When to walk away...

[gypsy]

I'm seriously thinking about my need to be on long term disability. This is so scary for me. My diagnosis only came six months ago and it's been a complete free fall from there. I've had continues flares. Both my hands are now completely numb. The fatigue and depression is debilitating. I've fallen and broke my ankle. Then had to have surgery to repair it. My bladder doesnt like me. And my head feels all jumbled up. The steroids, coupled with the immobility and weight gain after my fall, has spiked my blood sugar. And I just dont know if I will be able to keep up with work and three kids. I'm off on medical leave right now and I'm wondering if I should throw in the towel. I'm 32. I called Social Security and have some paperwork.

I did the numbers and between SS and my private LTD plan through work, my take home pay would be more if I stopped working. Go figure. My nuero says whenever I feel like I cant do it, he'll sign whatever he needs to. My pcp is a little more hesitant. I could be a happy stay at home mom. Idk how Social Security determines all this though. I know there is at least a 6 month waiting period and then if there is a denial, it could be a long time. Does anyone know the criteria I must meet to qualify? I cant assume that just because I have MS, i will be approved. But are they looking at symptoms, quality of life, job duties when making these determinations? Any insight would help.

[Scooter24]

Gypsy- just make sure your figures are correct, my LTD would pay the difference only between what I got from SS and what thier payments would be, not both combined, If they allow you to go on LTD from my understanding they will provide you assistance to get on SS at no charge to you so they can relief from paying you anything or at least only the difference. Also the LTD will start as soon as they approve you then SSI will kick in once approved or at the end of the waiting period. and you should get $ for the kids also at that point.
If your dr is backing you up on this and with your other problems it would seem you have a good chance but like this MS stuff we are all different. good luck with your decision.

[gypsy]

Thanks. I checked with the company that administers my LTD and the figure they gave me is based on my highest years earnings since my employment began. They said ths SS income would not impact it and I've always chosen to pre pay the taxes on it. I then asked the SS office and was told that my private LTD would not impact SSI, but it would impact Supplemental SI. And my children would qualify for an additional amount. It's such a huge step, but I seriously dont know if I can physically do my job anymore. I can barely stand at the sink long enough to do the dishes.

[MrsBones]

Idk how Social Security determines all this though. I know there is at least a 6 month waiting period and then if there is a denial, it could be a long time. Does anyone know the criteria I must meet to qualify? I cant assume that just because I have MS, i will be approved. But are they looking at symptoms, quality of life, job duties when making these determinations? Any insight would help.

What they look at is your prior work history, education, medical records and your answers on a questionnaire you'll complete regarding your day to day issues. They may also send you for testing or examination by their doctors.

If your medical records and answers show that you:
1) can't do the kind of work you had before
2) can't because of your disabilities obtain work in a
new field
3) have physical/mental/emotional disabilities that
require assistance or adaptations of a degree that
wouldn't be possible in your existing or prior
positions (for example: use of a mobility aid,
medical devices, daily naps, assistance of a
caregiver, etc) to manage daily activities or work
duties
4) do not have or can not get the education to go into
a line of work that would otherwise suit your abilities
( example: You didn't go to college and worked
primarily as a waitress. You are now unable to walk
and don't have the resources to go to college now or
maybe you didn't finish high school)
5) your condition isn't expected to change in one year or will result in death

then you may qualify.

It's important when completing all application forms and questionaires to complete them thoroughly and honestly with as much practical detail as possible. They won't care about a tingly foot, but if that foot prevents you from walking, that's what matters to them. Just explain how MS disables you.

I would recommend hiring either a lawyer or other disabilty advocate to help navigate the waters. Yes, they do have to be paid but it would come out of your first SSDI payment and they are limited by law as to how much they get.

My lawyer got a whopping $200. I told him he did too good of a job. I was approved in 2 months so I had very little back pay he could have laid claim to. I would gladly have paid more however, for the advice and peace of mind having someone do the truly stressful stuff for me. All I did was an online application, phone interview and complete the form on daily activities. He made sure the correct paperwork was done by my docs, that they were completed in time and received by SS.
He also helped with the LTD application and would have assisted with any children's applications, if I had any.

