FMLA and LTD, SSI, SSD

[ree221]

Hello All,

I hope this finds you all as well as can be with no pain!

I disclosed to my employer because I have been taking off too much from work and my balance is getting bad when I walk I look drunk. Lol. Before anyone could start talking I had to disclose. They are very understanding but like any employer their bottom line is money and I realize that.

I was approved FMLA; my MS doc certified the forms. I did not request an accommodation yet although I need one. I'm afraid of rocking the boat although I know it is my right to ask.

I had a neuropsych that took 4 hours long and it uncovered deficits in all areas. They were surprised I've been working this long. Lol. Anyway, my main issues are cognitive, depression, extreme fatigue, migraines, vertigo and eye issues (Uveitis). I have many other things going on but those are the main things that interfere with my doing a good job or not being able to work some days. I do not have an official dx of MS yet; Probable MS and Demylinating Disease are the DX's he puts on my chart. I go for follow up MRI's but they have not showed changes since baseline. I meet all other criteria; everything else has been ruled out. Anyway, I digress...

Can someone tell me, briefly what comes first and what the steps are after FMLA? I am wondering if I have LTD (my employer offers it but I don't remember if I signed up. I called today but I'm waiting to hear back). I already went out on STD for Clinical Depression.

Some background info:

I have been with my employer 11 years and prior to that I worked for a straight 14 years with one employer; both of them are hospitals. I now work in upper management in an Analytic role. They already took away my Analytic duties due to my inability to perform them. When I returned from my leave for depression they basically demoted me to a position of a more clerical nature; although very stressful and I still do a lot of higher functioning duties but the main ones I was hired for I no longer do. I sense that I am not well liked because I also have social anxiety and I keep to myself. But that's beside the point although it does hurt my interpersonal relationships and makes it less likely they will make an accommodation when I ask for one.

What happens after FMLA runs out? What do I need to do, if anything? I'm so confused with reading all these posts. Can someone guide me in the right direction?

Thanks so much for any help anyone can give!

[MSW1963]

ree221, I'm not sure if you're considering accommodation, LTD or keeping both options in mind.

Based on your years of employment, demotion, and results of your neuropsych evaluation you may meet requirements for STD, LTD, retirement benefits offered by your employer, and possibly SSDI.

Have you discussed the possibility of applying for STD, LTD and SSDI with your MS doc? Your MS doc is required to sign insurance forms certifying you are disabled, with supporting dx. Having your MS doc's support is of primary importance.
Verify the status of your STD and LTD coverage.

Also consider how the loss of income you have already experienced will impact your future STD/LTD benefits. STD is usually calculated at approximately 75%? of current income, and LTD at about 60% of current income.

If you are concerned about exhausting the 12 weeks of annual FMLA protected leave, you will have few options available to you if the 12 weeks are used and you are unable to return work.

When FMLA protected leave is exhausted, the possibility of termination of employment seems the likely next step for employers. Former employees are typically not entitled to benefits such as STD and LTD. One exception is if the date of disability certified by your MS doc pre-dates the date of termination of employment.

You may already know that a definate MS dx is not necessary to qualify for STD, LTD, SSDI or employment based retirement benefits. A dx of Probable MS and Demylinating Disease with supporting dx of your disabiling sx by your MS doc are sufficient to meet disability requirements for most benefits.

If you feel you need the help of a disability attorney, contact your local chapter of the NMSS for a referral.

Best wishes comming your way.

[lstrl]

I can't add much to this, but you may be able to look at a paycheck stub to see if LTD is one of your deductions. If you're paying for it, it should be on there. Some companies give their employees that benefit for free, and in that case, I really don't know because I've always had to pay for it.

[ree221]

Thank you MSW and Lstrl!!

Very helpful information; I do have a few more questions. I hope you don't mind.

The way I understand it, FMLA entitles someone with a qualifying disability for 12 weeks unpaid leave per year. Doesn't it continue after that each year as long as you are still able to work?

