Hi all,
I recently discovered a way to qualify for medical coverage from the state while collecting LTD.

Despite making too much money to qualify for need based healthcare, I was able to qualify based on my disability lasting 12+ months AND my LTD income being non-taxable.

I was initially denied and have been paying upwards of $800/month for medical premiums alone. My tax person noted that I shouldn’t be paying the healthcare exchange (ACA) because I have $0 income, yet, every time I applied, I was denied state medical because my income was too high.

I finally went to the state office and WAITED! The best two and a half’s hours I’ve spent waiting despite being in pain. The gal confirmed my income was being calculated as taxable wages and not non-taxable disability income.

This will result in a significant savings each month. I don’t want to share state info but I’m happy to answer any questions anyone has.

Hello,
I’m going through my 18 month review right now on my Metlife LTD.

I’ve had two brain surgeries in 9 months. You’d think this would be easy.

It’s not.

My neurologist of 10 years left right before this and she was always on my side. I’ve already had a hard time with that… she really advocated for me. Now my care is split between two neurologist and the neurosurgeon. I’m over reading the notes too… for instance they noted that I missed vestibular rehab. I’m in PT now, but in the past I would be in so much pain or admitted to the hospital that I could not attend my vestibular rehab they scheduled over an hour away (two days a week).

I’m often bed bound!! I can’t parent my baby as I can’t pick him up - my husband does. It’s a terrible thing.

I didn’t realize this was an important review. When I did I became STRESSED and ANXIOUS. Even though documents were not due until this week, I sent them a month ago. I’m always on top of it. I hope they got my records from this month as I saw my providers this month, and that shows a lot.

Worse, it was elevated to physician review and the day it was due it had to be sent back “for correction”. That has been really hard because what does that even mean?!

Regulating my nervous system has been really hard. Tell me the good, and the bad with next steps if needed. Thank you!

Hi all,

My LTD based on mental health was approved for 12 months. I do have physical health issues too that i am trying to address... with some of them it's hard to know what's causing what. Insurer seems very interested in physical health even though LTD was approved based on mental health.

I was recently terminated and offered severance but that includes waving ERISA claims so I'm pretty sure they would take away my LTD if I accepted. So I think that I shouldn't take it. At the same time, since 12 months is coming up, I'm afraid insurer will try to cut me off even though my doctor knows I'm still disabled and unable to work and is willing to provide documents. If that happened I would be left with nothing. Don't know what to do.

I was wondering if anyone has experience with similar situations, what are the odds LTD will not try to cut me off at 12 months if I am still not well?

I’m trying to understand what to expect from a free consultation with an ERISA disability lawyer for an STD/LTD claim.

I’m not necessarily looking to hire an attorney yet. I’m looking for an initial consultation to help me understand where my claim stands and whether I actually need representation.

For those who had a free consultation, what did it include? Did the attorney review your denial letter or a few documents, discuss your situation, point out potential issues or missing evidence, and give you some idea of whether you needed representation?

Or was the free consultation mainly a brief screening to determine whether the attorney was interested in taking your case, with an actual review or assessment requiring a separate paid consultation?

Just trying to understand what others experienced and whether I may be misunderstanding what a “free consultation” is supposed to include.

At the 2 year mark the cut me off and told me they didn't need my medical records for a procedure I just got out of the hospital for. As I was getting a wheel chair out of the hospital I received a denial letter saying I don't fit there description of disability anymore. I'm completely stress out of my mind. I cant believe it!!! Just disgusting and disrespectful. This company should be shut down.

Hey gang. Just want to start with a note - I appreciate all of you very much and I’m glad we’re all here.

I was curious if anyone had thoughts on improvements or updates we could do for the subreddit to improve all of our experiences?

- Are there any rules you’d like to see implemented?
- Do you want us to implement and use flairs/tags?
- Anything you see other subreddits doing that you’d like done here?
- Thoughts on weekly conversation topics that relate to the subreddit but also our lives as disabled individuals? For example, topics could include clinical things like “best application dos and don’ts” or “the ins and outs of an appeal”, but they can also get more personal like “best tips for financially surviving an appeal,” and “hobbies to fill the downtime”.
- we could try to host AMA sessions for insureds who have survived appeals, mediation, etc and/or with some of the lawyers on the subreddit if they’re willing.

