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    #16
    Yikes!

    I came across this post and it really scares me because I am off work for a couple of months and am in the process of applying for LTD.

    The pain, fatigue and cognitive issues were severe and I just needed a break. I am terrified that I am going to be denied and cause financial strain on my husband.

    How long did the appeal take? Why were you initially denied? I was already feeling guilty and selfish for taking the time off right before the holidays.

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      #17
      Hi KevsLuv,

      Do you have a copy of your employees LTD policy? If not, get it ASAP. Definitions of eligibility, disability, and time frames can vary by policy. So you need to have the polucy.

      My employer's policy gave them 60 days to review the application for LTD. Once denied, I had 60 days to notify my intention of appeal. After appeal, the had 45 days to review, but could extend it another 30 days if they notified by writing prior to o the 45 day expiration.

      So it is really important to get the policy. Most policies have a 2 year provision in their definition of disability. The first 2 years, it is usually unable to do your job and after 2 years, switches to any occupation, doesn't matter what it is or what it pays. Mine also has a provision that if disabled due to depression and/or anxiety, after 2 years, can't collect LTD.

      So mine changes definition in Feb, 2016 so they are reviewing my medical records again since initial filing to determine if will continue LTD benefit or if denying. My lawyer told me it is really hard to get a denial at the 2 year reversed on appeal.

      Most LTD carriers require you file for SSDI and have a provision that they are entitled to offset the SSDI benefit from what they pay. And just because Social Security was awarded, it does not mean LTD will be. They don't have to honor the same definition of disability. So as an example, if you were collecting 1500 from LTD, and SSDI awarded at 1000, then LTD carrier only has to pay 500.

      I am not trying to scare you, but you do need to know what you may encounter. Make sure your doctors, especially neurologist, support your. filing for LTD and SSDI. Get copies of your medical records and review to see if accurate and will support your need for disability. It is a full time job in itself.

      Good luck.
      Kathy
      DX 01/06, currently on Tysabri

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        #18
        Thanks

        I will request a copy of the policy tomorrow. It's discouraging because they are quick to pay people who go out on maternity or stress leave. I don't see how depression or anxiety are considered more "disabled" than MS.

        I am only going to be off for about 8 weeks and am only asking for pay for 5 of those weeks because I am using sick time for the other 3 weeks.

        My neuro definitely supports my filing for LTD as she is the one who suggested I take a leave of absence. Thanks for the advice!

        I have paid for this insurance for over 5 years--it sucks that I have to jump thru so many hoops to actually use it.

        Comment


          #19
          Originally posted by KevsLuv View Post
          I will request a copy of the policy tomorrow. It's discouraging because they are quick to pay people who go out on maternity or stress leave. I don't see how depression or anxiety are considered more "disabled" than MS.

          I am only going to be off for about 8 weeks and am only asking for pay for 5 of those weeks because I am using sick time for the other 3 weeks.

          My neuro definitely supports my filing for LTD as she is the one who suggested I take a leave of absence. Thanks for the advice!

          I have paid for this insurance for over 5 years--it sucks that I have to jump thru so many hoops to actually use it.
          Actually it may not be too bad if you have a return to work date. Mine was open ended,with neuro opinion that I most likely would not return to work.

          Actually, anxiety/depression in my policy was excluded from benefits after two years, unless in an institution.

          I hope since yours is temporary, it will be easier. Also, I had a separate independent policy I paid. They awarded right away based on doctor recommendation. It was my employer based LTD, in which they paid the premium that I had trouble.

          Good luck. Let me know how you make out.
          Kathy
          DX 01/06, currently on Tysabri

          Comment


            #20
            Hi KevsLuv:
            Originally posted by KevsLuv View Post
            I am only going to be off for about 8 weeks and am only asking for pay for 5 of those weeks because I am using sick time for the other 3 weeks.
            It sounds like you somehow got the wrong idea about what LTD is. Eight weeks is short-term disability (STD), not long term. Depending on the plan, STD can run for 6 months or up to a year. LTD is not intended for disability leaves shorter than that, and you won't be approved for LTD for a short-term leave.

            Some LTD plans require that a person first go on STD and exhaust all of it before being eligible for LTD. And that takes months, possibly more than a year, with reasonable assurance that the person will be disabled for a longer period of time than that. An 8-week leave doesn't fit that category.

            Originally posted by KevsLuv View Post
            It's discouraging because they are quick to pay people who go out on maternity or stress leave. I don't see how depression or anxiety are considered more "disabled" than MS.
            It sounds like "they" are quick to pay on maternity or stress leave because those are generally short-term leaves (less than 1 year and often only a few months), not long term.

