posted
Thinking others might be on LTD and can help me with this.
I am too sick to work and am applying for LTD through work. Even though my actual diagnosis was made 2 weeks ago (7 months into 2008), my insurance company is saying this is a pre-existing condition because I had symptoms in the year of 2007. By doing this, it defaults to our previous company that has a 180 day elimination period meaning now I wouldn't get benefits until December 2008.
I don't think this is pre-existing because my diagnosis wasn't definitive until this year.
Can anyone offer some advise? Should I get a lawyer?
Posts: 215 | From Phoenix, AZ | Registered: Jul 2008
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hiker53
Frequent Contributor (5K+ posts)
Member # 6046
posted
I think a lawyer would be helpful if you can afford it.
-------------------- Hiker53
"God is light. In Him there is no darkness." 1John 1:5 Posts: 8879 | From Illinois | Registered: Aug 2004
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cantgiveupyet
Frequent Contributor (1K+ posts)
Member # 8165
posted
you need to talk to a lawyer. Most will answer questions over the phone.
Check out BettyG new newbies packet at the top of the page. There is a yahoo group called disinissues that can be very helpful.
-------------------- "Say it straight simple and with a smile."
"Thus the task is, not so much to see what no one has seen yet, But to think what nobody has thought yet, About what everybody sees."
-Schopenhauer
pos babs, bart, igenex WB igm/igg Posts: 3156 | From Lyme limbo | Registered: Oct 2005
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bettyg
Unregistered
posted
yes,
click on my newbies link below;
use EDIT, FIND, and type in DISINISSUES and read until you see the area where you can sign up for this FREE SITE, but it's nothing like this.
go to their FILES area and look for ltd info there!
GET A LAWYER FOR LTD!! this is the most corrupt system you will go thru.
i didn't do this myself, as it's worse than SSDI, ss disability insurance, benefits!!!
member, conniemc, knows alot about LTD since she went thru it and is a NON-LAWYER REPRESENTING SSDI claims...
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posted
Talked to hubby about this. If your symptoms have not changed significantly it doesn't matter whether you had an actual diagnosis or not -- the insurance company would consider this as the same illness you had in 2007 and for Long-term disability the prior employer would be responsible.
However, if your current company has short-term disability or salary continuation you may be covered under their short-term plan -- would depend on if there is a waiting period for coverage or if there is a pre-existing condition clause. Your plan booklet should explain your benefits or someone in Human Services should be able to answer your questions.
Would be a good idea to get copies of all medical records from 2007 and 2008.
There is a waiting period for Social Security disability also. I think the time frame is 5 months. Would suggest waiting 6 months to apply as they have a one year look back period. By then you will know more about your response to treatment and your doc should be able to help you with the required forms.
For social security the disability has to be expected to last at least 12 months in total to qualify for social security disability. If you are age 50 or older it will greatly improve your odds of winning your claim. Lyme and other tickborne illnesses are not "listed illnesses".
Almost always need a lawyer to help with filing your case -- it is easier to file a claim under another related illness such as chronic fatigue or seizures etc rather than just trying to get it approved based on Lyme.
Social security claims usually take at least 2 or 3 years to get approved from start to finish. You would get a "lump-sum" check for back benefits and then an ongoing monthly check once the claim was approved.
People can qualify for both private disability and social security disability. Rules are different for each.
Hope this info is of some help.
Bea Seibert
Posts: 7306 | From Martinsville,VA,USA | Registered: Oct 2004
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