Hey Barbara A & TMers, I just got my LTD forms today. This one looks longer than before. In the past, I had a doctor that would fill it out only as I answered each question to him. lol This one is asking for Monthly SSI benefit amount. I know they could had asked me sooner, because each rise we got from SSDI, I didn't tell LTD, since I thought that LTD should already know that everyone got a rise & thought that my LTD would go up the same amount anyway. I didn't think I needed to tell LTD how much. Does our LTD go down as we get a rise from SSDI? Just jumping through more hoops, Todd in CC, TX
--- On Sun, 12/7/08, [EMAIL PROTECTED] <[EMAIL PROTECTED]> wrote: From: [EMAIL PROTECTED] <[EMAIL PROTECTED]> Subject: Re: [TMIC] your thoughts? To: [EMAIL PROTECTED], [email protected] Date: Sunday, December 7, 2008, 11:15 PM Hi Candi, I wish you the best of luck with your LTD hearing. You have a right to all the paperwork out of your file at the insurance co. and should order it if you do not already have it. The insurance companies have no conscience at all. Their job is to get people off the disability roles, and I understand that they need to get the ones off that aren't really disabled, but not the ones that are. My LTD provider (Prudential) did the same as yours regarding sending a letter to my doctor requesting that he complete a form about my condition and what my capabilities were. They also stated on the letter to him that I had been working on a part-time basis and requested the stand, sit, walk, etc. questions. Now, my policy states that I am entitled to benefits if I am able to work on a full-time basis based on my training or what I can be trained to do, something like that, and on and on. I haven't worked at all since Dec. 2000, and they know it or they would not have been paying me. This was sent to my Neuro, and all previous correspondence was sent to PCP. The Neuro hadn't even asked me to come into his office for a visit before sending back the form to the insurance company stating that since I had been working part-time that I could work full-time now, after listing capabilities that don't match me at all. In the meantime, I had gone to a Physiatrist that the insurance co. set up for a review of my condition. This doc stated that I was not able to work. Then, since the insurance co. got the form back from my Neuro stating I could work full-time, they contacted their doc and asked him to reverse his decision and state that I could work, telling him that my doc must know my condition better than he does, and he did it. I was denied my coverage at that point. It took a couple of visits to the Neuro to get everything squared away with his paperwork and re-submitted. It also took me requesting copies of all my paperwork from the insurance co. in order to have ammunition for my appeal. There were about 3 reams of paper worth of copies they sent me, and most were triplicates of my early TM years, including hospital info. That was very depressing looking back at that stuff. I had to submit 2 appeals. They were tough, but I'm glad that I stuck with it and finally noticed what they did with the doc they hired. That was very underhanded and let them know it was wrong and not proper business practice. When I later told my husband he was really angry and felt we could have sued them for what they did, but I don't know. Especially since I may not have caught what they did, and could have possibly lost again and had the expense of a lawyer. If it went to a lawyer and I would win, they pay the lawyer. If I lose, I pay the lawyer. This was about 3 years ago, and I just got another letter with a form for a doctor's statement. I now have a new PCP and Neuro, so I hope all goes well. I have a HMO and the process is that I drop off the forms to the medical secretaries and they go back and forth to docs to be filled out, transcribed, approved, distributed and filed. I sent emails to them letting them know I am available for questions and the trouble that I had last time. I hope this works out without any snags. If we don't fight for our rights, who will do it for us?? Hugs to all, Barbara A Make your life easier with all your friends, email, and favorite sites in one place. Try it now.
