Employment/Benefits Issues during Pregnancy

[veranaz22]

(Not sure if this is the correct place to post. If not, please advise, thanks!)

Hi! I'm currently about 21 weeks pregnant in Hawaii, and have not been working since February. My employer and doctor are putting me in a vicious circle of running paperwork that is going nowhere, leaving me with no income.

On my first appointment with my doctor, I was given a 15-lb weight limit for carrying/lifting (which is what the practice does for everyone who is pregnant under their care). My position requires to be able to lift at least 50 lbs, and I was then removed from my shifts because of my new restriction. I'm currently "still employed" by them, but is placed as "inactive." I would be activated again after giving birth.

My employer then proceeds to start my Temporary Disability Insurance (TDI) papers since they said I'd qualify for it and FMLA. I then go to my doctor for them to fill out their portion of the forms. The doctor's office refused to fill out the papers saying it was fraudulent for them to do so and that I was the first to ask that of them, they only do that a few weeks prior to the due date. I report it back to my employer who then says it's the first they've heard of a doctor refusing to fill out TDI papers, especially since I'm not the first pregnant lady they've had working my position. This is when I started to consider Unemployment Insurance (UI) since there are no light-duty shifts from my employer.

After filing an initial claim with UI, I come into contact with someone from the UI office helping me with my claims himself. He gives me forms to be filled out by my employer (since I am still technically employed, but with no hours) and my doctor. I ask each office if they could fill those out and sent them their portions since each said they could. This time, it was my employer who wouldn't fill out my paperwork because I qualify for TDI. Now paperwork is just running in circles with me in the middle, wasting time with me having no income at all. The only thing I've qualified for (thankfully, helps even a little) is WIC, which gives food checks for some key grocery items.

I'd like to tell each side to just give up and I'll just deal with the huge loss, but every bit counts and I feel there's something wrong here or something I'm missing. I can't afford to consult with a lawyer. Employment is really tough here that by the time I find an alternate employment, I'd be giving birth already anyways. I believe I've run out of assistance programs and benefits to try, and I've always been doing my share the best I can. Due to health concerns, I've "given up" during my first trimester, and approached this matter as "ok, fine, what do you want me to do now?" (too much stress that it was starting to scare me that I would lose my child). What else is there to do? Do I have grounds to sue anyone?

Thanks so much for "listening" and thanks in advance for any insight!

 

[ecmst12]

Honestly I would have found another doctor that wouldn't restrict my duty so early in the pregnancy, or if they WERE restricting my duty because of risk factors, they would fill out the appropriate paperwork for my disability insurance. FMLA only protects your job for 12 weeks though, so they can fire you whenever they like at this point. And I just think it's insane to be out of work for your entire pregnancy when you don't have any particular risk factors or problems going on. I can't believe you have let this go on for 5 months.

You also don't qualify for unemployment unless you are able to work and actively seeking work. Are you actively seeking a new job?

 

[commentator]

Unemployment is NOT a prospect at all in this circumstance. You must be fully able, available and actively seeking work with no restrictions in order to qualify for unemployment benefits. It is not welfare for people who can't work due to health issues. Unemployment benefits are mutually exclusive with disability programs. You can't qualify for both at the same time.

I agree with the poster who said if the doctor's office insisted on giving you a restriction, and then refused to sign the paperwork for disability, you should have found another doctor's office. What on earth would be their reason for saying, since they gave you the restriction and it made you unable to do the job, that they wouldn't sign the paperwork for disability? That's unreasonable! The state's disability program I don't know anything much about, but I suspect that it would be the alternative of choice and that your employer should be the one helping you, which sounds like they were trying to, and then you talked to a complete idiot in the doctor's office (which wouldn't be too surprising, since the doctor may not have the most qualified staff)

Honestly, the doctor sounds like the whole problem in this situation. There is no disability program that does not require the doctor (who put the restriction on you in the first place) to provide information about the restrictions. Was your job just super, super heavy lifting, that you could not have done it while you were pregnant? If they had not given you this restriction, would it have been necessary for you to lift 50 pounds every day?

Unemployment insurance is NOT a needs based welfare program for those who can't work otherwise. Food stamps and TANF are the two needs based programs, and you can sign up for them, if your income is low enough, but they will send you right back to the doctor who put the restrictions on you in the first place. There is no one you can sue, but for heaven's sake, even a free clinic would be more cooperative than these jerks at your obstetrician's office who interruped your employment by giving you the restrictions, then refused to sign the papers to let you be on disability.