I have to say you are very lucky with your LTD. The vast majority do as Scooter24 said, and reduce your payments when you get SSDI. In fact, I never heard of one who didn't. Yay for you!

Good luck in making your decision.

[gypsy]

Thank you MrsBones! That info is extremely helpful. I did consider enlisting the help of a lawyer. Every time I see my nuero, he asks why I insist on pushing my limits. I think he's concerned about my progression. As I lay here typing this, my legs are tremoring. I think I'm going to go forward with the process and see where it takes me. I know I'm still relatively young, but I cant see pushing past the physical aspects of what I'm going through right now. It is a scary time for me and I need to truly focus on getting better. Nothing else.

[Scooter24]

gypsy- at this time you need to think about yourself and your family, what good will you be to your family if you keep working but are shot by the end of 8 hrs, what will you gain by working more. the program is there use it. Just try to stay active as much as possible if you do stop working it will make you feel better than just laying around.
It is a hard decision, I had no choice at the time as I was going to be laid off anyway. it just worked out for me.
FYI all I did was fill out the forms online and called my dr's and told them I was applying and was approved in 2 months, but they were very supportive of my applying and I am sure that helped when they had to do thier part of the paperwork.
Goo luck and keep us advised on your progress.

[MrsBones]

Thank you MrsBones! That info is extremely helpful. I did consider enlisting the help of a lawyer. Every time I see my nuero, he asks why I insist on pushing my limits. I think he's concerned about my progression. As I lay here typing this, my legs are tremoring. I think I'm going to go forward with the process and see where it takes me. I know I'm still relatively young, but I cant see pushing past the physical aspects of what I'm going through right now. It is a scary time for me and I need to truly focus on getting better. Nothing else.

You're welcome

It's a hard decision to make, though if you ask me, retiring when you're young is the way to go if you have the option. It stinks to be young and not really able to work, but giving yourself the break now while you have your youth will give you the opportunity to concentrate on taking care of yourself without the pressures, stress and physical battles working brings.

Lots of people don't use lawyers and have no problems. I chose to use one since I knew some other folks who have had to wait years and go through a few appeals to be approved. I decided to head off as many complications as possible by using a lawyer. I really think that his follow up calls and letters to both my docs and Social Security kept things running smoothly.

Another option you might look into is calling your local chapter of the NMSS. They have an infomational pack with good general advice on employment issues, including applying for disability : http://www.nationalmssociety.org/gov...ity/index.aspx

and as an example of other info they provide, here's the MS Works page regarding legal assistance from my chapter: http://www.nationalmssociety.org/cha...nce/index.aspx

[gypsy]

I had an appointment with my pcp today. It was a follow up for depression and we always talk about my ms. We went over my recent relapse(it's been bad) and before I said anything about SSI, she said to me "I dont want you working anymore". So the decision has been made. I guess between the parasthesia, tremors, fatigue, and balance issues, she's seriously concerned about my ability to function at work. My nuero was already on board. So this is it.

[dstreett57]

Gypsy,

I hate to be the bearer of bad news, but you cannot count on getting LTD for anymore than a couple of years if you get it at all. These programs are set up to benefit your employer, not you. The insurance company will do everything in it's considerable power to get out of paying you.

If you are awarded LTD after 2 years the contract changes to say you are considered disabled only if you cannot work any job. Or the mental health provision that states they will only pay for two years for disability CONTRIBUTED to by a mental health problem. (like depression) LTD through your work is covered under a special law called ERISA which makes it impossible to sue the insurance company or employer for any damages if they just refuse to pay you. For this reason many insurers simply don't pay even if they are well aware you are totally disabled.

Your only recourse is to sue them in federal court. Unless your disability award is above a certain amount a month no lawyer will take your case. This is the harsh reality for all of us with MS unable to work,. We thought we were covered, but we really are not. These insurers speed millions of dollars on congress and 'donations' to MS organizations, and for that reason you never see any of this important information until it is too late.

Do a google search on ERISA ~ Disability ~ Multiple Sclerosis and search through all the different court cases that come up. It is very important to know before you go out on disability all the tricks the insurance companies pull to be able to disqualify you. Try to avoid talking to them on the phone or filling out questionnaires from them until you have a basic understanding of all the issues. Good luck to you in these trying times in your life.

*****post broken into paragraphs for easier reading*****