What is the name of your state (only U.S. law)? PA
When I signed up for my companies STD plan I had a pre-existing condition which I spoke at length with the rep about how and when I could have surgery and get it paid for. He recommended having my paperwork in as early as possible so the claim would be approved prior to my surgery, and to have my doctor agree to write a letter stating the reason for my surgery was a new condition and I could do it before the companies 6 month waiting period. My doctor agreed and I scheduled surgery 3 months into my coverage. I turned all of my paperwork in to our human resources person a month before my surgery. She made no comment to me that she did not plan to turn it in until the day of my surgery. The day prior to my surgery I found it odd that I did not hear anything from the STD company and so I made some phone calls and discovered she had not turned in any of my paperwork. I began to file my claim myself and had my supervisor speak to her where she stated "STD paperwork could not be filed until I actually stopped working" which was completely inaccurate. As anticipated no 4 weeks post surgery my claim is still being investigated because of my pre-existing conditions and I am therefore not receiving any compensation.
So my questions are do I have any recourse against either the human resources person who has delayed my payment, or any ability to get payment from my company in place of STD because it doesn't seem fair that I may have to go 6-8 weeks without payment because this woman did not know how to do her job. My second question is that if this claim is for some reason denied I would have waited to have the surgery, which I now no longer have the option to do so do I have to take a loss for the 12 + weeks of work that I will be out??
When I signed up for my companies STD plan I had a pre-existing condition which I spoke at length with the rep about how and when I could have surgery and get it paid for. He recommended having my paperwork in as early as possible so the claim would be approved prior to my surgery, and to have my doctor agree to write a letter stating the reason for my surgery was a new condition and I could do it before the companies 6 month waiting period. My doctor agreed and I scheduled surgery 3 months into my coverage. I turned all of my paperwork in to our human resources person a month before my surgery. She made no comment to me that she did not plan to turn it in until the day of my surgery. The day prior to my surgery I found it odd that I did not hear anything from the STD company and so I made some phone calls and discovered she had not turned in any of my paperwork. I began to file my claim myself and had my supervisor speak to her where she stated "STD paperwork could not be filed until I actually stopped working" which was completely inaccurate. As anticipated no 4 weeks post surgery my claim is still being investigated because of my pre-existing conditions and I am therefore not receiving any compensation.
So my questions are do I have any recourse against either the human resources person who has delayed my payment, or any ability to get payment from my company in place of STD because it doesn't seem fair that I may have to go 6-8 weeks without payment because this woman did not know how to do her job. My second question is that if this claim is for some reason denied I would have waited to have the surgery, which I now no longer have the option to do so do I have to take a loss for the 12 + weeks of work that I will be out??