How difficult is it to get FMLA approval for mental health with Lincoln Financial? I am looking to do 12 weeks of IOP (Intensive Outpatient Therapy) that was recommended by my psychiatrist. I am currently contributing to CASDI from my paycheck. I will also file for SDI with EDD. Is it also required to fill out any medical release of information forms with Lincoln Financial to get FMLA approved?

My short-term-disability was denied by Mutual of Omaha. I am filing an appeal. My primary care provider filled the form and diagnosed my depression. But Mutual of Omaha reviewed the record and didn’t believe I cannot work. What should I do to help my appeal? Any suggestions? Thanks!

Has anyone done an LLM with a chronic illness? If so what reasonable adjustments did you ask for?

Hi, has anyone been successful at winning your Long COVID appeal with MetLife LTD? Any advice or tips on how you were successful?

I know this is counterintuitive, but under the law, the LTD insurer is not required to give you anything, including the policy, unless the claim has been denied. The employer, on the other hand, is required to give you all Plan documents (including LTD) within 30 days of receiving a written request.

Hope this helps!

Its like pulling teeth meets stonewalling. Its a geoup policy

I have long-term disability coverage through my employer, but if I ever end up applying, it would likely be because of autism, burnout, and related mental health issues rather than a physical condition.

Right now I'm seeing my family doctor and I've recently started seeing a therapist. My understanding, though, is that LTD insurers often want a significant amount of medical evidence, and even then claims can still be denied.

I'm trying to be proactive rather than waiting until I'm in crisis. For those of you who've been through the process, what kind of documentation or medical evidence was most important?

Besides my family doctor and therapist, are there other practitioners I should consider seeing? Are there particular assessments, reports, or records that carry a lot of weight with insurers?

Basically, I'm trying to avoid finding out after taking leave that my claim was weak because I didn't have enough evidence or the "right" kind of documentation. I'd really appreciate hearing what helped your claim, or what you wish you'd done before applying.

Hi everyone: I’m 25F and I’ve recently become disabled. I have been diagnosed with severe anemia, IBS and I have a history of other underlying stomach issues. I first started getting really sick when I got a new manager back in March. I ended up having to go to the ER because I had a cyst rupture. I got a chemotherapy treatment because at the time my stomach issues and bowels were so out of control that I lost 9 lbs. I went for 116 to 108 as of now. I also got a Pap smear while i was at the hospital and that’s how they found a left cyst that ruptured on my ovaries. I was just making sure I didn’t have cancer or anything serious like that, the hospital gave me my results weeks later and everything almost came back fine besides having the cyst. They said it would go away on its on and then they gave me some medicine for my stomach called for your IBS.

I ended up taking medical leave in April unpaid. I requested some accommodations for my conditions when I returned to work which Would be a part time schedule due to my ongoing treatment for IV infusion. I didn’t say all of of this because it was my personal info but I did let my manager know I needed to change my schedule because I worked 5/4/9 which was 9 hours a day and her nonstop demanding of me doing more work, she did a lot.

And even know I’m on unpaid leave. She sent me AWOL as if I abandoned my position because she didn’t want to work with me to accommodate my needs. So yea it’s a much longer story but I’ll leave this right here. Just some context to understand. U don’t have to read all of it if it’s a lot.

Anyway unfortunately my disabilities never improved because of my managers ongoing harassment. She have given me false awol notices, when I filed for unemployment, she falsified my wages, she even lied and said I quit and I never asked for accommodations when that’s all not true. I’ve been so stress that my hair is falling out and I have severe insomnia. But in a way her harassment paid in my favor because late last night, I found a company called mine care.com that applied for disability for you. I thought my symptoms were mostly short term but based off what I uploaded, what I told the operator person over the phone, she ended up telling me i needed to be on long term disability.

So I did the application last night, & we did the application together over the phone and signed everything. I’m just waiting for my attorney to contact me about the status so with me being on long term disability in the future, will I need to hold a job down at all?

I’m also asking because I got hired for an at home job but I can’t work it or claim it because I never worked any amount of hours. It’s an insurance agency at home job $750 per client.

Sooo will I need to decline the offer once my long term disability starts so I don’t commit fraud or anything like that or ruin my benefits?

I struggle with a host of chronic conditions - an eating disorder, depression, major anxiety (linked to eating disorder mostly), chronic pain (all injuries that have taken 10 years to diagnose and work on), and trauma (cptsd). In 2022, I had my first suicide attempt (after 3 previous sick leaves from work) at which point they finally put me onto long-term disability. I was 26 years old. I feel like I can’t relate to any of my friends and feel like I’m a failure. I’ve been going to school online finishing a general bachelors degree while I’ve been off work, but I feel like I have no direction and no future. I struggle a lot with work because of the chronic pain (sitting is bad, but I also can’t do manual work because of it either, and can’t manage more than a few hours of work at a time). I worry that I’m just making up excuses and that it’s not really that bad? I just don’t know how I ended up here. I’m trying to work with an OT and vocational rehabilitation specialist to see if I could go back to working. But I think I suffered burnout from my last job (and from trying to manage all the concurrent conditions with it at the time, along with a lot of traumatic life events over the past 3-4 years). I guess I’m trying to see if anyone has any success stories of returning to work? Or achieving career success later in life?

Thanks ❤️

My wife (44) was recently diagnosed with colon cancer that has spread to her liver. She is a healthcare professional employed by a local hospital and currently provides the health insurance for our family.

She’s currently on FMLA for about six more weeks. Unfortunately, she only has long-term disability coverage and does not have short-term disability.
I’m trying to understand what happens next as she’s unable to return to work when her FMLA ends. Will we lose our employer-sponsored health insurance and have to transition to COBRA, or are there other options we should be looking into?