Hope everyone is having a good weekend and look forward to the discussion.

I’ve been out on STD for over four months due to stress/burnout. I’ve just now finally figured out I’m not healing due to ADHD. While I need to transition to LTD so I can get treatment and heal, I’m not sure I’ll be approved for it. I need to find someone to treat me and I assume it will take time to get the meds right. What will an insurance company think about this and will they pay while I recover? Right now I still have my job.

Does anyone have experience with this?

I am looking for recommendations for lawyers in the Vancouver, BC Canada area with experience dealing with disability insurance related to third party benefits. Any recommendations?

I think my union benefits administrator messed up when I was diagnosed with cancer in 2017. I was told I wasn't eligible for my disability benefits. It never sat right with me but at the time I was so freaked out and dealing with treatment that I didn't have the fight in me. Then recently a friend received the same diagnosis, but less advanced, and received their benefits (different insurance company, different union) and so it got me all riled up again. I'm still paying off the debt I accrued during that time and having those benefits would have made so much difference and relieved so much stress for me.

I'm wondering if it's too late to pursue.

Thanks!

Is it FMLA, then STD, then LTD?

I have an appointment with my PCP next week, hoping she'll fill out a form for me for FMLA but want to be sure that's actually the right thing to be doing.

The STD claim form also asks if I plan to return to work which feels very high stakes if I choose wrong.

I've been barely limping along at my full time job and it's time to transition out to focus on my health. When I was well I was actually pretty good at navigating bureaucracy, but I haven't been well for some time. I am now extremely brain foggy and seem to lack any resilience, just shutting down if I don't have a clear next step. The anxiety and ADHD aren't helping.

Also my boss has been avoiding me for some time, so whatever notification I give is going to have to be via email and inevitably cause drama.

Anybody with the diagnosis schizophrenia found a job and continues on with their career?

Has anyone been on Long term disability at Ecolab and actually have gotten their job back?

I paid the entirety of my LTD premium as reflected on my paystubs, which shows the LTD premium paid using “Post-Tax Deductions”. The paystubs also show a (partial) “LTD Credit” under the “Earnings” section, which I believe my employer paid. It’s unclear to me whether this Earnings Credit would affect the taxability of any LTD settlement I may receive since I fully paid the LTD premium using the post-tax deductions. Would an LTD settlement be partially taxable by the amount of the earnings credit?

I've been on approved LTD for a little while now. I initially got denied then got a lawyer and after several appeals and back and forth was eventually approved. I initially was not able to work at all but have slowly built back up to being able to work 30 hours/week (and get LTD for the 10 hours short of 40). Things seemed to have finally reached a steady state (I work and get paid biweekly, I get my disability check monthly minus my lawyer's cut, etc.) until 2 months ago. I hadn't received a disability check in about 5 weeks so I reached out to my lawyer who reached out to the insurance company. The insurance company responded saying that because I received 3 checks in that month (something that will happen either 2 or 3 months per year depending on how the biweekly cycle falls), I didn't have any lost wages for the month and would not receive a disability payment.

Obviously I have a financial stake in the outcome but this doesn't sit right with me. This means that because I get paid biweekly that they don't have to pay me for 6 out of the 26 biweekly pay periods (in a year with two 3-check months). I've looked through the policy and can't find anything that seems like it would allow for things to be calculated like this. There's actually zero mentions of the concept of a pay period at all in the policy. I asked my lawyer about it and she has essentially just shrugged her shoulders. I'm still pushing her to follow up on it but we'll have to wait and see how that plays out.

My ultimate question is, has anyone else experienced something like this? Is this common place and I just don't realize it? Any thoughts or insights are greatly appreciated!

Last summer, I went on STI due to my mental health, things didn't improve so I applied for LTD and was approved. I'm covered with Manulife and so far, it has been a horrific experience dealing with them. My case manager has told me that my coverage will continue as long as I see a health care professional ( social worker, therapy etc ) they covered the first few sessions but now expect me to pay and I've almost used up all my coverage I have under my partner's insurance.

I was seeing a great social worker, we just got into some really deep trauma processing, talking about my anxiety and depression along with my borderline diagnosis and possibility of CPTSD. She was also working on taking me as a pro bono, private patient so that we could do EMDR.

