well off to get help and
yet not enough to make ends meet - a rock and a hard place that seems to be
our
life! I just hope that Obama can help us all in ways that we can only dream
of!
Thank you for letting me boil over! Everytime I think about this, I get
upset and I know that I shouldn't because all it does is harm me! Since July,
I've had more attacks of spasms, headaches, and more pain. I know it is
because of the stress!
I need to follow my advice - let go let God! Some days its easier than
others.
Life is short! Break the rules! Forgive quickly! Kiss slowly!
Love truly, Laugh uncontrollably .
And never regret anything that made you smile.
Prayers and thoughts for you and yours,
Candy K.
----- Original Message -----
From: [EMAIL PROTECTED]
To: [EMAIL PROTECTED], tmic-list@eskimo.com
Sent: Monday, December 8, 2008 12:15:39 AM (GMT-0500) America/New_York
Subject: Re: [TMIC] your thoughts?
Hi Candi,
I wish you the best of luck with your LTD hearing. You have a right to
all the paperwork out of your file at the insurance co. and should order it
if you do not already have it. The insurance companies have no conscience at
all. Their job is to get people off the disability roles, and I understand
that they need to get the ones off that aren't really disabled, but not the
ones that are.
My LTD provider (Prudential) did the same as yours regarding sending a
letter to my doctor requesting that he complete a form about my condition and
what my capabilities were. They also stated on the letter to him that I had
been working on a part-time basis and requested the stand, sit, walk, etc.
questions. Now, my policy states that I am entitled to benefits if I am able
to work on a full-time basis based on my training or what I can be trained to
do, something like that, and on and on. I haven't worked at all since Dec.
2000, and they know it or they would not have been paying me.
This was sent to my Neuro, and all previous correspondence was sent to
PCP. The Neuro hadn't even asked me to come into his office for a visit
before sending back the form to the insurance company stating that since I had
been working part-time that I could work full-time now, after listing
capabilities that don't match me at all.
In the meantime, I had gone to a Physiatrist that the insurance co. set
up for a review of my condition. This doc stated that I was not able to
work. Then, since the insurance co. got the form back from my Neuro stating I
could work full-time, they contacted their doc and asked him to reverse his
decision and state that I could work, telling him that my doc must know my
condition better than he does, and he did it. I was denied my coverage at
that
point.
It took a couple of visits to the Neuro to get everything squared away
with his paperwork and re-submitted. It also took me requesting copies of all
my paperwork from the insurance co. in order to have ammunition for my
appeal. There were about 3 reams of paper worth of copies they sent me, and
most
were triplicates of my early TM years, including hospital info. That was
very depressing looking back at that stuff. I had to submit 2 appeals. They
were tough, but I'm glad that I stuck with it and finally noticed what they
did
with the doc they hired. That was very underhanded and let them know it was
wrong and not proper business practice. When I later told my husband he was
really angry and felt we could have sued them for what they did, but I don't
know. Especially since I may not have caught what they did, and could have
possibly lost again and had the expense of a lawyer. If it went to a lawyer
and I would win, they pay the lawyer. If I lose, I pay the lawyer.
This was about 3 years ago, and I just got another letter with a form
for a doctor's statement. I now have a new PCP and Neuro, so I hope all goes
well. I have a HMO and the process is that I drop off the forms to the
medical secretaries and they go back and forth to docs to be filled out,
transcribed, approved, distributed and filed. I sent emails to them letting
them know
I am available for questions and the trouble that I had last time. I hope
this works out without any snags. If we don't fight for our rights, who will
do
it for us??
Hugs to all, Barbara A
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