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Kick 'Em When They're Down

disability insurance

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#21 Golden01

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Posted 22 August 2013 - 08:04 AM

One thing someone told to remember as my husband was going through the disability process is that "HR is not your friend", they are usually working to protect the employer's not the employee's interests. One of my husband's doctors encouraged us to think similarly about the disability companies. In our phone interviews, we worked from a written list of talking points that included the symptoms his doctor saw most problematic for him continuing to work (in some cases these were not the ones we saw as the biggest problems). We were amazed at how, usually through casual conversation, they would try to take us down a path that wasn't part of our script (Are you feeling better today?, What do you have planned for the weekend?, etc.). We found they knew nothing about PD.

Kevin, Would accommodation under the ADA act be something to consider between now and October 2015? Might ensure shorter hours, change in shift times, or different responsibilities, etc. Here's a link with information that helped us: http://askjan.org/media/PD.html

#22 KimAgain

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Posted 22 August 2013 - 09:08 AM

I would add... be prepared to fight HARD if you have to. My insurance company refused to pay in the beginning and, eventually, I had to seek legal help. It didn't get to court because we settled (can't name the insurance company or the settlement amount because we negotiated a higher amount for a confidentiality agreement), but I was asked to prove that I was "sufficiently disabled" for benefits. What??! Well, they explained, although my doctors had signed me off as 100% disabled, they--the insurance company--felt I was something less than disabled because I could, generally, feed myself, communicate, and take care of my personal hygiene needs. So, basically, they felt they should only have to pay out if I were functionally, a vegetable--this, despite the fact that their policy said no such thing.

The point is, they turned me down four times before I totally lost the plot and contacted an attorney! Even THAT was a bumpy ride. I talked to three attorney's by phone who only wanted to know how close to a million dollars the settlement could potentially be, because anything less was not worth their time. I finally got an offer from the insurance company on my own, but to say it was an insulting amount is to understate it by a long, long way. I took the offer to a really cool attorney who negotiated a 1000 times better settlement and took lower than his customary fee because, he said, my case was so worthy.

So, here's the takeaway: Insurance companies want to take money, but they will do anything and everything they can to avoid giving any back, even when it is owed, so be relentless in pursuing what is due you. Read your policy very, very carefully!

Good luck to you,
Kim

Dx 1994, age 45.  DBS surgery, 2009:  Bi-lateral; wires to one battery - on my left side.  300mg Sinemet CR daily.


#23 Golden01

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Posted 23 August 2013 - 07:30 AM

My husband has a small private disability policy that we paid premiums on since the early 1980s. It has been paying a monthly benefit since he retired on disability in April 2012. Last month, we got an offer from the company for a "lump sum payment" that would be a little more than half of what he would receive if we keep getting the monthly benefits until he turns 65. The letter was worded to make it sound like a good deal in case you were no longer disabled, you would have received this money. Since we know his PD is not going away, we thanked them nicely and turned down the "optional" offer. Yesterday, we got a letter thanking us for notifying them we had declined the offer and, in another envelope, an entire set of new forms for a "review" of his claim. Coincidence?

We'll fill out the forms, go see his doctors, check to be sure all the paperwork gets in, do any phone interviews, and he'll still be disabled from PD. I'm confident the monthly benefits will continue but why does it have to be so complicated?

Full disclosure - My husband was diagnosed when he was 50 so I guess I shouldn't be posting here but your topics and feedback are great!

#24 RNwithPD

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Posted 23 August 2013 - 09:13 AM

I am painfully aware of how the insurance industry operates. I've had homeowner's and auto claims before that I had to fight to get the proper payout. As far as accommodations are concerned, I am somewhat limited by the fact that I can't place an undue hardship on my employer. Because 12-hour shifts are the norm for nurses, if they cut my shifts back to 8 hours it would just mess everybody else up - so that's not an option. I can request that they only schedule me every other day so that I can rest between shifts (which they are already doing), plus a couple extra things such as not being pulled to other areas of the hospital, not being forced to be the charge nurse, etc. Eventually, though, I'll have to switch to a different position such as case management or nurse education. However, after reading my disability policy, I will make sure to switch back to nightshift on the unit and make sure that my last day of work is a weekend. My policy states that they DO include shift differentials when calculating disability payments, and that they calculate the monthly payment based on the last shift you work before becoming disabled. SO, if I work a weekend night shift and then file, I'll get about $6.50 more per hour calculated into my disability payments. Every penny counts.

Kevin

P.S. Golden...it almost seems that their "offer" was a veiled threat - either accept our 50% buyout or take a chance on losing your coverage.

Currently age 42.  Symptomatic at age 36.  Diagnosed at age 39.  Sinemet 2-tabs every 4 hrs (800-1000mg levodopa daily); Amantadine 100 mg 3 times/day; Primidone 50 mg 3 times/day; gabapentin 200 mg 3 times/day; Klonopin 1 mg at bedtime; Seroquel 50 mg at bedtime; Effexor 75 mg daily; Vit-D3 5000 IU daily;Vit-B Complex daily; Melatonin 3 mg at bedtime


#25 Golden01

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Posted 10 September 2013 - 08:28 AM

Whoo hooo!! Got all those pesky forms filled out and mailed to the disability company. We were slower than planned at getting them done. Keep your fingers crossed that we get the notice the benefits will continue. I'm confident this time around.

