This is topic filing long term disability in forum Medical Questions at LymeNet Flash.


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Posted by np (Member # 938) on :
 
help!

I am a nurse practitioner and have had lyme for 12 years, essentially my entire career. I got it when i moved to rural western massachusetts after college. the only thing good that came from it was that i was then able to diagnose and treat and usually cure a couple hundred or so patients.

I have to now face up to the fact that I can no longer work. My neuro symptoms are severe, pain is unbearable and quality of life sucks.

I pay for long term disability insurance at work. even though i am terrified of filing and essentially ending my career, i really think i have no other option.

i will spare you all the details, all the treatments and all the difficulty we all struggle with to live with chronic lyme.

i am too sick and too tired to do a thorough onsite search of the topic of disability. would someone out there point me in the right direction? this is a huge topic.

Also, I know I will be fired soon because my symptoms interfere with my ability to work. My disability insurance via Cigma is through my employer.

Now i feel i must hurry and file before i loose my job but fear my performance evals might lead them to say i am only filing because my job is in jeopardy.

anyone out there with an opinion? i would love to hear it.....i am scared to death. i am single, own a home, and essentially have no one else to rely on.

is it helpful to get an experienced attorney right off the back?

Thanks to anyone with a suggestion or a personal story. I could use a little thread of hope right about now. [Frown]
 
Posted by cantgiveupyet (Member # 8165) on :
 
Hey,

this is a subject near and dear to my heart.

First things first...does your company have short term disability?

Also looking into your FMLA leave...if you have this your job will be secure for 12 weeks while you are out on leave.

Find out the procedure you need to follow to go out on leave.

My long term company is cigna and i was just approved with lyme diagnosis. My major symptom is my bladder...severe pain at times.

make sure that your LLMD keeps good notes during your visit and you stress how you cannot work any longer due to lyme disease and your symptoms...make sure that he lists all of them too.

does your employer know you have lyme disease?

i would work on doing this ASAP.

Hang in there, and dont give up.
 
Posted by Trina (Member # 9270) on :
 
Oh one more thought, if you are on pain medication for your illness ect..., anti anexity mediction, wouldn't it be near impossible for you to do your job and for your employer to let you go on cigma short term disabiity? Do you have a good doctor that will back your claim for disability? You need one for regular disabiliy.Get a copy of your medical records, come right out and tell them you are going to apply and ask if they have a problem with you apply as you phsyicaly and mentally just can't work any longer.If they say thay will bingo.If they talk like no .Don't bother using that doc as a refrence of any kind on the disability papers.Hope this helps
 
Posted by bettyg (Member # 6147) on :
 
Trina, please hit the enter button and double space between each paragraph for us neuro lymies. We thank you for this consideration. [kiss]

I'd like to expand on what Trina said at the end of her post. You want to ask your MD if they WILL support you on doing extra work for you to be approved for SSDi BENEFITS!

The MD will NOT support you; find a new PCP or LLMD to support you. They will need to do a RFC, residual function capacity, Q/A on you showing these facts :

how long you can sit, stand, walk, drive, climb, crawl, bend, use your hands, talk, etc.

It's these things in bold that will WIN your case; NOT your diagnosis & symptoms!
************************************

Go to TREEPATROL'S NEWBIE LINKs and look for MINOUCAT'S DISABIITY LINKS ... read it over good.

I have put a lot in there about my 5 yrs. of experiences on 2 SSDI claims until I was approved 7-1-05 WITHOUT an attorney.

1st claim had OUT-of-state lawyer who didn't win & DIDN'T HAVE ALL MY RFC/MFC, mental function capacity q/as to the DDS staff!

If you have a lawyer, make sure they CAN represent you in FEDERL COURT if you end up going there. Mine didn't volunteer that info until he quit me almost 4 yrs as my lawyer. His quitting me was the best thing as I was doing all the work anyway.

Read the stuff about DISINISSUES good, especially the part/link about female MD have a TEMPLATE there for you to look at or copy so you can prepare your claim like hers. Spend the time getting all essential info NOW so you can be approved 1st step on 1st claim! Don't be like me...5 yrs of yell.

