New Doc/LTD Disability

[LisaColumbus]

Hi all,

I'm in kind of a weird spot tight now and hope someone may have some suggestions. My Short term disability has just expired and is now in the process of being reviewed for Long Term Disability. They have sent a bunch of forms to my general doctor and he is uncomfortable filling them out since he has a limited knowledge of POTS and NCS. I haven't seen Dr Grubb in over a year, I went to Cleveland Clinic 2x for testing and had been seeing a local arrhythmia specialist. The problem is, she left the practice and moved out of state last week. I need to schedule an appointment with her partner but am unsure how to broach the subject of disability paperwork, since he has never seen me. Any ideas?

[steph37822]

oops

[Poohbear]

I agree with Steph. I would do a couple of things...I would print of some articles from this site and others that show how complex this disorder is. I would share them with your current Dr. and explain your predicament to him/her. I would ask if he would reconsider filling out the form with you and suggest sending the articles to the disability review as well.

I would also go ahead and set up an appt with a new electrophysiologist and explain that you need a Dr more knowledgeable about Dysautonomia and you are pushed to do so at this time because your GP doesn't feel knowledgeable/comfortable enough with the forms and your future progress and you need more help than you can get from him.

It may also help if you write a letter to your GP to have placed in your file being very specific and detailed about the ways this disorder has impacted your daily life. List all symptoms you have, how frequently each occurs, what duties of your job you are not able to do and why. This way, even if he doesn't do so great with filling out forms hopefully a reviewer will still read it.

What LTD carrier does your employer use, do you know?

I have gone through the process already of going from STD to LTD and also SSD.

One condition of my LTD plan is that you have to start the paperwork for Social Security Disability as well. Have they asked you to do this yet? If not, can you ask someone what the requirements are.

If you have more questions let us know. The more detailed you fill the reports out the better off you will be.

Good luck!!

[LisaColumbus]

Thanks for the advice Steph and Poohbear, I will give that a shot. My LTD carrier is MetLife. Just getting the short term disability straightened out with them was a mess. I will finally be getting payment from them for the last 26 weeks, only 3 weeks after the STD ran out...its crazy. They have not mentioned the SSD yet and I doubt they will until the LTD claim is approved. I thought Unum was bad....this company is ridiculous!

[Poohbear]

My advice is to go ahead and file for SS disability as well, regardless of what your employer does. The SS process is LONG, tedious and involved it's easier to start the SS process and cancel it at some point if you need to then to wait 8 months to see if you really need it.

On SS disability you have to be disabled for 8 months I think it is before they will start to pay so the earlier you start the process the better. This way, if your employers plan denies you or only pays for a limited number of months you've already got the ball rolling on the SS.

The way it works is if you are approved for SS and you are receiving benefits from your LTD then SS pays first and your employer would pay only (if any) the difference from your LTD benefit and what SS pays.

For example, Say SS says you are eligible for $1200 a month but you are getting $2500 from your employer. Then Social Security would pay $1200 and your LTD would pay $1300 a month. If your employers benefit is less or = to what Social Security would pay then SS would pay and your LTD would pay nothing.

You are welcome to email me if you have questions.

Make sure you keep copies of any and every form they send out and I would also recommend mailing anything to them via certified, return receipt requested so you have proof of them receiving info, the date and who signed.

Good Luck!

[morgan617]

Lisa, how have you been feeling since your ablation? With ssdi, you have to know your disability will last a year. It's actually not how long you've already been disabled. I would go to the eps doc that did the ablation and have him write that it failed, if it did, and you are still quite disabled by the arrythmias you have. I think you said he was very knowledgeable about POTS. Just don't try and get the disability with pots dx. As much as we all know how debilitating it is, it is not on their list so they won't accept it. Period. But they will accept that your arrythmias are debilitating. It takes 6 months to get approved, give or take no days. No matter how much you bug them, you will not know for six months. You get your first check in the 7th month, on a wednesday, depending on where your birthday falls. Mine is the last week of the month, so I get my check the last wednesday of the month. The sooner you apply, the sooner you get it. I know that no one likes to think of being disabled that long, but it is pretty much the reality of the disease. And let them know how depressed you are about this. I made no bones about it. It was completely life altering for me and that makes me SAD. Depression that interferes with your life is also on the list, and I don't know about anyone else, but there are days I don't want to get out of bed. I just want to lie there and lick my wounds and never get up again. That is major depression. I'm not sure how the money end works. It's my only income, and they deduct from everything they can. I will get medicare this year and they will want to deduct for part B, although I have coverage through my spouse, so I won't, but if I change my mind later they will charge 16% more of my money to get it. But it is still more than nothing. morgan

