ON SSDI - Under Review W/Private Disability

[rudy222]

I have been disabled since 2009 applied for SSDI and was approved first try in less than 60 days. I am now up for review under my employer's private disability policy, the 36 month "any occupation" review. I was deemed disabled from doing "my own" occupation, but this one scares me. I have read this is much harder to prove but I don't know why, if I cant do my own job what makes them think I can do something else????

I was wondering if anyone had any feedback with the 36 month review or could give me some ray of hope. Lost much sleep and cannot afford an attorney, had to already hire one paid him $6,000 and he did nothing and I mean nothing, honestly. Money is a huge issue after losing work and having my income slashed in half. I think you understand.

If they take this away from me I lose Health Insurance, Life Insurance Polices and my monthly income. I don't know where I could go and find work even part time and sustain a position. Plus that would greatly impact my SSDI. Are there any legal ramifications that the private disability company must follow if a person is already on SSDI?

 

[QueenElinor]

SSDI essentially is a kind of "any occupation" disability insurance. I'm sure if you look back at your applications for private disability there's a spot where you indicate whether you receive SSDI, so that must factor into their decision somehow, and that's definitely in your favor.

However, they're only legally required to adhere to the contract they made with your employer, and to their description of qualifications & benefits. You should obtain that from your employer, and you must read it thoroughly. I think some insurance companies bank on the fact that people are too discouraged or intimidated to fight with them, so don't let them off the hook if they say "no". You must fight, whether by yourself or with an attorney. The consequences of not doing so are simply too high.

 

[peemagg]

Can't you find a lawyer who only gets paid if you win? I just received my SSDI and the lawyer I had only got paid if we won.

 

[Tinker'n'Fun]

I receive SSDI and a private insurance supplement. Every single year they send the paperwork hoping that I don't fill it out so they can stop payment.

Ask your employer for all the paperwork and conditions from the company paying you the check. Read it slowly and carefully. I was able to get through mine without an attorney. Once I was deemed disabled they were not allowed to challenge it, but can request that the doctor verify that my condition has not improved and I have not returned to work. Many of the forms they send you may not be required. I just write on file refer to original for all but the physicians update report. I do not allow them access to my benefit information.

If you are receiving SSDI, do you not get Medicare? Is this company providing you with a secondary insurance.

Please note mine must pay be until retirement age. It was in the contract and I am going to make sure that they abide by it. Also, if I get an increase in SSDI, they can not reduce their portion. It is a set amount from when my disability was approved. They can not look at SSDI income that is given to me for my children and I refuse all information about my family other than myself.

Please get the paperwork and read it. IF you do not understand it, I am sure there are agencies that could assist you before hiring an attorney.

I will be praying this works out for you. I know how stressful it is for me each year.

 

[rudy222]

If I refused or did not comply their forms in their entirety they would definitely drop me. I opted out of Medicare because yes I am still insured with my employer and if this disability remains in effect should continue with the healthcare plan until I am 65 at which time I can then apply for Medicare. Although if I do get an increase in SSDI, they do not take the difference, guess I am lucky there. They did take the lump sum I got when I was approved for SSDI though, $13,000.

I could never return to work, I am down up to 18 days a month I don't know anyone that would hire me now being out of work three years on a disability, collecting SSDI and having all these health problems.

I just wonder if these, like you say are their scare tactics. I have not had a solid night sleep for almost 4 years worrying about this. That in itself probably is not healthy! They love to intimidate a person, mislead and most of all not tell the truth and manipulate dr. notes. I have caught them doing this brought it to their attention and they don't seem to care.

I was receiving letters from my employer threatening to fill my position in my job, the union agreed these were their "drop dead" letters forcing someone to go back to work, therefore making a break in my disability. I returned to work for a week as the short term disability ended and I did not want to lose my job. I remember going back to work sick, my first day back my Manager took me into a room welcomed me back and we started talking about happenings in the department, I mentioned some things (wont go into them now) she questioned me asking if I would hit the person (another co-worker) had I in any way said "yes" even jokingly they would have hauled me down to HR and fired me calling me a threat to the company. They were doing anything they could to fire me, this after 23 years of solid employment.

Two days of returning to work, as I was fighting with the disability company to win the LTD case coming out of short term disability. They did not approve it so this was another reason why I went back to work as I would have not income. Being single, I had no other choice. They carefully orchestrated this so there would be a break and if I went out again I would have to start all over and I did. Upon doing this I lost life insurance policies, healthcare everything. That's when I continued to fight and they decided they would only approve me for a disability for "depression" they as much as talked me into it. But told me I had to start all over again proving myself after months and months of paperwork I had to start anew.

Five or six months into this now new LTD policy for what they deemed was for "depression" I did have to hire an atty this disability caps off in 24 months, then I would have been done. I fought this as my numerous conditions were clearly medical. I hired an attorney he charged me $6,000 he did nothing but write 3 letters to them. Approximately two months after hiring him, I was approved for SSDI, that's what made the disability company then change the disability to one for depression to a medical disability as that was what SSDI was approved for my medical conditions.

He did nothing, I did all his paperwork and research and he took all the credit for it. I dropped him once the disability company changed it from depression to medical. It just angers me one has to pay that much money (in others cases much more) to fight for their health and well being. Paying him was not like SSDI where he would get some back pay, this is private insurance and I had to pay him. ON top of all this a possible foreclosure on my house, and losing money in my 401K to survive it was hell.

I just want it over and wonder if anyone else had experience with the "any occupation" review when they clearly have medical issues. I don't want to write my conditions (s) in a forum if anyone would like to further discuss or could give me more comfort in the situation, please private message me, I will respond.

Many, many thanks to those that have responded.

 

[peemagg]

I had to fight for my SSDI. I was told the reason I was denied the first time was that I could do a sit down job, since my disability deals with my feet and legs. The issue was though that I can't work when I am fatigued with hardly any activity and that my condition gets worse when I sit with it hanging down or walking or standing on it for long.

I found some information from a person on the But You Don't Look Sick site. There was a woman on there who helps people get their disability by using her inside knowledge of the system. Her name is Carolyn Magura. She has information on there that can be purchased for a small amount to help you. It even included forms to be filled out by doctors and others you deal with.

It was the forms that I had my physical therapist and my doctor fill out that the judge looked at and had the vocational consultant look at and according to the restrictions that I have, the two deemed that there was no occupation that I could do.

I would be sure to get any and every doctor or other medical provider that you see to fill out what your current restrictions are. They need to be very specific and thorough. If you go to the site I referred to earlier in this post, you might be able to find those papers I got. I hope it all goes as smooth for you as it was for me! I wish you luck.

 

[rudy222]

Thank you all.....

"peemagg" I remember talking to the disability company asking them does it not matter that my doctor has indicated in writing that I cannot work in any capacity? she said to me "he has to prove it" but....they never tell me what he has to do to prove it, of coarse they will not give me direction we know that.

He did put in writing by completing one of their forms that I MUST not drive while under the influence of my pain meds, detailed some limitations on paperwork they requested shouldn't this be enough?

Do you think I should have my doctor write them a letter that more specifically outlines my limitations?

I looked at the site you suggested, do you know of any site or place I could go to for like a sample letter or an example of a letter my doctor can complete what all is necessary in that letter to please the disability company as him "proving it" ??

 

[peemagg]

I pm'd you.

 

[rudy222]

hello peemagg i emailed you a couple times but i dont think they are going thru saying i need to have 10 posts? so i dont think your getting my emails and i am hoping you can help me...

 

[peemagg]

rudy222,

I'll pm my email to you.