I had very detailed things in my wordperfect but I've lost all my software, reloaded things, and things are NOT working, so I can't open it and copy/paste it here.

I'm hoping my detailed things showing things I'd change had I known all this & that.

Again, print off a lot of MINOUCAT'S LINKS & my info. Obsorb it all in bits & pieces.

But get a copy of ALL your medical records 12 years or have you worked longer & had these symptoms then too? That's it for now. I'll let you answer more before I go on & on....

My passion is helping folks like you/me NOT repeat the mistakes I did for 5 years, and your providing ALL the necessary supportive/objective findings for approval. [Big Grin]
 
Posted by np (Member # 938) on :
 
Thank you so much, all of you, for your advice.

I will go to the sites you recommended. if i may,

i would like a little more advice. I read a

a couple of websites about disability and they

listed lyme disease as the top one they deny. is

this true? is that why it is best to base the

claim on the functional aspects?

i require narcotics to get my pain down low


enough, after work, so i can try to rest. how

do they respond to chronic pain diagnoses?

i am thinking of asking my doc to do a brain MRI because of my speech and cognitive problems. it might look like multiple sclerosis. does an abnormal result carry any wieght? will they require me to see a neurologist? if it is not abnormal, will they hold that as a TESTAMENT THAT I AM NOT SICK?

i now live in oregon and our support groups say there are no lyme docs in oregon or washington but my nurse practitioner is willing and supportive of pursuing disability. she suggested going to a physical therapy practice that does a 2 day functional eval that addresses the residual function tests.

can disability force me to take a job like flipping burgers or bagging groceries since i cant continue my chosen profession? that scares me because then i would go bankrupt. any thoughts you guys?


any of you know whether i can file my cigma

claim, after being fired if the termination from

work resulted from lyme related symptoms like

stamina, pain,etc?

thank you sooooo much.

[confused] i am scared to take the plunge, because if i am denied i will lose everything i have worked so hard for. at least with the private disability money i could keep my house and pay my bills. i am soooo scared.
 
Posted by np (Member # 938) on :
 
cantgiveupyet, trina, and bettg and anyone else with an opinion, please read my last entry in response to yours. also, might i email any of you so i can get off the message board?
thanks
karen
[confused]
 
Posted by Trina (Member # 9270) on :
 
Hello,
You can email any time you like.
 
Posted by seibertneurolyme (Member # 6416) on :
 
np,

Talked to hubby and I think I got everything straight.

Apply for short-term disability now -- usually must do this before can apply for long-term. Usually this is a very simple process and is usually automatically granted. Legally you can't be fired while out on short-term disability.

Hubby had automatic salary continuation for 6 months on his short-term policy -- get a copy of the rules from H.R. -- every company is different. He was automatically terminated by his company after the 6 months, but was eligible for long-term disability as it was a continuation of the same illness.

Long-term disability is another ballgame -- may take a year or more to settle -- hardly ever win a monthly benefit -- may have to go through 2 or 3 appeals before a hearing or settlement conference.

Depending on your policy -- if you pay the premiums or if your employer pays them it makes a difference as to whether the benefits are taxable for income taxes.

Most private policies also require you to apply for Social Security Disability and base their settlement offer on the assumption that you will win Social Security. You will probably need a lawyer for the private policy -- standard fee is a contingency fee of 33% plus minimal expenses, but without the lawyer you probably don't stand much chance at all.

Hubby missed out on a year or two of Social Security benefits because we did not file for that soon enough -- at the time he did not have a diagnosis so we felt we would be wasting our time to even file.

Rules for private disability and Social Security are different. Usually private policies specify that you have to be unable to perform your own job for the 1st 2 years and then any job after that to continue to receive benefits -- Social Security says you have to be unable to perform any job.

The rules Betty was talking about are for Social Security Disability. Social Security could also take 2 -3 years to settle unless you are really lucky.

My advice would be to get your finances in order and if necessary refinance your home or take out a home equity loan now while you are still employed or before your short-term disability runs out. Also check into some of those low rate credit card deals if your credit is good.