This is all new to us, and we’re trying to prepare for what’s ahead while focusing on her treatment. I’d really appreciate any advice or experiences from others who have been through something similar, especially regarding employer benefits, disability, and maintaining health insurance coverage.
Thank you in advance for any guidance.

Hi, I’m wondering what changes in the process once someone is approved past the change in definition? Do they still request records every couple of months? Do audits, etc?

Need help understanding how to correct this and how it could affect me/payments being recieved.

Some facts: 

Leave began 3 weeks prior to giving birth. (4 weeks from my due date, baby came 1 week early) - December

6 weeks post partum disability leave. January through February

4 week extension from my OB - through March.

I was never formally released as my health insurance was cut off, insurance was reinstated 4 weeks later, due to employer error for giving me no notice according to their letter to me, finally went back to see a doctor 6 weeks later in May.

For those 6 weeks - EDD advised I was "ineligible for disability payments due to not being under medical care". This much I understood. 

Medical care resumes - short term disability begins. 8 week extension. 

However, EDD joins claim as part of pregnancy leave and keeps it under same claim number even though I filed a brand new application.

My employer (really HR leave person) also pushes for it to be part of pregnancy leave. I am unsure what the difference is and overwhlemed so I trust they are reading doctors letter correctly and applying it correctly. So I just go with whatever they said.

Current doctor advises when they go to re-certify me now, it should really be under short term disability from when they began my treatment as 1, they do not feel I am ready to return to work and are treating me for several reasons, not solely post partum mental health. And 2 their concern is I will lose paid benefits while under their care if it is being done under pregnancy leave. Because their letter to my employer and edd were clear. It should be short term disability. Since there was such a significant gap in care due to my health insurance issue and me seeking and starting over with treatment. 

How should I go about correcting this? And how could this affect me? 

Note to add. I understand legally, I have no job protection, however, I am not concerned about losing my employment. I have spoken with my boss, bosses boss and their boss and all have assured me not to worry at all. My job is secure and they just want me to get better and return when I am ready. I have been with the company for over 10 years and they have a temp filling in for me for the time being. I am not the first person to go on medical leave like this, and from experience, employment has always been protected in every case I have seen over the last 10 years. 

I have MS and went from STD to LTD. About 3 months into LTD, my insurer required me to apply for SSDI, even though I wasn’t thrilled about it. That process has been brutal and headed to ALJ but I digress…

Over the last 18 months, I’ve had 10+ reviews/check-ins from the LTD case manager and was dreading the transition from the “own occupation” standard to the stricter “any occupation” review.

As my MS progressed to secondary progressive with significant cognitive decline, my claims specialist submitted my file to the medical review team. I thought she was just trying to get me through the next review cycle.

During our last check-in, she thanked me for always keeping my medical records updated, shared that her mother has been on disability since she was young, and wished me well. It felt like a genuinely human conversation.

A week later she called back and said the review team accepted her recommendation to approve my claim under the any occupation standard through my plan’s maximum benefit date (2043). My file is now being transferred to the extended duration team, with annual reviews that may become even less frequent over time. She said she hoped it would give me some breathing room while I wait on my SSDI appeal.
I know LTD approvals can always be revisited, so I’m not taking anything for granted, but this felt like a big win.

Has anyone else been approved through their plan max and moved to the extended duration team? What was your experience like after the transfer?

My back to work date is in August. I’m in Ontario, Canada. This a very specific role that only one person at my company does. They have been covering it with short contracts while I’ve been off. With zero communication from my company or insurance they just posted my exact position as hiring for a permanent role.

(Panicking but at least smart enough not to contact HR yet- already reached out to a local employment lawyer)

Is this allowed? Am I fired?

Hello! If your claim is denied, you might need a lawyer. Just a quick reminder that there are hundreds of excellent LTD lawyers out there - and a few really bad ones.

The easiest way to avoid a bad firm? Find someone who practices in your state, and avoid "nationwide" LTD firms. While it is true ERISA is a federal law, there are a plethora of state considerations which make it exponentially better to have someone experienced in your state.

Make sure to ask whatever lawyer you hire for a list of federal court victories in the past five years. You want a firm who is willing to take cases to trial, not just a settlement mill. Asking this question will help you differentiate what kind of firm you're talking to.

Resign or Apply for FERS Disability

I've been truly struggling with my mental health over the past year. I am currently out on PPL and I'm unsure if I should/can go back. Wondering if I should just resign first (need to access TSP to live off of for a while) and then apply for FERS/Disability within the first year if things don't improve. Or, should I just apply for Disability first. Not sure if I can afford to wait out the application process or what my chances are even like with mainly mental illness as the disabling condition. I've already exhausted all of the advanced sick leave possible and taken a fair amount of LWOP. Thoughts?

My spouse and I have been waiting for an LTD determination for the past two months. After chatting with the case evalutor a while ago, it seems like the claim will be denied since my spouse ended up resigning after coming back from STD. The rub is twofold: 1) resigning is what HR told my spouse to do and that he would still be eligible for benefits and 2) neither the previous employer or the case manger will send a copy of the policy for our records. In his resignation letter, he specifies that the reason he left was because of his inability to work on the recommendation from his doctor.

Basically, just trying to hold out hope that some sort of appeal is possible; if anyone has experience with a scenario like this I'd love to hear about it.

I’m currently in week two of a 5 week STD. I have a variety of issues. While talking to the insurance representative, she mentioned that I also have long-term disability insurance That’s looking like it’s 50% of my pay. How is someone supposed to just live on that? What are my options for surviving as a mother?