[LisaColumbus]

Hi Morgan thanks for the SSD advice, Ive been putting that off because I'm just not up for the fight at this point. But soon

As far as the ablation, the palps have settled down but I see no difference what so ever. Not better, not worse. Heck for all I know they could have knocked me out, gone out partying for a few hours and then came back and woke me up and said "All done" I am just very greatful that I haven't seen any negative effects, that was my greatest fear.

[Sunfish]

Hi Lisa -

I had just started posting on here before heading off to Vanderbilt about a month ago & am just jumping back on board - hopefully to stay this time - but had to chime in as it sounds like we're in a lot of the same situation. Namely I'm on LTD with Metlife and it has been nonstop craziness with them....that's putting it nicely:-) I was on STD for 2 weeks in November, then nonstop since 12/30...first STD & now LTD. No one there ever calls me back, I have gotten only one payment on time since January, etc...I could go on & on but I'll sum it up with saying that I totally get your frustration!! But a few things...

To give you a "heads up", I was aware of the SSDI application requirement in the policy but had no clue regarding its timeline. They plunged it on me with less than a month "deadline" to proove to them I had applied. I was leaving for Vanderbilt in a few days so I managed to get an additional month extension, which means I have until the end of June. This was not easy & was solely b/c I was scheduled to be out of state for an inpatient hospitalization that they had proof of for more than half of my time period to apply. And then they thought I was nuts that I wanted the extension confirmed in writing. Now that I'm doing the app (online), it is VERY time-consuming, so you may want to at least start looking it over since when MetLife does throw it at you it's pretty quick. Also, it's 6 months after you're fully disabled that you can get paid (following 5 months of disability) with the required expectation of remaining disabled for a year...I've been reading up A LOT the past few weeks so am pretty up to speed on the details.

On a more positive note, I had a positive phone experience today with MetLife - my first one mind you, and only after it taking an hour to get this person on the phone. I was calling about my lack of check (that was "due" last week), to check on status of my approval with updated info they had from Vandy, etc...and couldn't get any straight answers. And since my "case manager" never calls back (okay, she did once...) I refused to buy the "leave a message" deal...essentially I wouldn't get off the phone until I had a live person that had more to say than the initial call center folks. And it payed off as I got through to an incredibly nice lady who, on top of trying to figure out why things weren't happening with my claim that should have been, then proceeded to ask me a bunch of questions about the research study I was in at Vanderbilt, about dysautonomic, etc just out of her own curiousity...she started to apologize for asking & I was like - no problem...ask away...so...there is at least one person there who sort of gets it and - even better - made something happen. B/c when I got home from an appt later in the day there was a message from my case manager (total shock) stating that my claim is now approved through August 31st. So...I will finally - hopefully - have a break from having to deal with them on a regular basis. So...hold on & keep bugging them as eventually things will come through. It certainly is rediculous though, eh?

And lastly - I agree with the others re: your GP filling out the forms. If he has any records, results, etc and has seen you at all he should be able to do them. I actually did some of them with my GP &/or her NP b/c even though she knows me well some of the questions are a bit obscure. FOr me she's my point person with all the specialists I've had to be seeing, etc. I will say though that I know MetLIfe needed a lot more than what was actually on their silly questionaires (at least the ones we got) when it came to LTD, so be prepared.

Good luck with everything & let me know how things go with the LTD. I feel your pain!

:-)melissa