You will need funds to support yourself for a minimum of 1 year after the short-term policy runs out. And remember that your insurance premiums will increase greatly after short-term policy runs out when you convert to COBRA. H.R. should be able to give you those numbers so you can budget accordingly.

We borrowed from family and still owe thousands on credit cards. I have been unable to work for the entire 5 years as hubby requires full-time care.

Our Social Security attorney was very good and had experience with chronic illnesses -- we never met him -- just communicated by phone and fax. It was probably the easiest $5300 he ever made (maximum fee for Social Security). Hubby got impatient and sent a letter to the judge and he made his decision on the medical records without an actual hearing.

Let me know if you would like the name of our Social Security attorney -- he is in Detroit.

Bea Seibert
 
Posted by bettyg (Member # 6147) on :
 
quote:
Originally posted by np:
[QB] Thank you so much, all of you, for your advice.

I read a a couple of websites about disability and they listed lyme disease as the top one they deny. is this true?

is that why it is best to base the claim on the functional aspects?

i require narcotics to get my pain down low ?

i am thinking of asking my doc to do a brain MRI because of my speech and cognitive problems. it might look like multiple sclerosis . does an abnormal result carry any wieght?

will they require me to see a neurologist? if it is not abnormal, will they hold that as a TESTAMENT THAT I AM NOT SICK?

she suggested going to a physical therapy practice that does a 2 day functional eval that addresses the residual function tests.

can disability force me to take a job like flipping burgers or bagging groceries since i cant continue my chosen profession?

that scares me because then i would go bankrupt. any thoughts you guys?

any of you know whether i can file my CIGMA
claim, after being fired if the termination from
work resulted from lyme related symptoms like
stamina, pain,etc? thank you sooooo much.

[confused] i am scared to take the plunge, because if i am denied i will lose everything i have worked so hard for.

at least with the private disability money i could keep my house and pay my bills. i am soooo scared.

Karen, earlier I sent you my email per yur request. I'll try to answer any questions that I can from above; I deleted other stuff not pertinent so I could concentrate on your questions.

Yes, we all get scared going thru this ordeal of LTD, SSDI, SSI, etc. It's the FEAR OF THE UNKNOWN, but that's where you are lucky; you have all of us whose shoes you are walking in now. We each have our own expertise to guide you thru these troubled, unknown water. [group hug] [kiss]

On the DISINISSUES site I recommend to you/others, lymies have written in there saying they WERE APPROVED for SSDI, but I don't know on what step ofthe 4 steps there are.

Those approved for any LTD complain constantly about all these "spies" of every moment being watched by neighbors and unmarked/suspicious cars. It's the worst of the 2 processes to go thru from what I have read on the disinissues board the last 1-2 years I've received their postings.

Karen, let me emphasize again to ALL reading, it is never your illness/diseases that win your approval for benefits; it's the functional thing of WHY can't you do your job as I showed the specific examples in my earlier post.

How good is your health insurance? My April 06 brain MRI was $10,000 plus. Radiologist reading it did NOT see any lyme disease but wasn't given all the paperwork I brought to him to view either.

2 day PT tests sound good as they would show what you can DO & FOR HOW LONG! Since they are 2-8 hr. days...good; will show all the fatigue & why you can't continue doing these.

No, they can't force you into turning hamburgers, etc.

You never know if DDS Will require to go to anyone...neurologist, psychiatrist, etc. It all depends what is in YOUR MEDICAL FILES YOU GIVE them.

This is one time by getting ALL your medical records; I paid for mine! Read them over thoroughly to make sure your MD has provided enough EVIDENCE or what you need to do to be approved.

I'll call it quits on this; need to get off internet soon. You have my email now Karen.
Hope this eases some of your anxiety level. [kiss]
 
Posted by Monica (Member # 224) on :
 
I don't know how your state's statutes respond to disability.

First apply for short term disability through your employer/Cigna. I had good experience with Cigna back in 2002 with another matter.

After short term comes long term. Again, don't know your state's regulations, but Cigna should help.

Most states have websites regarding disability that they finance.
 


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