 

[ESteele]

Follow the above advice. Find a new obstetrician “who does not play a lawyer on TV.” You may want to find a physician who specializes in high risk pregnancies. Your new doctor may complete the requisite insurance paperwork.

Based on my limited understanding of the Hawaii disability insurance program for pregnant employees, you should be able to collect the disability benefits because you cannot perform the duties of your position (i.e., lift 50 lbs.) based on your pregnancy. The fact that your limitation occurred early in your pregnancy should not be dispositive.

More fundamentally, your physician should not make this call. If the insurance carrier has an issue with you going on disability early in your pregnancy, it will address the issue. I would think, though, your circumstances are not unique. In my opinion, it is likely that other Hawaii female employees have encountered similar circumstances and obtained disability benefits.

 

[ecmst12]

I do not think OP's pregnancy is high risk. This doctor simply puts EVERY patient on a lifting restriction regardless of their individual circumstances, which is a terrible and unnecessary policy. The problem is there is no medical justification for this restriction so they know disability won't approve it, yet they won't REMOVE it so the patient can go back to work. If there WAS a medical justification, there would be no problem completing the paperwork and getting it approved. IMO, that makes this a shady practice and OP should get as far away from them as she can.

 

[veranaz22]

Thanks everyone for your input! I ask because I just want to understand at this point. A check in the mail would just be a plus at this point.

The reason why I tried the UI route is because TDI is going nowhere and I didn't want to waste time with no income, and the worst that could happen is I'd just get denied. This is my first pregnancy, so I wouldn't know what is normal or not when it comes to doctor's practices. Even though my job requires me to be able to lift 50+ lbs (I'm a private home care nurse aide...change old people's diapers and sweep their houses), the regular clients assigned to me at the time were mostly bedridden or can sit/stand/walk independent of me. Which is why I went ahead and notified my employer of my "condition" to avoid being assigned more dependent clients. The 50+ lb requirement would apply in scenarios such as if my client would collapse or fall, he/she would need my help to lift him/her off the floor; or if the need arises that I'd have to drag my clients out of a fire. I've let this go on for so long, because the stress and worry starts a vicious cycle of me worrying for the health of my unborn child. Especially if it were going nowhere anyways.

Yes, I am actively seeing a new job. But unfortunately, my only job experience would put me in the same work situation. I would have to ask to be given specific types of clients as well. I could only apply for jobs where I don't have the experience.

The person I spoke with at UI stated that I can still claim benefits, after explaining to him my situation. He gave me forms to be filled out by my employer and doctor, which pretty much just verifies that I am pregnant, and that my employer has no suitable jobs/shifts to offer me. I do all of my share, according to what he and the letters I get tell me to do (fill out my forms, make my resume/profile, etc). Even though UI is a long-shot, their office has been most informative and most clear-cut out of everyone I had to deal with.

The reason why I didn't bother with going with another doctor, is that this doctor is the one who started my care and gave me the restriction to begin with. I would have to have that same doctor lift the restriction, which she won't do until after I give birth. I agree they're being unreasonable, especially since the TDI papers just ask to verify what's going on with my health and it would be up to TDI (not the doctors) to determine if I'd be eligible or not.

Fortunately, I did qualify for MedQuest, health insurance was my main concern. TDI would only extend my insurance for a few months. Then, I'd have to apply for MedQuest anyways if I didn't want to pay the full premium myself. I would have had to pay out of pocket to get into my Husband's plan, which would cost about half my benefits if I even qualified. Even then, I probably wouldn't be able to claim maternity benefits because most have some sort of waiting period if I'm not mistaken. Once I got MedQuest, I've given up completely on following-up on the other papers, and just let them contact me if they need anything. If not, oh well.

Wouldn't a high-risk OB require a referral? I'm not considered high-risk because everything is going well health-wise, which again, I refuse to ruin with paperwork stress that is just going in circles. In the first sign of trouble, I wanted to ask my employer if they could give me the OBs that has signed off on the other workers in my position in the past. One that would be a breech of confidentiality/HIPAA issue, two, I still have to deal with the doctor that started it anyways. I don't know of other females in my position (former classmates went a different career path, and the only co-workers I know work in the office).

Thanks again for your responses! Also for any additional responses!

