Need advice on Long Term Disability appeal claim

Discussion in 'Fibromyalgia Main Forum' started by wildflowers2, Apr 7, 2006.

  1. wildflowers2

    wildflowers2 New Member

    Hi, I have appealed my long term disability claim.
    So, today I get a phone call from them trying to pin me down as to WHY I cant work. I was vauge with my answers.
    Cant trust those snakes anyway.

    Then they asked what are My restrictions and limataions by my doctor. I said call him. They also wanted to know IF I was going to file another claim with workmans comp.
    I said I didnt know. They asked IF my lawyer was handling my workers comp. I said no. They asked about social security and IF I heard anything and I said no.

    And was my sickness due to depression? I said call the doctor....

    And was I being treated for my depression I said yes.

    I smell a rat.

    So, what do I say to these clowns? I taped the converstion.

    They also asked me What I did all day. I said I got up
    sick had about 20 minutes to do something and was back in bed sick.

    thanks.....




  2. Dara

    Dara New Member

    They were the worse people I had to deal with when I filed for my SSD.

    After I was approved by SSD, then they finally approved it. Even though mine was not for depression I still only got it for 24 months.

    It sounded to me as though Skeesix thought that if it was not for depression that the disabilty benefits would continue. Does anyone know if this is correct? The endorsement page of my policy did say 24 months coverage.

    Dara
  3. jakeg

    jakeg New Member

    If your policy has FM listed in the limitations section as only being paid for 2 years that is all they will pay regardless of the length of time you are disabled by this DD.

    My policy states 2 yrs for fibro along with multiple other conditions that are considered self reported. If you or your employer have agreed to the terms of the policy at it's inception then there is no way around this.

    The policy is a legal binding contract between the provider of the policy and who ever pays for the policy.

    Jake
  4. suzetal

    suzetal New Member

    All they want to pay me for is depression and on the policy thats only 2 yrs.

    My shrink in his letter to them told them that my depression was caused by my FM and was secondary condition to my FM.

    But there doctor who never saw me or talked to me stated that I did not have FM.That was in her first letter in her 2nd she said that the arthritis foundation did not recognize FM .And that there was nothing wrong with me physically just mentally.Ticked me off.

    They did pay me on FM in the first year and did recognize it as a disability.

    I have a GREAT case and am confident I will win.And when I do I already have a news channel that is going to do a story on how Ins. Co. has treated me and the money I have lost in my fight.I am going to make it public so others don't fall for there scams .Also they want most people to give up the fight well I wont.I know I'm right .

    We are ,were hard working people and did not become sick cause we wanted to .I am a high school dropout and worked very hard to get were I was.I had just gotten a promotion to management and had a year of schooling in there management program.

    I was 50 when all this happened .And the best part is due to my experience in the job I got higher scores than some of the collage grads.I was proud of myself.

    Than BAM got sick.........All down hill no longer work at all but do hope someday to go back.

    Did win SSD but still going to fight the ins.Co Oh and I don't want the monthly payment settlement nope my attorneys have been instructed to get a full one time settlement.

    I do not need to deal with those ignorant unbelievers for 10 yrs no way...

    This is part of my story and I'm sticking to it LOL.

    Hope all goes well for you .Be careful get all your records .DO NOT GIVE UP.The good guys always win.Thats us.

    Sue
  5. wildflowers2

    wildflowers2 New Member

    First..thanks for the input.

    I have a lawyer for social security disability.

    I dont have one for the long term disability appeal.
    When I went to one he said since I had ALL the paper work
    new medical findings I should file. As he gets 250.00/hr and needed 750.00 retainer. So, I am hoping I can
    win this myself.

    I WILL WIN!!!! Good ideas though on instead of phone calls put it in writing!!!

    I will take more information from people

    thanks
  6. obrnlc

    obrnlc New Member

    hi flowers, i am dealing with the infamous "U" for my ltd company, working on a second appeal and sent a 12-15 page letter--our illness just cannot be summed up in a phone call or one of there "forms". Have had to get an attorney this time, but feel free to contact me for YEARS of there dirty dealings, I have my surveillance tapes, all phone calls, all correspondence, etc. and can tell you ANYTHING you say will be twisted against you! If you don't have the "self-reporting illness" clause of 2 years, they will try to get rid of you on the mental health issue after 2 years, so be so careful of anything you say! And hurray for you for thinking to tape the conversation, i didn't realize for awhile how important that was! Document EVERYTHING you say to them, and here's another tip----
    Don't ever say never (say I rarely, or it is very difficult for me..... instead of I can't or don't) or they will use that against you if they have to pay a private investigator 3 times your annual benefits to catch you doing something, even once, that you said you COULDN'T do!!! Good luck and hopefully we will talk again--L