Long term disability insurance: Navigating a system that is designed to screw us

I’ve written about the roller coaster effect before, and it’s happening again now.  This time it’s both physical and emotional, not to mention financial.

In addition to all of the irritating, difficult, painful physical problems, I’m also dealing with bureaucratic crap.  I wrote last week that the long term disability insurance company is denying my claim for benefits, but it turns out that it’s worse than I’d thought.  As it turns out, they aren’t suggesting that I’m not ill.  Instead, they are saying that I’ve been sick for a long time and they see no evidence that it’s gotten any worse.  Basically, if I was well enough to work a year ago, I should be able to work now, too.  But how do you prove worsening fatigue?  I don’t have a blood test or MRI for that.

Then it gets worse.  According to the lawyer I spoke to (who came highly recommended by friends who used her for their own SSDI claim) I will have an extra problem because I did not see a doctor in the few weeks leading up to my leave from work.  In fact, my last appointment before leaving my job was 2 months earlier.  At that appointment my doctor and I discussed the possibility that I might have to stop working, but I don’t know if that was recorded in my medical records.  I think it’s time to cough up the money and get a copy of my own records.  I wish someone would have told me that life would be easier if I saw my doctor in person before leaving my job, instead of just speaking with her on the phone 4 separate times.  I’d have gladly done it, if I’d only known.

The lawyer talked about the many steps we would take to appeal the LTD denial, including getting letters from my doctors and from friends and family, as well as hiring a vocational expert to study my case and write a report explaining why I can’t work.  This all sounds wonderfully proactive, but there’s one part that makes me very nervous: the lawyer isn’t confident enough in my case to take it on a contingency basis.  Damn!

So basically the system is designed to screw us.  I got insurance and paid my premiums, and the company denied my claim to save themselves money.  In order to get them to pay what they rightfully owe me, I have to spend a lot of time and energy and effort and money (none of which I have any extra of) to hire a lawyer.  If I ever get well (or well enough, at least) I am going to fight this system.  I don’t know how I’ll do it, but I will get it publicized, I’ll get my legislators involved, I’ll do whatever it takes, but this simply can not be allowed to continue!  But first I need to get my own claim approved and focus on my health.

And in case you’re wondering, the appeal will take approximately 6 months and cost me $7000-$10,000, plus expenses.  Expenses are for things like paying for copies of medical records, paying for the vocational expert, etc.  If we lose, I’m out that money.  If we win, the insurance company owes me $30,000 per year and they will pay me what they owe me from the date I became eligible a few months ago.  They will not pay the legal expenses I incur.

Yep, the system sucks.

Oh, and of course this is also at the same time that I am looking into practitioners, tests, and treatments that will not be covered by my health insurance, I feel like crap daily, I am enduring the most stress of my entire life, and my scant energy should be used to research my treatment options and to recover.  Like I said, this system is designed to screw us.

3 Responses to Long term disability insurance: Navigating a system that is designed to screw us

  1. abcsofra says:

    You should immediately file for SSDI through the federal government. This way…maybe…you can get approved for that. You will have to file for that anyway even if you win the LTD thru your employer…so file online for the SSDI. But before you do, be sure your doctor agrees that you are disabled and you may want to get an attorney to work with you for the SSDI (THEY DO NOT charge you for this!). They will take a % of the money once you receive it (and yes you may have to appeal the first decision as many are told no regardles of whether they are disabled or not). But do apply for SSDI immediately as well. And good luck on both counts. And of course you were turned down for the LTD….they have lawyers on retainer and know you will have to pay from your pocket to get what is rightfully yours. ((HUGS)))

    • chronicrants says:

      Thanks so much for the advice and for the support. I am going to apply for SSDI, but I have been trying to get a handle on the process for LTD first – it’s too exhausting to do both at once. Plus, I’m not eligible for SSDI yet. I’ll get the paperwork ready this summer, but I can’t get approved yet. Of course, like you said, I’ll probably be turned down the first time anyway. I have a lawyer to work with on that, and hopefully it’ll go smoothly. And as for LTD and their lawyers, I have no idea how to change that horrible system, but if I ever get healthy, I will definitely work on it. I’ll lobby Congress or whatever to change the system. It’s just plain wrong.
      And thanks for the hugs – it totally helps 🙂

  2. Really….such a beneficial site.

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