#26 metfan31

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Posted 10 September 2013 - 12:17 PM

Reading all this got my gears turning so I decided to look into my own employer group benefits...

Forget about whether or not they find a way to deny my claim, which I doubt they could, I have worked there and been covered 8+ yrs and yet to receive an official Dx, but get this. I'm 33, if I am considered disabled prior to age 63 (thirty years from now) The maximum duration of benefits they pay 60% of my salary is 42months. I could have set asside that premium into a savings acount and gotten more than the two years salary that roughly equates too.

My advice for all of us who can still work, sock as much as you can into a 401K and a Health Savings Account while you still can. At least make sure you get 100% of whatever company match they offer.

#27 Golden01

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Posted 10 September 2013 - 09:50 PM

Dave Ramsey recommends disability insurance. If you don't have an official DX, you might still be able to get a private policy that would be on top of your employer's 42 month plan. We took out a small private policy about 30 years ago and it is a real help now. Premiums weren't much and we get an extra $1,000 a month until my husband turns 65. That is, of course, if they approve the forms we just sent in! I agree with you on saving as much as you can!

#28 Golden01

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Posted 20 September 2013 - 07:41 AM

Checked with the disability company yesterday. They have everything need they need from us and from the doctor to evaluate continuation of his disability benefits. Now we wait. My husband just went on disability last year. Is this rigorous review something to expect every year? It' seems like they are asking, has his PD been cured since you last filled out forms? 



#29 Beau's Mom

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Posted 20 September 2013 - 09:13 AM

Golden, I don't know how individual policies work, but I am rarely asked by my employer's policy or by SSD for re-determination reviews.


Dianne

I am not a human being trying to have a spiritual experience; I am a spiritual being having a (sometimes difficult) human experience.

#30 Golden01

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Posted 20 September 2013 - 07:55 PM

Beau's Mom - Thank you, it helps to know that we probably won't get the review on his employer's policy or SSD. I am not sure why I am concerned, I know his PD hasn't gone away. Got a copy of the doctor's forms today. She clearly indicates "NO" to these questions "Has the patient returned to his/her prior level of functional ability at this time?" and "Do you Expect improvement in the patient's functional abilities?". While I've shared the forms with my husband, I didn't bring his attention to the doctor's answer of "Never" to the question about whether or not she expects improvement. I know that is true but it hit me like a ton of bricks when I read it today. Will be glad when we get the approval letter, will give me something to check off the worry list. 



#31 Beau's Mom

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Posted 20 September 2013 - 11:56 PM

Yeah, seeing that word "Never" in writing is hard to digest. Like other shocks you've grieved, you will grieve this loss of hope as well. It hurts to get through to acceptance. It hurts even more to stay in denial. I finally realized that resistance is futile. Know you are not alone in your grief and loss.


Dianne

I am not a human being trying to have a spiritual experience; I am a spiritual being having a (sometimes difficult) human experience.

#32 Golden01

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Posted 17 October 2013 - 06:28 AM

Good news, so why am I feeling aggravated? Called the private disability company as it has been over a month since we made sure all the paperwork was in and had not heard anything. They indicated he'd been approved for continuation of benefits but  they "don't send out letters". Not sure how we would have known if I hadn't continued to have this on my mind and finally called them. Guess when the check did or didn't hit the bank would have been another way to find out. Good news, that's what I need to remember. 



#33 Beau's Mom

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Posted 17 October 2013 - 09:43 AM

Golden01, maybe they're just passive-aggressive and can't bear to admit defeat. I found my first SSDI check in my account well before I got a call or a letter.  ((((HUGS))))


Dianne

I am not a human being trying to have a spiritual experience; I am a spiritual being having a (sometimes difficult) human experience.

#34 Golden01

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Posted 18 October 2013 - 07:43 AM

Thanks for the good words. This month's benefits are in the bank!



#35 Annikin

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Posted 22 November 2013 - 11:05 PM

I looked into long term disability and you might be surprised that long-term usually means 3 yrs and that's it. 



#36 Jlc

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Posted 23 November 2013 - 06:59 PM

I work for the federal government in Canada and our long term disability lasts from whenever it starts until the age of 65. I guess I am very lucky in that way.

#37 Rogerstar1

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Posted 23 November 2013 - 08:45 PM

I work for the federal government in Canada and our long term disability lasts from whenever it starts until the age of 65. I guess I am very lucky in that way.

Jlc: I believe your benefits are akin to Social Security Disability in the US where qualifying is 'for life'.  Previous comments spoke to privately purchased or employer provided disability insurance that can expire promptly, depending on the terms of the policy. 







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