Confused - don't know what to do

[shellos8]

I've been thinking a lot lately about disability. I was diagnosed a little over 2 years ago. Right from the beginning I've had cognitive problems which are continuing to get worse. It's scary the things I forget or things I say or do. I'm working full time as a P&C Insurance Agent in a fast paced office. The mistakes I'm making are just not acceptable and I don't know what to do about it. My employer is aware of some of them but not all.

My employer also offers long term disability but no short term.

A few questions:

1. What should I be doing to build a possible case for disability?

2. Why does it take so long to get approved?

3. Would I be able to apply for disability while on long term disablity with my employer?

4. I'm a single mother and if I have to stop working for any amount of time before getting any benefits I won't make it. I don't know what to do.

Any advice, direction, whatever...would be so appreciated. Thank you.

[MSW1963]

With your dx just 2yr ago, you are at high risk of having your LTD claim denied for pre-existing condition.

There are several waiting periods in the typical Group LTD policy that must be met. If you were in an auto accident, for instance, your LTD would probably cover your claim, you would very likely recover and return to work with no further LTD benefit payments.

With a condition like MS or other 'dreaded diseases', LTD becomes much more complicated and the benefit payment period could last for the remainder of your life, hence the limitations for 'pre-existing conditions' in most Group LTD policies.

The typical waiting periods break down as follows:

1yr waiting period for 'eligibility', meaning you must be employed no less than a year to begin paying premiums=participating in LTD benefit plan

The second year typically is the elimination period, you are required to pay premiums, but no claims are honored in the first year of participation.

The third year claims are honored, but if your claim involves the dx of an illness, versus the auto accident example, typical Group LTD policies have a 2yr look back period. Insurer can look into your medical records for any indication, discussion in doc's notes, etc., that your MS presented within 2yrs from the policy effective date.

You should check your policy for the specific limitations, pre-existing exclusion, look back period, etc., because not every Group LTD policy is exactly the same, each can have variations on the limitations, pre-existing condition exclusion.

Once you have met the look back period in your Group LTD policy, your claim can't be denied based on pre-existing condition.

You will still be required to meet the policy's defination of 'disabled/disability'.

I wouldn't start building my case for disability, proof of MS dx, etc., until you have met all your LTD policy limitations.

If you are eligible, apply for FMLA, use the 12 weeks annual FMLA leave to help meet the limitations in your LTD policy. You will need your doc's support for FMLA, (=Family and Medical Leave Act), as a doc's signature is required on the FMLA request for leave form.

You are probably somewhat familiar with policy limitations as they apply to P&C. Read your LTD policy.

Best of luck and I hope this helps.

[MSW1963]

Most LTD policies require that you apply for SSDI within the first year. You do not have to be approved for SSDI, but typically there's a requirement in the policy that an application for SSDI be made within the first? year. If you are denied SSDI benefits, it has no impact on your LTD eligibility or benefit amount.

If approved for SSDI, your LTD payments are coordinated with the SSDI benefit amount so you do not collect more than a total of <60%? 65%?> of your pre-disability income. Your insurance company will collect amounts that may exceede the <60%? 65%?> maximum combined benefit.

Take care and good luck.