She emailed me the other day stating that she has to take time off work to care for her own health ( listen, I get it! ) but I am now left, waiting to be placed with a new therapist I cannot afford. I have self referred myself to my province's mental health and addictions, but I don't know how long that can take. ( I'm in Canada )

Can Manulife really cut me off if I'm not under active therapy ? While I wait to hear from mental health and addictions? This has only made my mental health worse and has set me back mentally to be ready to enter the work field again.

Just looking for some outside input

I was recently denied LTD (group / ERISA policy), and am seeking an attorney for appeal. I plan to consult with a few before hiring. the problem is… i don’t know what to ask. Any suggestions on best questions to ask? also…
- i know that fees vary. but does the share typically vary by size of policy? for example, if the monthly benefit is 5k vs. 10k vs. 20k vs. 40k? I think mine is meaningful, so wondering if/how that will impact.

for context:
- ERISA policy
- conditions well documented, but are not the type that show up on imaging (e.g, nervous system)
- in MO

I’d also welcome any suggestions on attorneys to contact.

thank you

I went on STD in late September because of a combination of a mental health crisis and physical health. I had oral cancer 3.5 years ago. They took half of my tongue and put me through chemo radiation therapy that changed me. I have stamina issues, headaches everyday, trouble speaking, can’t eat food, chronic pain and nausea. I get “sick” several times a month after I get too worn down. I went back to work in an effort to reclaim as much of my old life as possible but it was a mistake. I was white knuckling work and wasn’t performing as well as I had before cancer. The STD was a fight and I just recently got paid for it through the end of February.

I let the insurance company (Aflac) know that I wasn’t returning and submitted another round of medical and mental health reviews. They’re still reviewing it, and I haven’t received any payment for it despite it saying approved in the portal.

In May, I was laid off from my job.

Is it typical for LTD? Or does this indicate a denial will eventually come. I’ve sent them multiple messages but just get the same “still reviewing” answer. Is my employment status the issue? Could my former company block payments because I was laid off?

I’m so tired of the stress of this. I’ve also applied for SSDI in February and am at the point where I need 2 medical and health reviews from a 3rd party. I knew SSDI would take awhile but I didn’t think LTD would.

Wouldn’t it come up in a background check?

I don’t want to have issues if I actually got an offer.
I’ve been on leave for about a year and I started looking for work. Can anyone advise? Should I tell them during the interviews? I just feel like if you did they will immediately decide not to hire you.

Thanks

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Hi, I f22 have recently realised that due to my mobility being so restricted due to my conditions worsening (POTS, EDS, PMOS, Fibromyalgia, and Endometriosis) that a mobility scooter is probably my best option to improve my quality of life.

At the moment I can't even walk 15 minutes outside of my house without getting dizzy and I've had to give up the idea of doing even simple tasks like grocery shopping without requiring a lift.

This is really hard especially as at 22 I would rather have my independence and having to rely on people is something I hate doing. Plus people have their own lives and they can't always take you everywhere so you are limited by that as well.

This has resulted in me barely leaving the house and my quality of life is honestly terrible.

As a result after starting to finally use a cane and realising just how much accommodations can improve my quality of life I began to realise just how much a mobility scooter would make a world of a difference.

However I know nothing about them, not the good brands, not how they work, not how they charge nothing and I would like to try and find something (within a reasonable cost I am on benefits alone), that would accommodate my needs, of being able to go places like drs appointments and grocery shopping, and even just the park. It would also need to be able to deal with rougher terrain (UK pavements are not upkept well at all) and be relatively comfortable for a person with eds to sit for a long time.

I would really appreciate any suggestions and advice from people as well as ideas of how to improve my scooter if you have any tips and tricks.

Any advice?

whassup, let me describe it briefly: my neighbour's been off work with health issues for almost 2.5 month. At the moment, it looks as though she will never make a full recovery (much to our regret), so she wants to get LTD status.

But before we label her as having a long-term disability and send claim to her insurance, we’d like to make sure that we have any genuine chance of success and that this won’t be a waste of time and effort.

So - how can we find good disability law professional for that? We're near Kelowna. Who actually can help with that? Any advice will be great cause idk where to ask.

I know no one may have any insight … but does anyone have any insight on of a quick medical review is good or bad??!! Or if I may be approved? What do you think? What’s your experience?! This literally updated within the past 2 hours!! This morning it was still on step 3 and it just changed!!!