I found out that my employer does not offer LTD but there is a sort of "abbreviated" LTD that is about 2 years which I thought LTD was also two years. Anyway, I was given the phone number for that disability insurance company but have not called yet. Please note that I already used STD when I was out on leave for Clinical Depression. I exhausted those benefits. So that means I don't get a continuation for STD right? Sorry, I am so naive with this stuff.

Also, of note; they did not reduce my salary when they initially took some job functions away. Now that I'm on FMLA I am at least safe in that regard which is why I pursued it.

I have not officially discussed STD, LTD, etc with my Neuro yet but he made a passing comment about work and if and when it "gets to be too much you let me know and I support you 100% and with insurance it won't be a fight". That was a huge sigh of relief. But it still doesn't ensure I won't get denied as 95% of applicants always do even when it is a cut and dry case of total disability. So, I am prepared for the fight. However, it is my intention to work as long as I possibly can. I DON'T WANT TO STOP WORKING. #1, I need my current level of income and #2, even though I have issues that have affected my work I am refusing to believe that I can't work anymore. I am still functioning and getting the job done, although not the original job anymore. If my condition worsens then I will probably have to face that reality and cross that bridge.

Your thoughts and feedback mean a lot. Thank you!

Ree

[MSW1963]

Ree, I'm an advocate for continuing to work, it's very important for current and future financial security and for the positive mental health aspects of living a productive and purposeful life.

FMLA is defined by federal regs as up to 12 weeks unpaid leave per year. The clock starts ticking for the 12 weeks with the date of the first leave taken. FMLA can be used incrementally over 12 months, or can be taken as a single 12 weeks LOA.

I recommend contacting the Department of Insurance in your state for info about STD regs involving possible limits on number of claims or max benefit payments under STD in your state.

Follow up with your STD insurance carrier about limitations involving multiple claims or life time maximums based on number of claims or maximum benefit payment amounts under the policy. State insurance regs and policy limitations determine if multiple STD claims will be honored.

STD policy limitations are typically not as restrictive as LTD because the financial exposure is limited to the time period benefits will be paid. For example a STD policy with a max of 6 months of coverage, versus LTD, which will potentially pay benefits until retirement age.

One fairly new trend in STD and LTD insurance is for employers to change insurance carriers without a grandfather clause for long term employees who have met policy limitations under a previous policy.

For example, employees with 25yrs employment history who met a 2yr claims waiting period decades ago under an existing policy based on effective date, would not meet the requirement under a replacement policy without a specific grandfather clause for employees with long employment history.

Any changes in coverage at your request can also effect the policy effective date. For example if you request an increase in the benefit amount from 75% to 85% or a specific dollar amount, the policy will usually have a new policy effective date, with new 2yr claim waiting period.

With employee benefits open enrollment in full swing, just a few things to keep in mind.

Personally, I never imagined retiring, ever. I loved working and miss it more than I can say. I was athletic and in good health, aside from decades of un-dx MS.

Hope this info helps and best of luck to you.

[ree221]

Ree, I'm an advocate for continuing to work, it's very important for current and future financial security and for the positive mental health aspects of living a productive and purposeful life.

As stated in my previous post I WANT to keep working as long as I can. The thought of not being able to scares the hell out of me.

FMLA is defined by federal regs as up to 12 weeks unpaid leave per year. The clock starts ticking for the 12 weeks with the date of the first leave taken. FMLA can be used incrementally over 12 months, or can be taken as a single 12 weeks LOA.

Ok, thanks for the clarification; I wasn't sure if after using it after one year if one would be eligible to keep using it. My employer requires re-certification every 6 months; which will be in January.

I recommend contacting the Department of Insurance in your state for info about STD regs involving possible limits on number of claims or max benefit payments under STD in your state.

Great idea. I will definitely do that!

