Termination of disability insurance

[Ksajb]

What is the name of your state? SC

My husband has been on long term disability for a year now due to bad knees (needs total knee replacement but is considered too young at 43). He has been denied SS and has no training in anything other than the vending business which is what the dr. will not release him to continue doing. He's now enrolled in college to pursue gainful employment in another field upon graduation.

His insurance co. is 100% positive they will cut him off in a year due to the 'any occupation' clause which applies after 24 months. They've offered him a 'buy-out' for the remainder of his disability period (1 year). We've pretty much decided not to take it because his condition will inevitably be worse - there is no way it will improve without surgery.

Here are my questions:

1. Any good reasons to accept the buy out?

2. Is there any chance we could win if we got a lawyer involved? Because husband is in school, it makes a statement that he feels he can work at 'some' occupation in the future.

3. If he gets cut off, does that make him no longer disabled? If that is the case, he and our daughter may not qualify for financial aid (he doesn't now due to income). I understand that there is an increased chance of receiving financial aid if he's disabled.

4. Voc rehab has done nothing for us. What other resources are out there that we can look into?

Thank you for your input!

karen

 

[TxMsLady]

Kasjb,

I can't help you with the "buy out" question, but I do want to encourage your husband to reapply for SS Disability. I've been in the field assisting clients with SSI/SSDI apps for 10 yrs now...it's not unusual for the first application to be denied. If he is still within his 60 day appeal period, tell your husband to file an appeal (Reconsideration) and list any additional medical info. he may have acquired since the original application was submitted. If he's not within the 60 days, he can reapply. If he's denied again, tell him to not hesitate to appeal the decision. What happens is the Disability Report will be assigned to another Disability Examiner at the Disability Determination Service. If THAT'S denied, request a hearing!! It takes awhile for a hearing to be scheduled (about a year), but your husband has nothing to lose and something to gain if he is approved. And, if approved, the SSA usually goes back to the date of the original filing in the way of back pay. Sometimes, it just takes being before a judge to plead your case. Best wishes to you and I hope things get better soon. Hang in there!