Jump to content

Short Term Disability


Recommended Posts

I applied for short term disability through my work and was denied. We then appealed it and were still denied. I did some research on the insurance company that denied me and, apparently, they are known for denying people. We are having a hard time finding a lawyer or any office that handles short term disability. We have found long term disability and, of course, social security disability, but not short term disability. We live in Dallas, TX. Does anyone know of anyone who can help me, please? Thanks.

Link to post
Share on other sites
I applied for short term disability through my work and was denied. We then appealed it and were still denied. I did some research on the insurance company that denied me and, apparently, they are known for denying people. We are having a hard time finding a lawyer or any office that handles short term disability. We have found long term disability and, of course, social security disability, but not short term disability. We live in Dallas, TX. Does anyone know of anyone who can help me, please? Thanks.

Have you gone through corporate HR? Is the plan owned by the employer?

Link to post
Share on other sites

I don't have experience with short-term disability, but I've been receiving long-term disability benefits for some time now. I'd find out exactly WHY you were denied... was it that you don't have a proper diagnosis yet? they don't view your symptoms as severe enough? they don't see dysautonomia as a valid diagnosis? etc...

Be as specific as possible in describing your disability. Talk about how you feel on your worst days. The last time my long-term disability was up for review, I sent them a letter called "A Day in My Life," which described how my symptoms impact my daily activities. You probably already have done this, but just a thought.

I believe they have to provide you with the reason for denial. Talking with your corporate HR is a great idea too.

Then, I'd try to get to my doctor and provide the documentation of your symptoms or diagnosis that the insurer says is inadequate or missing. If they still deny you, you always have your state's insurance commissioner as a resource if you think you're being unfairly denied. It's funny how just mentioning involving the insurance commissioner sometimes prompts results. You can usually go online and file a complaint with the insurance commissioner. Be as specific as possible!!!

I'd also get a copy of the entire short-term disability company's policy. Good luck, and keep trying!

I was disabled on May 18, 2007, and it wasn't until February of 2008 that I finally received a disability payment (I got a really nice check, though!).

Link to post
Share on other sites

Are you applying for STD insurance or benefits? If you are applying for new insurance with a known condition like POTS, you will most surely be denied. It is like applying for fire insurance when the building is already burning - unfortunately too late.

If you already have the insurance and want to collect your salary while you are out sick, I am surprised they would deny you. I was out on STD due to POTS 3 different times for a month each, and all I needed was to fill out a simple form and get a dr's note. Getting paid for short term sick leave is much easier than going through the long-term disability process. The others are right that your HR people should be able to help you.

Link to post
Share on other sites

Several times (different periods) I had to use my STD benefits. I probably have some language I used as well as additional information. Please message me with specific questions as well as your insurance carrier.

I too had an insurance carrier known for their denials. However, I was well armed - included personal information as well as some articles by Dr. Grubb and the Dysautonomia prepared by NIH on the DRF website. I was awarded benefits on my initial application. In fact, there were some provisions providing return to work attempts.

Good luck. Don't give up. Remember that you probably know more than the analyst working your claim.

Lois

Link to post
Share on other sites

Thank you all for your words and encouragement.

I was denied because of my "alleged POTS". I was shocked because I figured with STD they would approve it. I printed out handouts and articles regarding POTS as I was certain the medical review team probably never heard of POTS. I even gave me them a few personal account stories about how it feels to live a day with POTS describing crawling to the bathroom and back to bed, being sick, dizzy, nausea, etc. They approved me for two weeks to "allow time for my cardiac work ups", apparently two weeks is suppose to cure POTS. Who knew? :o

They said I could bring a civil action suit against them and that other voluntary dispute options are available, such as mediation. I just never thought it would come to this for STD. It is through my employer and I would go to my HR department except I am the HR administrator and I am not positive my boss believes that I am sick as I have heard from other co-workers mention this.

I feel alone, defeated, and hopeless. I would love to go back to work this minute! I am not looking for a free ride or a handout. I just want to live my life but POTS isn't letting me to do that how I used to. I am afraid to apply for long-term disability because it's through the same insurance carrier and if they denied me my STD, they will deny me my LTD.

Currently, in the process of getting help with social security disability. Like we don't have enough to worry about with having POTS, now we have to fight the insurance and administration! Life is swell! :lol:

Link to post
Share on other sites
It is through my employer and I would go to my HR department except I am the HR administrator...

There should be someone above you that you can contact if its not just a small business. Someone in the corporate office that handles the insurance claims. Or a third party that can deal with the arbitration between you and the insurance company. I had to go through this and am still fighting with BCBS about a claim so I know about the process. You should definately not give up! It's been nine months and I'm still fighting. :3

Link to post
Share on other sites
Great health care system we have huh....................

We have got to change something! We suffer through enough without having to deal with all of this!

Link to post
Share on other sites
It is through my employer and I would go to my HR department except I am the HR administrator...

There should be someone above you that you can contact if its not just a small business. Someone in the corporate office that handles the insurance claims. Or a third party that can deal with the arbitration between you and the insurance company. I had to go through this and am still fighting with BCBS about a claim so I know about the process. You should definately not give up! It's been nine months and I'm still fighting. :3

We are a small business and it's just us two in the HR office. Plus, she doesn't believe me anyway.

Glad to hear you are still fighting. That makes me want to continue to fight as well. BCBS can be frustrating, I know! You hang in there. We should both never give up or anyone else for that matter. I will fight until I can no longer fight or I have exhausted all my options. I just filed a complaint with my state's department of insurance. If that doesn't work, then civil suit here I come! :)

I love your quote by the way.

Link to post
Share on other sites

I would apply for everything I could...And once your cardiac workup is finished, you should have new ammunition to fight with. For example, have you had a tilt table test yet? Have your cardio sign or write/sign a letter detailing your disability again, along with test results. I wrote the letter for my cardio, he changed a few things and signed it using the medical center's letterhead. Make sure you use the phrase "unable to work a full-time week" and that you never know if you can make it in to work on a particular day until you wake up that day. Apply for LTD, too! It took me several months, but I was finally granted LTD with back pay.

The sooner you apply for federal disability, the better. They almost always deny you the first time, a lot of people are denied the second, but get disability if they follow through and go to court. That's what happened to me. It was amazing how quickly the judge granted my disability benefits when I'd been turned down the first two times (I had a lawyer for court).

Keep trying and don't give up! All my best and good luck,

Jana

Link to post
Share on other sites

Join the conversation

You can post now and register later. If you have an account, sign in now to post with your account.

Guest
Reply to this topic...

×   Pasted as rich text.   Paste as plain text instead

  Only 75 emoji are allowed.

×   Your link has been automatically embedded.   Display as a link instead

×   Your previous content has been restored.   Clear editor

×   You cannot paste images directly. Upload or insert images from URL.

×
×
  • Create New...