long term disability

Discussion in 'Fibromyalgia Main Forum' started by poodlemommy, Feb 19, 2003.

  1. poodlemommy

    poodlemommy New Member

    HI gang. I know I have posted this question on others messages but I thought best to post by itself as I really would like some feed back. For those of you who have been approved for Long term disability with your employee benefits, I have a question. Most contracts cover you up to 2 years for not being able to do your job then up to 65 if you cant do any job. That is how my contract reads. It also states that the job they expect me to go to must pay what I am getting on disability or I have the right to not take it. My question is what has happened to those of you after the 2 year mark. Did you have to fight all over again . Do they keep paying you while you prove if you can or cant work. Any feed back would really be appreciated. I am new at this and like to be prepared. I just got approved and started recieving benefits in Jan so I was wondering what happens when that time comes. Thanks so much for listening to me ramble and posting this more than once. Have a good evening
    poodlemum
  2. Mom3

    Mom3 New Member

    Hi and welcome to this site, I am Canadian too and I also go on the arthritis site and I have seen you there too. I don't always post though been having a bad flare up. I am presently on ltd and I also have sunlife. My term is 3 years of not capable of doing my former job, I had to give it up because of my fibro I did go back doing another light job and they were paying me the difference of hours worked. Yes I believe you will have to get reassessed at the 2 year mark and it will be harder to get approved for any occupation clause from your carrier. Be prepared and make sure you will seek specialists who will support you. I would start a journal so they can see what difficulties you are having. Also depending on your age it could be more difficult they will probably advise you to apply for cpp. Mom3
  3. poodlemommy

    poodlemommy New Member

    thanks for responding. I did apply for Government disability a month ago but no response yet. I am continuing to see 2 specialists and my family doctor on a regular basis. I do journal every day. It does help. Did you have a hard time getting your disability. It took me almost a year.
    love poodlemum
  4. Katrina

    Katrina New Member

    Poodlemommy- I was receiving LTD benefits through my employee benefits policy with a diagnosis of Fibro. Naiive as I was...I thought I was all set, after all - I had all the medical documentation and the support of my Human Resources Dept.(in fact, they encouraged me to apply for LTD, as it was very clear I was quite ill.) At the 2 year mark, my benefits were discontinued. I too, have the type of policy that covers two years unable to do my job and then after that, until age 65 for any other job, as I would be unable to do ANY job on a consistent basis for gainful employment. The "plan" also contains the clause regarding this "other job" would need to pay me at least as much as my disablilty monthly benefits, which is in excess of $2000. If this "other job" paid less, the difference would be paid by the insurance company. Well, as I said, naiive was I. They terminated my benefits based on a diagnosis of Mental Health Issue, for which the policy has a two-year limit. No mention of Fibro. Denied based on the fact that they determined my diagnosis was Depression. I have never been diagnosed with depression, nor have I been treated for depression with medication or otherwise. The basis for denial was very wrong and there was no medical evidence of such. When I joined some message boards, I discovered, as so many do, that they do this "because they can." So - now this clause regarding not having to accept a lower paying position is useless, as they have denied benefits in full. Yes, their reason was wrong. But I had to appeal. And this begins a long, stressful, exhausting story.
    I am happy you had the incite to ask about this now, so you can do some research and be ready to deal with this if it occurs. I was absolutely blown away when I received the letter notifying me of the discontinuation, I truly thought it was an error. You are fortunate that you have this time to research, keep detailed records, and perhaps save some of your monthly benefit, just in case. I would not wish what I have gone through regarding this issue on anyone. Don't misunderstand, I am clearly not in the minority here. I do not know a single person where their plan contains a two-year limit that this has not happened to. I wish you the best, I see you fought for it for 8 months, and you deserve it. And you deserve to have it continue as long as you are unable to work. Unfortunately, we have to prove we can't work, they do not have to prove their erroneous diagnosis. Thinking of you, Katrina
  5. poodlemommy

    poodlemommy New Member

    thanks so much for your post. That is what I suspected would happen and yes I am going to save like crazy. How long has it been since they cut you off? Have you been accepted yet? Do you have a lawyer? Did you apply for the Government disability? I did so I figure I have time while being paid by my insurance company to try to secure the Goverment pension. God knows I've pain into it for 28 years. What a system we have. It is so unfair , yet the scammers sit back get paid, order pizza, drink beer and laugh all the way to the bank. Thanks again for replying , I needed to hear that.
    love poodlemum
  6. Carlacat

