fmla, std/ltd and termination

[pooh1965]

(arizona)..i have been on disability leave from my employer (due to a hostile work environment which caused PTSD anxiety and clinical depression) for eight months. i have applied for std/ltd thru my employers disability insurance. they have yet to determine if i am approved. they did deny benefits eight months ago, and i appealed, of which i am still in the appeal stage. my employer advised me my fmla time ran out several months ago. i recently received notice from my employer that if i do not return to work within the next month, i am a voluntary termination. since it appears they are going to drag this std/ltd claim out until they vouluntary terminate me, is there anything i can do? what if they do terminate me and im on ltd? would my ltd benefits terminate too? if im on medical leave of absence, can they still do a voluntary termination on me even if i havent terminated or dont plan on terminating? ltd pays for years, if approved, but what if the employer terminates you during that time period? thanks...t

 

[ellencee]

pooh1965

I hope that you have a copy of your policy for std and ltd benefits. The policy will list exclusions to coverage. Post-traumatic Stress Disorder may be an excluded disability.
Do you have any idea of the length of the appeal process? I believe that I am correct in saying that you can not file a lawsuit based on denial of benefits until the appeal process is complete.
What were you told, or received a document stating, as regards a Worker's Compensation claim? Based on your statement that it was work-related, I imagine you submitted a claim.
Why can you not return to work? Please just tell me the reason you can not go to work each day, perform your duties, etc.

 

[pooh1965]

std/ltd , WC etc...

hi. thank you for your reply ellencee... i have checked the std/ltd benefits booklet, PTSD is not exluded...i did file for worker's comp but was denied stating this was not work related...the reason i am on disability leave is for severe stress,anxiety,panic disorder and clinical depression, of which my pschyotherapist states this is due to the hostile work environment/harassment i endured at my poe. i also applied for ssdi and am awaiting a determination on that claim, of which ss had me do a consultative exam with a dr of their choice, and he stated as well, i cannot work at this time, that he feels he sees tramatic and devestating condition. im just thinking since my employer is stating i must return to work within a month, and they and their disability benefits dept is dragging this std/ltd claim (in bad faith) but is ERISA benefit, that my ltd will be cancelled once they terminate me and then i wont qualify for benefits. since they know this date is fast approaching, they are making no determination , i feel, until i am terminated, then will say sorry, you dont qualify for benefits due to termination. yet, i filed for std 8/2001 and still waiting appeals of which i filed in 12/2001 and still waiting (spd states appeals determination to be made within 120 days)..they violated this by dragging this on for 4 months. then i applied for ltd (my therapist and MD state i will be out of work until aprox 8/2003) in 1/2002 and still havent heard the determination of this claim as well. each time i call the disability benefits insurance, they claim both the claims are still under review!! (seems to me they are delaying this just to get out of paying by waiting --and knowing--i will be a voluntary termination in just a few more weeks!) .... i have tried to obtain legal representation, however they have stated my case would be too costly to litigate. i have so much documentation and doctor statements, tests ect that should qualify me for benefits, yet they keep extending this determination period and deny me my rightful benefits. i am a single mother of three small children, no income for eight months. this process as well has exhaberated my condition. i at this time cannot work for my employer or any employer. thanks for your input/suggestions... (arizona)

 

[ellencee]

At this point, I must defer to an attorney. I do not know what step you should take next. Surely an attorney can at least tell you whether or not you should continue to make your premium payments (like you can with no income, I know).
Social Security Disability Benefits (not SSDI, which is Social Security Death Index), aren't going to be retroactive through the date of disability, when short term benefits would have begun. Although an attorney may not be willing to litigate this for you, maybe one will be willing to guide you through the steps you should take.
The only encouraging thing I find in your notes are that the SS independent examiner said you could not work.
Why would you want to return to a place of employment that caused your PTSD? Of course, they have the right to terminate you; you aren't working. I do not believe that this 'administrative' action cancels your right to receive benefits.
I still do not understand why you can not work at any job; and that is the determining factor. Why can you not work at any job? Please don't answer with due to PTSD--tell us exactly what--you can't put your clothes on without assistance? you can not complete an assignment? you can not type or answer the phone? you can not sit for longer than a certain length of time before X happens? what are the physical, or mental, limitations that prevent you from, say, working at an answering service or a paging service?
As I said, at this point, I must defer to attorney. The attorney will need to know the answers to the questions that I have posed as regards your inability to work at any job for which you are qualified or may become qualified.

 

[pooh1965]

reply...

thanks again for your reply...the reason i cannot return to my current employer or any employer at this time is due to severe panic attacks, uncontrollable shaking (all the time), severe depression (uncontrollable crying almost all day/night, depressive thoughts, anger outburts when in public), dizziness (which i also recently went to a neurologist and completed a eeg and was found to have epelipetic? seizures) which are causing a great deal of the dizziness and lightheadedness...in the past year, my attendance at my employer suffered greatly, as had my performance due to the depression and panic/anxiety attacks. as well, i received notice today from my benefits dept that if i do not make the ltd payment (which i elected as extra coverage, should i become disabled) within three weeks, my ltd will be terminated. but, i have absolutely no income and am not able to remit payment!! the std/ltd benefit would or should have been paying me for over the past eight months, and keep delaying this determination process. one reason they denied in the beginning is due to i am able to write a neat, organized, sophisticated appeal letter, which they came to the conclusion that i am not disabled, regardless of my MD, RNP mental health nurse, consultative examiner for ssdi... my std/ltd never once requested an IME, which they should have, and would have found the illness months ago. i feel they are just stalling in order to get my beenfits canceled and or terminated employment so they dont have to pay benefits..maybe im wrong, but it surely seems this way anymore. thanks for any advice/suggestions...i have tried to contact several employment, ERISA, std/ltd and ss attornies. all say too costly to litigate, with the exception of ssdi attorney. they will take my case if ssdi denies me. what i am concerned with is the std/ltd benefits, which they would owe me aprox. 15,000.00 in back benefit pay.. my spd states if i cannot work at my employer, or any occ within my employer, i am considered disabled. UP is stating i should have found employment outside of my employer, and thus the reason for denial. this is not what the spd states. thanks again......