seekhelp
Frequent Contributor (5K+ posts)
Member # 15067
posted
I am trying to write an appeal letter to my long-term disability insurer who cut off my benefits several months ago. NOTE, this is not SSDI. It's a private plan offered through my employer (ERISA compliant).
I obviously went through endless testing, but not too much significant has come up except for my 'Igenix positive - CDC negative' IgM and IgG WBs and LabCorp CD-57 score of 30.
I have no letter of support from my LLMD (current or past one acknowleding their Dx and the limits on my life). I don't even know if my current LLMD would do this, but I'm sure the cost would be astronomical.
Is it common for a LLMD to do these? If so, what price, if any, did the LLMD attach to this service? I mean a decent letter, not just a one pager saying I think John Smith has Bb.
I read through the post-it note on disability resources in this section. Good info.
What I don't know is if saying you have Lyme in your appeal is basically burying your own grave since this disease is despised so much. Am I better off using Fibro/CFS?
I don't think having 4 of 5 positive IgG bands or 1 of 2 IgM bands and lots of IND bands on both will make a difference to an insurance company. A non-CDC positive = no Lyme idiot. Can't you read the test result? lol.
I'm so lost how to approach this. Many days I don't even feel well enough to do all this. Fun stuff, huh? The insurers know sick people will struggle greatly appealing.
Posts: 7545 | From The 5th Dimension - The Twilight Zone | Registered: Mar 2008
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seekhelp
Frequent Contributor (5K+ posts)
Member # 15067
posted
Now I KNOW some of you must've gone through a LTD appeal under an ERISA plan!!! Please if you can help at all, it is important. There are way too many ill people not able to work on Lymenet for this not to be the case.
Another thing I'm trying to find is what is a fair fee for attorney representation with these types of cases. I spoke to one, but I'm pretty sure he was robbing me blind. I did not appreciate that.
I'm wondering how many used an attorney for their appeal/court representation and how many filed their own appeal. These are the types of issues I'm looking for feedback on.
Posts: 7545 | From The 5th Dimension - The Twilight Zone | Registered: Mar 2008
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sutherngrl
Frequent Contributor (1K+ posts)
Member # 16270
posted
I was too ill to fight for my LTD, so I gave it up. Also at the time I had no diagnosis, just knew I was very ill with a bunch of negative test.
I did file later for SSDI and of course lost on the first try. It was so discouraging that I gave up.
I have considered getting an attorney and try for SSDI. Some attorneys charge only if they win your case, then they take a percentage of what you win.
I would be puzzled as to what diagnosis to go with, FM or LD. I mean neither can be proven. Both would be clinical diagnosis.
I think it matters more how disabled you are and less what the diagnosis is; according to what others have said anyway. Like how many minutes or hours you can sit, stand, bend, etc. Still it does seem scary to use the Lyme diagnosis. Seems Fibro is more accepted by everyone.
I would not attempt it without an attorney, but that is just me. It would be too stressful to try it on my own.
Surely someone will come along that has been down this road.
Posts: 4035 | From Mississippi | Registered: Jul 2008
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glm1111
Frequent Contributor (5K+ posts)
Member # 16556
posted
I know someone that has personal liability insurance and they finally won. They found out exactly what dx are in their guidelines (insurance co)and what they would except as a disability.
Example, autoimmune disease, POTS, clinical depression etc. He then sought out different doctors like neurologists who specialized in these maladys. Just an idea as to how you might go about collecting what you have been paying in to.
Gael
-------------------- PARASITES/WORMS ARE NOW RECOGNIZED AS THE NUMBER 1 CO-INFECTION IN LYME DISEASE BY ILADS* Posts: 6418 | From philadelphia pa | Registered: Jul 2008
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