    Carlacat New Member

    to try and get benefits. This is so crazy..seems like it takes forever. I have my employer behing me so maybe that will help speed up the process.
    Carla

    Poodlmommy.....When did you apply and how long did it take you to get benefits from long term??
  7. lea

    lea Member

    You may want want to join Disinissues.
    You can do a google search to find and join it.
    best,
    lea
  8. LindaLoonyTunes

    LindaLoonyTunes New Member

    that a vast majority of people collecting SSI are there because "they are mentally unable to work!". This is due to juvenile abuse of drugs, or alcoholism. All they have to do is prove a history of this and they get it! That is the big thing now and numerous people collect ssi and work under the table because they refuse to give up their benefits. Then when they think they are gonna be reviewed they check into the VA or some other hospital in order to continue their diagnosis of "mentally unable to work". I have (im ashamed to say) 2 brother who collect in this manner and many of their friends do the same. They have been collecting for years! It pisses me off because I have a 20 inch rod in my back from scoliosis surgery, have had a hip replacement and suffer severely from FM! I got laid off on Thursday so I will collect unemployment for awhile. Thank god I have been making a decent wage over the past few years so Unemployment will at least be a decent weekly amount. I have applied for 2 goverment jobs in my area (sSI as a phone intake person and the coast guard needs a secretary) Hopefully one of them will come through. My focus now is JOB SECURITY. I am sick of getting the shaft!
  9. poodlemommy

    poodlemommy New Member

    Hi thanks everyone for your posts. Just to reply to your questions carlakat. I have fibromyalgia and had a car accident Feb 25 2002. I went off work at that time and went on my sick benfits. I could have taken payment from my auto insurance but it was less money . I knew my sick benefits were going to run out in June so May 7th 2002 I applied for LTD. When my sick time ran out my auto insurance paid me but they cut me off in Nov 2002. So then I applied for umemployemnt sick benefits . I was allowed to collect for 15 weeks so that carried me until I got paid by my Long term disability which was just recently. So I applied May 7,2002 and was approved Jan 2003.Took almost 9 months. In November they sent me for a functional abilities test which I could not complete due to pain so the evaluator said he could not give a fair assesement. Then Dec they sent me to an orthapedic surgeon who's report stated I have a classic case of fibromyalgia. He felt I was honest and not exaggerating my symptoms. He was the doctor for the insurance company so I was please to see he was honest. Any how after they got his report they approved me. Dont know what is going to happen in 2 years though if I cant work. Time to save some money and get the house paid off just in case. Good luck to any of you out there trying. It sure is stressfull. I worked for the same company for almost 27 years and they did not support me at all in this. They just left me to deal with my LTD insurance on my own. That hurt , but I am just a number in the business world.
    have a great afternoon
    love poodlemum
  10. Katrina

    Katrina New Member

    In response to your questions - They cut me off in November 2001, which was earlier than the two-year mark. I was advised (by my poorly-functioning SSDI atty,whom I signed a contract with and later when it was time to act, HE was "impaired" perhaps by drugs or alcohol) to retain a particular atty. and appealed. After spending $20,000.00, my appeal was denied. But, crazy as it sounds, the insurance co. paid me through March 2002, which WAS the 2 year time limit for my job. They used that "mental health" diagnosis at this time.
    I have been receiving SSDI since December 2001 - so they deducted the amt. paid each month by SSDI for all the months in which I was paid by both SSDI and LTD. I receive more from SSDI. The plan dictates that I will not receive more than the initial amount of my monthly LTD. Therefore, each month SSDI amt. is to be deducted from the LTD amt. As far as appealing the denial, I could not justify spending any more for this atty. I appealed myself (which was very difficult and stressful) seven months ago, and they are "reviewing my file." So, I am receiving LTD payments a month at a time, as no official decision has been made yet.
    Boy - I understand what you mean about the scammers, I know of a few. It is unfair for certain. At least I can live with myself, I could never "work the system" as those you mention eating pizza, etc.
    I read you are in Canada, so I am sure there are some differences as far as the Gov't disability works. I must tell you, our stories are so similar; the years paid into the Gov't, Fibro, the LTD and the amount.
    Another note re: Lea 's message to you - please take her advice about disinissues, this has been invaluable to me in dealing with all of this.
    Again, I am so pleased you are aware of these possibilities should they arise. Perhaps you will be fortunate enough to be treated as well as your "scammers," although I doubt considering your Fibro, that you will "sit back get paid, order pizza, drink beer and laugh all the way to the bank." Unfortunately, those of us with disabling FM do no have the choice as to which days we can sit back and eat pizza. This DD has a mind of it's own. All my best thoughts and wishes to you. Katrina.
  11. poodlemommy