            Originally posted by KevsLuv View Post
            My neuro definitely supports my filing for LTD as she is the one who suggested I take a leave of absence.
            Did your neuro say LTD specifically? Or did she just suggest "a leave of absence" and you interpreted that as meaning LTD?

            Again, an 8-week leaved is STD, not LTD, so be sure you know what you're asking for before you fill out any paperwork for disability and with your HR department. For an 8-week leave, you should apply for STD.

            Comment


              #21
              Approved!

              I have been worried and stressed to the max about the pending LTD claim. My husband got the mail yesterday and there he found 2 checKS from LTD! That takes a major load off.

              I'm only off for 4 more weeks so I am going to finally breathe and try to relax before heading back to my very stressful job.

              Comment


                #22
                Originally posted by KevsLuv View Post
                I have been worried and stressed to the max about the pending LTD claim. My husband got the mail yesterday and there he found 2 checKS from LTD! That takes a major load off.

                I'm only off for 4 more weeks so I am going to finally breathe and try to relax before heading back to my very stressful job.
                Congratulations! Glad to hear.
                Kathy
                DX 01/06, currently on Tysabri

                Comment


                  #23
                  Originally posted by jreagan70 View Post
                  Hi KevsLuv:
                  Again, an 8-week leaved is STD, not LTD, so be sure you know what you're asking for before you fill out any paperwork for disability and with your HR department. For an 8-week leave, you should apply for STD.
                  I totally missed your comment when I last posted. I wonder if there is a difference in how each employer or insurance company defines it.

                  HR explained to me that our sick leave is our built in STD. Our LTD is used for anything over 2 weeks once our sick leave pays out.

                  So though I only requested 8 weeks, the same insurance company/policy would pay if I was off for a year. If I become permanently disabled before I have accumulated 284 sick leave, they will pay me for 2 years.

                  If I have over 284 sick hours, they will pay for life (or until retirement?) would reduce the income based on the amount of SSDI I'd get.

                  Comment


                    #24
                    Yes, it can be different per employer. Since STD and LTD are benefits and not every employer offers them, the company can structure how they want.

                    I believe most companies are structured more like jreagan described, mine was. My STD was 6 months and the amount paid depends on length of employment and how long out (0%-100%). This was adminstered by an outside company, but payments were self insured and paid by employer. LTD was then from 6 months on, and all eligible employees received same %, set at 60%. This is insured through Aetna in my case, and they manage claims and pay benefits. My employer is not involved.

                    The other big differentiator was that for STD, they guaranteed your same position back. Legally, for FMLA, they only have to hold it 12 weeks, but they hold it an additional 3 months. For LTD, no guarantee. When return, if my job is open, then mine. If not, and another job is, then mine. But if no job open, out of luck.

                    Again, aside from FMLA, the rest are policies set by employer. It is one of the things most people never understand or research until they need it.
                    Kathy
                    DX 01/06, currently on Tysabri

                    Comment


                      #25
                      Last month, SSDI approved.

                      Found out today, my LTD ws appoved following review at 2 year mark. I was fortunate that the change in disability definition at 2 year mark in my group policy was any occupation, but had clause that had to pay 80% of pre-disability disability earnings.

                      I feel so relieved and fortunate. It had relieved so much stress.

                      Thanks for letting me shout it from the mountaintop!
                      Kathy
                      DX 01/06, currently on Tysabri

                      Comment


                        #26
                        So happy for you!!!!

                        Kathy, I am so very happy for you - greatest news ever!!!
                        Diagnosed RRMS 4/7/15, symptoms for 8 months prior. Copaxone 4/27/15

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                          #27
                          Originally posted by Boymom123 View Post
                          Kathy, I am so very happy for you - greatest news ever!!!
                          Thank you so much Boymom123! It is a good start to the year.
                          Kathy
                          DX 01/06, currently on Tysabri

                          Comment


                            #28
                            Originally posted by pennstater View Post
                            Last month, SSDI approved.

                            Found out today, my LTD ws appoved following review at 2 year mark. I was fortunate that the change in disability definition at 2 year mark in my group policy was any occupation, but had clause that had to pay 80% of pre-disability disability earnings.

                            I feel so relieved and fortunate. It had relieved so much stress.

                            Thanks for letting me shout it from the mountaintop!
                            Congrats Kathy! You can now take a deep breath (take it right before you shout from that virtual mountaintop)
                            1st sx '89 Dx '99 w/RRMS - SP since 2010
                            Administrator Message Boards/Moderator

                            Comment


                              #29
                              Originally posted by Seasha View Post
                              Congrats Kathy! You can now take a deep breath (take it right before you shout from that virtual mountaintop)
                              Thanks Seasha! You gave me a great idea. Have to drive to a mountaintop, but would be worth it to shout it out!
                              Kathy
                              DX 01/06, currently on Tysabri

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