Short term/long term disability denial

Discussion in 'Fibromyalgia Main Forum' started by footballmom, Jul 11, 2008.

  1. footballmom

    footballmom New Member

    I've been off of work since Feb. because of FMS,

    rhematoid, osteo arthritis, plus a host of other problems.
    I'm collecting std with the intent to go to ltd and apply
    for ssdi. I see my doctor regularly and he is very good
    about filling out any paperwork that is needed for my
    insurance company. (Lincoln Financial)My short term
    disability would have run out the middle of August then in a perfect world I would be able to collect my long term.

    Yesterday I received a call from Lincoln tellin me that my std claim has been denied because there isn't enough proof that I can't work. The lady that called was a real gem. First she calls me first thing in the morning so my brain isn't really working yet, tehn she proceeds to tell me that there is nothing wrong with me and there is no reason that I can't work. I don't have to bend, lift stand all day etc and the fact that I take all the meds doesn't mean anything. (my doctor put in his letter to them that because of all the meds that I'm on that I can't interact with coworkes and that they make me tired etc) she said many people take meds and can still work.

    Needless to say I'm ticked. So I called work and gave them my two cents. becasue I worked in HR and payroll I know the way we pay std. It's a self funded insurance. Meaning tht my employer contracted lincoln to monitor std claims and that my employer can pay any claim they want to. So I told them that they coulkd continue paying my claim until I can get this straightened out. They of course are refusing. They said that Lincoln said I can work. So I came back at them and said, fine. I'll be in on Monday. Knowing full well that my job has already been filled because my FMLA has run out and they aren't required to hold my job.

    They called me back late yesterday afternoon and told me that there is no work for me (I knew this) so I told them that either they have to pay me my STD or they have to fire me. I will not quit. If they fire me then I want to be able to collect unemployment (their doctor said I'm fit to work so I should be eligble) They said they will get back to me on Monday.

    Here's the question. Do I force their hand and make them fire me or do I try and fight Lincoln for my std/ltd? another question....have you ever heard of insurance companies "spying" on you during the std phase? The reason I ask is last week I walked out to my mailbox and as I was walking out I saw a white car sitting near the end of my driveway. As I started walking the driver took off. It looked as though he was talking on a walkie talkie or CB kind of device. At the time I thought it was really odd but brushed it aside, now I wonder if someone was watching me. It's not that they would have seen me do much because I don't do more that 15 20 minutes of stuff a day outside and that's on my good days., but don't you think that was strange?

    Thanks for letting me rant. I would have yesterday but I was so upset. My blood pressure was through the roof and I ahd a terrible headache. I think from the high blood pressure.

  2. CKater

    CKater New Member

    Jesus's bad enough to be sick, now let's have the employer start harassing us right??? Your post has my blood pressure up. I have heard of insurance companies monitoring people on workers comp, but not on std. But I guess it would be possible. As for your employer...what about ADA? You do have a disability, and your doctor sounds like he's very supportive. I have a real supportive employer, thank god. Your story sounds like a nightmare you poor thing. Trying to deal with the DD and then this. Fight them!
  3. footballmom

    footballmom New Member

    My employer DID make reasonable accomodadtions for me but even after doing so, the fact remained that I couldn't keep up with my work and I wasn't reliable. I was dealing with peoples livlihoods, their pay and benefits and there were times that my mind just went blank I couldn't remember procedures and laws that I used to be able to remember like the back of my hand. Taking all kinds of meds for pain didn't help my fibrofog.

    I just get annoyed like everyone else because no one wants to take this "disease" seriously. And the girl that called me was an a**. Not to mention I think it is just a ploy because they never questioned my diagnosis before but 6 weeks before I'm to go on LTD BOOM.......they don't beleive I'm disabled.

    Now I'm stressed and I can just feel the flare coming on. I tried to relax by the pool this afternoon but it just isn't working. Of course my husbands out of town so I have no one to complain to. The kids don't quite get it and if I say anythign to my Mom she says oh I ache all over too. ARHHHHHHH

  4. marti_zavala

    marti_zavala Member

    I'm sure you know all this but sometimes when you are upset, it is hard to think straight.

    Get everything in writing.

    File for SSDI.

    Private insurance is notorious for playing these games. Also on LTD, they play a game around the two year mark (brain fog, I can't remember the ploy).

    It is time to file for SSDI. If your paper work is in order and with a helpful doctor, you could be approved on the record. I was approved in 60 days without a doctor or a lawyer on board.

    Take a deep breath and don't answer the phone in the morning. Use caution.

  5. landra

    landra New Member

    Yes, insurance companies do use surveilance (sp?) to dany you. There was recently a whole lot of entries on Disinissues about that. It is yahoo group like this and the address is in the Social Security info at the top of the page. They can give ideas about how to deal with the insurance co., and your employer. they also can give you information about applying for SSDI.

    I agree with Caladonia - get a lawyer!