 

[commentator]

Quote: "The person I spoke with at UI stated that I can still claim benefits, after explaining to him my situation. He gave me forms to be filled out by my employer and doctor, which pretty much just verifies that I am pregnant, and that my employer has no suitable jobs/shifts to offer me. I do all of my share, according to what he and the letters I get tell me to do (fill out my forms, make my resume/profile, etc). Even though UI is a long-shot, their office has been most informative and most clear-cut out of everyone I had to deal with."

I'm glad to hear that the U.I. system is working and that they are being helpful to people. However, I would be willing to bet you haven't been approved, though you've filed and have been claiming benefits for the weeks that have passed. Because I am suspecting that when they see that restriction on the medical statement that has been filled out by your wonderful doctor, that's going to cause you to be denied. One of the general questions you mention on the form is "Are there any restrictions on this person?" In most states, if the injury or condition was not work related, any restrictions, even a small one, will prohibit you from drawing benefits. I looked at Hawaii, and couldn't see anything different, but I sincerely do hope that is the case. If the employer let you go due to a restriction in your health condition, that's going to be a big issue.

I understand that a check in the mail is all you want, but I strongly suspect that that check in the mail would almost have to come from disability, not unemployment under these circumstances. You say that disability is "dragging their feet." What would it take for them to step along? Another note from another doctor? Anything you could do?

I still think this doctor refusing to do the forms to apply for your disability insurance is way out of line. They should know that you do a type of work where restricting your lifting would be a job killer, and that this is the type of work you are trained for and usually do. What do they think you should have to do, get a job washing dishes by hand somewhere through the rest of your pregnancy to pay your bills, or just go home and live without the income? Either way, this type of behavior would cause me to have very limited faith in the physician who is supposed to help me deliver a healthy child. Maybe a special high risk doctor would not be required, but I honestly would look for another one of some kind. There's something seriously wrong with this refusal to file the disability papers on their part.

Incidentally, your attitude of in the future refusing to deal with the paperwork necessary to deal with these issues isn't healthy or self protective, it's just a little silly. No one else, your unemployment system, the employer, or the disability program, cares a flip about whether you are approved, get the benefits you should be getting or what. That's your responsibility. If your baby isn't being stressed by your having to deal with paperwork, it'll still be stressed by having a mother who has lost most of her income.

 

[veranaz22]

$200/week for 6 weeks is all I'd be getting from TDI. Income/money can be replaced, my experiences from this pregnancy cannot. I plan to enjoy my pregnancy and not burden myself with things out of my control. I do what I legally can. With all parties involved, I'm given the exact same explanations and exact same forms. All parties stand firm no matter what I tell them. If I were to get a new doctor at this point, it would only be for legal purposes and would only add another party to deal with.

The issue is dragging, I get it, no need to rub it in, thank you very much. Since this only affects us short-term, I don't see the need to put more effort than I already have, especially since I apparently don't make nearly as much as everyone else here does.

 

[commentator]

As soon as your baby is born and you are released by your doctor to return to work (without restrictions) usually around the sixth to eighth week after your delivery, call your old employer up and ask if you can have your job there back. If they say you can't, then you will be able to begin drawing unemployment benefits at that point until you find another job.

So if you could get disability for $200 for 6 of the weeks left until your baby was born, I'd think that'd be sort of nice. I sure don't understand your comment about how we must all make more money than you do, because in the days when I was having children, I would never have had the liberty to turn down the slightest chance of some tiny amount of income coming in from anywhere. Your stated attitude of "Oh well, I just don't want the stress of it all" strikes me as the comment of somone who must be able to afford to take that path.

And it is so not true that all the different programs have exactly the same forms. They are all from different levels, agencies, departments, and certainly are not communicating with each other on your behalf, and do not require exactly the same information for their programs.

 

[ESteele]

I did not mean to suggest the OP’s pregnancy was actually high risk. My thinking was a physician who regularly interacts with employees with high risk pregnancies may better appreciate the fact that an individual patient could be “disabled” for insurance purposes due to a lifting restriction precluding her from working at her particular job. (I do not play an OB on TV. Nonetheless, I do not think any OB wants any of his or her patients lifting 50 lbs. or more during their pregnancies.) A 15 lb. lifting restriction would likely have a different effect on a construction worker than on a receptionist.

As mentioned above, the OP’s physician appears way out of line here. He should have completed the paperwork with the 15 lb. restriction, and allowed the insurance carrier to make a determination based on said paperwork. The physician is not in a position to evaluate whether the OP’s claim is valid or not. Accordingly, a change of doctors may straighten this situation out.