    poodlemommy New Member

    Hey Katrina thanks for a great post. From what I understand you LTD is still paying you after the 2 year period while they are investigating wether or not you still qualify. Is that correct. So am I safe in assuming I will not be cut off cold in 2 years and then left to try to prove my claim again. Just want to make sure I got this right. Thanks again. You've been a great support. All of you have . thanks guys.
    love poodlemum
  12. Mom3

    Mom3 New Member

    Hi I also got fibro my car accident Oct.2000, and the same with me I was diagnosed by the insurance doctor who thank goodness for his honesty I was able to collect from my insurance company and then my ltd carrier had to kick in. I have been on job accommodation but my employer refused to accommodate me so now I am faced with a grievance and fighting with them. Under the law of human rights your employer should accommodate a person with a disability. I was only capable of working 4 hours a day. I have 3 children and working to me is so important even though I feel very fatigued after the hours that I worked. I am now not working and waiting to see the outcome of this fight. I have a lawyer who will help me fight this, although I made it clear I don't want to work in the same department I am so distraught that my manager would not accommodate me any longer my respect for him is gone. I had such a bad flare up from all of this. I had been doing so well before my car accident and now i have had to learn to pace myself, which I find very frustrating. I hope you have a lawyer helping you thru this. Mom3
  13. lynnibw

    lynnibw New Member

    Hi ,,I noticed your posts,,and felt I had to reply,,,I have been on disability since 1999 with Fibro,,,thru Sunlife too,,was approved for CPP Disability too,,,had a battle in the beginning with both,,,but with many tests,,,and specialists documentation,,,I was able to collect..Now after this many years,,the insurance company wants new evidence,,that I am still unable to work,,,they sent me for a functional evaluation test,,,which lasted 41/2 hours..it was cruel punishment for someone with Fibro....it was exhausting,,and every part of my body ached when I left,,,it was repetitive motion testing..and strength testing,,,,it was very stressful...then three days later they send me to a specialist who has nothing to do with FM...he was an old retired,,,orthopedic surgeon,,,who doesn't believe in FM...he told me that I was depressed and that I should see a psychiatrist, and that I should join a fitness centre,,,believe me,,after coming away from that appointment,,I was depressed,,,crying,,,and wondering why I have to go through this all over again,,,,so I just wanted to let you know,,,that insurance companies will never leave you alone,,,because it is their goal to stop paying you....I am not sure what I am going to do once I receive a letter from them,,,but I am sure that it will be another long exhaustive process,,that I am not sure I can go through again,,,,if anyone has any suggestions,,from Canada ,,please help...I have a person helping me as far as legallities go...and I will contact him tomorrow,,,to ask his opinion...but I sure would like input from anyone here...so...I hope I didn't upset you ,,,but reality is ,,,we always will have to prove that we are in pain and that is what happens....
  14. poodlemommy

    poodlemommy New Member

    to mom3 . Yes I do have a lawyer. I cant work at all. Are you still collecting your LTD. That is so unfair how your employer is treating you. Its not worth it to go back to work. My doctor told my insurance that I cannot go on a trial work program due to pain and fatigue. Have a great day.
    poodlemum
  15. poodlemommy

    poodlemommy New Member

    To Linnabwy: I new it was always going to be a fight. I am sorry you had to go through all that. I have already gone through all those tests to get approved. Did you have to do the same before you were approved. At least from what I have seen Sunlife seems to accept people more than other companies. I wish you all the luck. Please post us on the outcome. I would really like to know how you make out after your reports come in. My prayers will be with you.
    love poodlemum

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