long term disabilty.....dropped???

[thepreludedude]

What is the name of your state? Indiana, but i work in Ohio.

hi. i have been on LTD since July 2001. i was having back and leg pain. finally after several mri's, pain blocks, physical therepy, etc. the surgeon decided to do another mri. this time showing herniated discs at S1 and L4, L5. I had surgery last july. i attempted to start physical therepy in nov. 03'. it was too much for me. it was making the pain worse. i then saw the doctor in dec. 03' he sent me back to physical therepy. this time starting with an easier approach. this time it seems to be working. i am getting more movement in my back and less pain. i am still very week.

well, in dec. 03' the disability insurance co. cut me off. saying that they were sure i was able to perform some kind of work. i had my surgeon, reg. doctor, chiropractor, and physical therepist send in my medical records along with letters stating that i was not ready to return to employment. after wasting time since december. i finally was able to get in touch with my claim rep. today. they had been delaying me since the end of january. she stated that the review board was unable to approve any more disability payments. she said i could officially appeal it. she is going to send me something in the mail. well, i only have 90 days from dec. 11,2003 to get this into them.

what should i do? what kind of information will i need to be able to get them to extend the disabilty for at least another month or two, plus receiving pay since december? i have zero income. my credit cards are racked up and i am trying to figure out how to pay for the doctor's visits, physical therepy visits, etc.

i am pretty sure i will not be able to handle any job at my current employer. since every job requires very heavy lifting and standing for 12 hour shifts.

what are all my options at this time? what happens if they do not extend it? should i see an attorney? if so, what kind? will i be able to receive unempolyment since i was on LTD?

thanks everyone. this is a very confusing time for me. i really just want to focus on getting well. now i have to screw around with this. tia.

 

[thepreludedude]

??????

 

[Beth3]

One of the pertinent issues that we can't answer here is how the LTD plan defines "disability." Specifically, whether the Plan considers you disabled if you are unable to perform ANY work or whether you are disabled if you cannot perform the job you had previously. (Usually referred to as "own occ.")

Since you have a limited time to appeal, I suggest you don't wait any longer for the insurance company to send you something. Hopefully, you have a copy of the LTD Plan and under the law, the document MUST include information on your rights to file an appeal and how to do it. That info is usually in the back of the booklet/plan document. You need to write them a letter formally stating you are filing an appeal of their decision to deny you benefits. Include copies of any pertinent documents.

As to whether you can claim UC benefits, I seriously doubt it. You are claiming to be totally disabled from working at present. One of the minimum requirements to be eligible for UC is that the claimaint be physically available and capable of working. You are free to file for benefits but the likelihood of your receiving them are slim.

 

[thepreludedude]

here is what it says:

"disability" and "diabled" mean that because of injury or sickness:
1. the insured cannot perform each of the material duties of his regular occupation: and
2. after benefits have been paid for 24 months, the insured cannot perform each of the material duties of any gainful occupation for which he is reasonably fitted by training, education, or experience.


so. #1 i cannot do, because i have to do lifting up to 70#'s. and #2 the doctor has me staying off work until i see him on 3/16. so how would i be able to do any occupation if i cannot work? i am currently in physical therepy which is working pretty well. i really do feel that by the end of march (hopefully sooner) that i might be well enough to return to some sort of job. but what about all the time between december 11,03 and now?? thanks for the help. i really apppreciate it.

 

[thepreludedude]

update:

well, when you think it can't get worse.....

i opened my mail yesterday to find out that my health insurance was cancelled at the beginning of the year. i contacted my company i work for. they said after 3 years i am automatically terminated. needless to say i have huge medical bills since january1st.

so, what do i do know? i assume if i am terminated that i will have a zero chance of extending the disability claim? not to mention that i probably couldn't afford to go see any doctor's or physical therapist to get documentation.

any help, at this awful time, will be gratefully appreciated. thanks.

 

[cbg]

Your health insurance, or even your employment, being terminated does NOT have any affect on your disability benefit status, in 9,999 out of 10,000 cases.

What was the status of your health insurance? It's not clear from your post whether your EMPLOYMENT was just terminated (in which case there may be some issues with the way your health insurance cancellation was handled) or whether your employment was termed long ago and this is the end of your COBRA.

 

[thepreludedude]

my health insurance was still being handled through my employer. i paid the weekly premiums (which i had paid up to 4/4/04). i was on long term disability. my employment has been terminated as of 12/31/03 same with the insurance. i spoke to the company today (that is how i found out i was terminated) and they said i could pick up COBRA, but i have no idea how i could afford that with currently no income??
thanks for helping

 

[tigger22472]

Here is what you need to do. It's not pretty but believe me my family has been in your situation in a way and you have to do what you need to do. You need to hit EVERY agency there is meaning welfare, trustees office... EVERYWHERE. Welfare will help you with working on getting you Medicade.... The Trustee's and other agencies will be able to help you and tell you where you need to go as far as helping getting other bills paid or at least delayed until you get through this period. Have you or your doctors talked about filing for Social Security Disability? It's a long process that if you're going to do you need to start NOW... the worse that can happen is you be denied... but don't take the first denial as an answer and don't get a lawyer until you've been denied twice. Talk to your doctors and see if they have a social worker available that can help you with the paper work.. in the end it's worth the wait...

*wishing you luck*

 

[thepreludedude]

^^thanks for the info. i REALLY appreciate it. i will look into this.

 

[thepreludedude]

so far....

contacted ohio and indiana unemployment. they cannot help since there was no reported wages from my employer for 2002 or 2003.

still looking for other services....

been trying to contact my union rep. still haven't heard from him.

 

[tigger22472]

unemployment isnt' going to help.. You need to go to the welfare deptment and sign the papers to get any other help you can get through them.... Then call your local trustees office and ask them what else you can do.

 

[thepreludedude]

tigger22472: thanks again. this is all new to me. i feel so helpless i found where the welfare services building is, so i am off to there soon. forgive me for being stupid about this, but where do i find the trustee? what does the trustee do? tia.

 

[tigger22472]

look in your phone book in the section where the state and county numbers are or look under XXXXXX County Trustees office. They also help get some of your bills paid if needed.

 

[thepreludedude]

^thanks again tigger. i went down to the welfare services and to the trustees office. filled out some forms. they are suppose to call me to set up an appointment. i am going down to my ex-employer tomorrow to see what can be done about COBRA, etc.

been going around passing out my resume today and online.

i have to send a written letter to officially appeal my long term disability decision by 3/11. any pointers on what need to put into it? tia.

..you know..this really sucks

 

[tigger22472]

Is the doctor releasing you to work? If he's not you are wasting time in looking for work as no one is going to take you on as you will become a liability to them.. Contact your doctor or your local Social Security office to apply for disability.