Dealing with LTD insurance

Discussion in 'Fibromyalgia Main Forum' started by lin21, Feb 18, 2003.

  1. lin21

    lin21 New Member

    Hi all---

    Has anyone had experience dealing with an LTD insurance company.
    I am in the process of appealing and was wondering if anyone has had trouble collecting because of an FMS diagnosis.
    They called me recently to ask why I couldn't do my job since it was sedetary.

  2. Dara

    Dara New Member

    I can't believe I just did what I did. I typed you a really long reply and then I went to edit my mistakes and hit delete instead.

    I have been fighting with LTD since November 2001. The company I have has been terrible. They believe that Fibromyalgia consists of having "aches and pains" so therefore you can do sedentary work. Their "doctor" wrote that since my doctor thinks I am so sick then why hasn't he reported me to department of motor vehicles as an impaired driver. Every letter and report sent to them they turn everything around to fit what they want it to say. Everytime I get a denial letter I appeal it. I have one more letter from my FM specialist that I'm waiting for and then I'm sending them one last appeal registered mail. I have already typed the letter and told them that I am giving them 30 days to reverse their decision and if not, then I will be hiring legal counsel, and if that should occur I will be asking for more than my monthly benefit amount. I'm sure their big attorney's aren't the least bit worried about me but I'm to the point of frustration with them I think I would spend everything I have coming just to fight them for it. I absolutely hate those people, I told them they should be ashamed of themselves and that at least when I was able to work I could be proud of what I was doing.

    Let me know how your claim comes out. I'm curious if we have the same LTD carrier. I don't know if it's OK for me to post their name on here or not.

  3. lin21

    lin21 New Member


    Thanks so much for the insight.
    The reason I had to appeal at all was because of this witch in the orthopedic doctor's office. She purposely screwed up the original form stating that I was only being treated for post knee surgery, which wasn't the case. I was totally crippled with the FMS and they were searching for a diagnosis.
    Finally he referred me to a neurologist who diagnosed it and referred me to a rheumie. This has been going on since October but sent in a my appeal in January.
    I received a call from the carrier last week and I wish I didn't talk with them since I was having a bad day. But when they asked me why I couldn't work at my sedetary job I explained to them that I cannot even lift my arms without excrutiating pain and numbs in my limbs.
    I am really hoping that they do now drag this on as we cannot afford it.
    Since my rheumie only sent them a short letter stating that I had fibro and couldn't work because of this they said they will be contacting him for further information. I don't know what else they want since they had all the tests results from the neurologist. The only thing the rheumie did was more extensive blood work.
    This is a large insurance carrier and since they were in the limelight not too long ago with a nationwide suit I'm hoping this gets handled in a timely fashion or they will have another suit on their hands.
    Thanks again,
  4. attorney

    attorney New Member

    I am an attorney representing a disabled client attempting to collect on her disability policy with New York Life. If any other members have had difficulty collecting benefits from NYL, please contact me or respond to this board. Thank you. Sam Blair: 1-800-800-6629.
  5. poodlemommy

    poodlemommy New Member

    Hi Nink: I just got approved for my LTD last month after fighting about 8 months. I did it without a lawyer. I am really curious about the 2 years business. I was sent to a disability assesment of their choosing and an orthapedic surgeon of their choosing. The surgeon said I was a classic case of fibromyalgia and next thing I was approvded. I had letters from my family doctor and 2 specialists. I was granted it on the fibromyalgia. Do you think they will cut me off in 2 years and I will have to start all over proving I cant work. What is your experience or any one elses out there. My contract says 2 years my job and then until 65 any other job provided it pays what I am getting on disability. Well I'm getting over $2100 a month clear on disability so I dont see how they are going to expect a company to pay me that much when I cant work. Any feed back would be appreciated.
    love poodlemum
  6. poodlemommy

    poodlemommy New Member

    thanks for such a fast response Nink. It is funny you mention Allstate. They have been my employer for the last 26 years. I hate to admit now that I worked for an Insurance company. My benefits are with Sunlife. What I was asking is in my contract for LTD it states that I receive an income from them for 2 years as I cannot do my job. After 2 years they will pay me up to 65 if I cannot do any job, anywhere. I was wondering if when the 2 years is up will they cut me off saying they think I can do a different job and will I have to fight to prove I cant work at anything. The one clause that was in my favour was that it says they cannot expect me to go to a job that pays less than they are paying me. They pay me over $2000 a month so I dont see how I could be expected to be cut off and sell pencils for $100 a week. So my thinking is based on my income they will probably have to continue paying me after 2 years as I wont be able to find a job that pays that much with my health issues. You were saying about how you had to fight this in 1990. I am sure that was hell. I was reading the LTD guidlines on the internet for Sunlife and they recognise fibro as a disability. This is Canadian so dont know it that makes a difference. So based on this stuff I rambled on about, does it make sense now. Do you see what I was asking about the 2 year cutoff.
    thanks again
  7. poodlemommy

    poodlemommy New Member

    thanks so much for taking the time to read my post.