Follow up with your STD insurance carrier about limitations involving multiple claims or life time maximums based on number of claims or maximum benefit payment amounts under the policy. State insurance regs and policy limitations determine if multiple STD claims will be honored.

Again, great idea.

STD policy limitations are typically not as restrictive as LTD because the financial exposure is limited to the time period benefits will be paid. For example a STD policy with a max of 6 months of coverage, versus LTD, which will potentially pay benefits until retirement age.

Yes, I realize that. I also realize most LTD applications are denied first time out even in cases where disability is cut and dry.

One fairly new trend in STD and LTD insurance is for employers to change insurance carriers without a grandfather clause for long term employees who have met policy limitations under a previous policy.

For example, employees with 25yrs employment history who met a 2yr claims waiting period decades ago under an existing policy based on effective date, would not meet the requirement under a replacement policy without a specific grandfather clause for employees with long employment history.

It's amazing how they invent loopholes to get away with paying claims. No grandfather clause for an long standing employee is despicable!

Any changes in coverage at your request can also effect the policy effective date. For example if you request an increase in the benefit amount from 75% to 85% or a specific dollar amount, the policy will usually have a new policy effective date, with new 2yr claim waiting period.

I have never requested any changes, thank goodness.

With employee benefits open enrollment in full swing, just a few things to keep in mind.

Personally, I never imagined retiring, ever. I loved working and miss it more than I can say. I was athletic and in good health, aside from decades of un-dx MS.

Sorry you are unable to work; I may be where you are prematurely at some point. Let's hope not.

Hope this info helps and best of luck to you.

MOST helpful. Thank you!

[sandy2672]

FMLA LTD SSD

I hope you get this. First time using it. I had a job I did for 20 years as a network specialist and was promoted to upper management. I took the promotion ( at another company) knowing it was going to be more work and more stressful, but had finally got the job I had wanted for years.

Anyway, I was unable to do the job, only a short time after I started my new job, I couldn't remember how to troubleshoot, I had done it for years and had been teaching others to do it. I was loosing my vision, falling, depressed, tingling feet, It was awful. It took approximately 2 years to diagnose me.

Looking back I realize this was going on for a long time just not as disabling. I was on FMLA. Went back to work. Had intermittent FMLA. Had disability payments from job which lowered as i was out longer time. I was unable to work and my Neuro took me out completely _ collected Disability 1/2 pay until getting approved for LTD and then SSD.

When my job had open enrollment (for all benefits) I always took LTD It was a fight to get approved for LTD. It took my doctor and I redoing paperwork several times over and over, but it kicked in while waiting for SSD. Now i receive SSD and LTD for the balance of the benefit I picked during open enrollment for LTD.

I had a choice of LTD 1/2 pay or full pay. I picked 1/2 not knowing this would happen just for safe keeping. But, I get SSD and will get a payment from LTD until I'm at least 65 years old. To meet 1/2 my pay. It is confusing ,but if you have a benefits coordinator at your job they should be able to answer any questions. I know its scary to ask, because you feel vulnerable, but just ask. If you are paying for LTD benefits-it may even say it on you paystub. It did on mine. Good luck I hope this helped and din't make it more confusing for you

[COLOR="Navy]** Moderator's note - Post broken into paragraphs for easier reading. Many people with MS have visual difficulties that prevent them from reading large blocks of print. **[/COLOR]

[thelegendlc]

Original Post Date

You provided some good additional information for this thread. However, it was originally posted here 15 months ago. The individual's question would probably already be solved.

[MSW1963]

sandy2672, it's always good to hear from someone who's been successful? and is receiving benefits that were paid for over a lifetime of work. Congratulations.

[MSW1963]

thelegendlc, You may be correct, but this thread started about 90 days ago? at least according to my brain that no longer manages anything involving a number, much less a calendar with so many of them.

[thelegendlc]

My Bad!

MSW1963
You are right about the original date of this post. My brain plays tricks with me regarding dates and numbers also. My apologies to those of you that responded to this thread.