I posted something earlier this week - not knowing how relevant it was to me until today

[The Straight Story]

California Bans Discretionary Clauses in Disability Insurance Policies

Imagine this situation: You're the victim of an unexpected accident or illness and all of a sudden you're not well enough to return to work. Thankfully, you've been carrying disability insurance coverage for years, so you could protect yourself and your family in case something like this happened. You go see a series of doctors and specialists who investigate your ailment and document that you are unable to return to work.

You are finally able to rest easy, knowing now that your disability has been medically proven you will be able to rely on your disability coverage and continue to support your family. Then, out of nowhere, your insurance company invokes its "discretion" to disagree with medical evidence and decide that you are not disabled. It denies your claim, leaving you with nothing.

http://www.democraticunderground.com/discuss/duboard.php?az=view_all&address=439x2303708

Long story short - I went on disability at work in late September for several issues. FINALLY last week my claim was approved (and I pay for short term disability insurance, I can be off up to 6 months with 2/3 pay) and I got a check. It barely covered my expenses from my time off.

But I was not worried, I would still get paid each week until my doctor released me (I won't see her until next week and a specialist late December).

Today:
The company that handles my claim called me and said I was good to go until the 15th - ie, today. I explained that the paperwork I sent them from my doctor had me off until at least mid-December.

"It does not matter, we need more paper work from your doctor(s) before we will continue payments"

"I don't see her until next week."

"Well, when you see her have her send in the new notes and we can evaluate it further then to determine whether or not your are currently disbaled."

So...no matter what my core physician says they don't care. Nothing has changed (gotten worse in some ways trying to adjust to the new meds, which she wants to up next week). If some case manager decides I am not temporarily disabled, so be it.

PS-My company supports me, wants me to take off the time I need, and my HR manager is calling them tomorrow to inquire about it all (my HR manager was the one who suggested I take off the time in the first place).

[ZombieHorde]

1. How frustrating. Fuckers.

I wish you well. :hug:

[Donnachaidh]

2. and our government has given these vermin a guarantee of profits thru the healthcare bill

Insurance companies should be driven into the sea -- never to return. :grr:

[WillyT]

3. K & R !!! - Thank You !!!

Everybody needs to know this.

:grouphug:

:hi:

:kick:

[dajoki]

4. I feel for you...

I went through somthing similar myself. Good luck!!:hi:

[gratuitous]

5. Those insurance companies can't hand out executive bonuses by paying claims, pal

Where's your humanity? Do you even for a second think about how embarrassing it is for a high-powered executive to pull into the marina in last year's yacht? The other club members would laugh themselves sick!

[Coyote_Bandit]

6. I know someone who went through that same frustration

The upside?

The disability insurance company provided legal counsel without fee to document her Social Security dsability claim. The Social Security claim was approved for permanent total disability without the need of going to a full hearing as most disability claims do.

Yes, the insurance company was able to recoup all the funds they had paid out. But the Social Security disability finding was timely without interruption in income and this woman's Social Security disability benefits are larger than what her disability insurance paid.

Best to you.