disability woes
 

Hello everyone,

I just found out it is better to double space these these!

Has anyone else had trouble getting long term disability for their injury?

I submitted paperwork for employer-paid LTD and even with the

Neuropsychologist's recommendation of " at least one year minimum of

unemployment due to moderate to severe cognitive deficits" this insurance

wants more proof by taking a Functional Capacity Exam.

It always seems like they want more and more proof, as if you are

suspected of lying about a head injury, and must prove it every way they

can think of. Even if you are arrested for a crime, your innocent until

proven guilty... guess just the opposite with this, huh?

It's 2 weeks shy of one year from the initail injury, and I've had NO source

of income to contribute to my family since losing my job ( almost 20 year

medical career), and I feel nearly useless. The disability is the only way I

can help us financially right now, but always something stops the process.

Just airing some frustration with this mess. Feels like 1 step forward,

2 stepes back. Your thoughts? Thanks in advance

Independant Assessments
 

I have had 3 independent assessments from my insurance company. I have

had an OT, Physician and Neurologist. I was also nervous about the whole

thing but all three determined I was unable to work. So far so good and I am

at 19 months now. I believe they have a protocol to stick with just to

eliminate the fakers. The physician who saw me says they can usually tell.

All three assessors were polite and professional but I too have heard horror

stories.

Good luck I hope it works out for you.

Actually, It does not help to double space every line. It makes it almost as difficult to follow from the end of one line to the next. What really helps is to double space after 4 or 5 lines, 6 lines maximum.

btw, You said, "Even if you are arrested for a crime, you're innocent until
proven guilty... guess just the opposite with this, huh?"

That may be how the laws are supposed to work but once arrested, expect to be treated like a convicted criminal. Ask for special considerations / treatment because of a brain injury and you will find out how cruel the criminal justice system can be.

Studies show that 60 percent or more of inmate populations show symptoms of brain injuries. And these numbers do not include those with mental disorders.

So, either way, we have a tough road and need to support each other.

I would have to agree with Mark here.

In trying to funnel thru the Disability aspect of the employer insurance system, they already "know" they won't find anything they "will verify as a problem" - thats how that system works.

Their assessors are paid to 'not' find anything wrong.... those that do are not kept on their referral system long, and a new one will be assigned to review you again - because 'they can' - and the insurer will inform you thusly (at least that is how it is in Maryland - as it probably is in many States; since the Federal system has given protections to the employer against 'soooo many fraudulent ' cases over the years).

Sorry for so many quotes , my commentary/sarcasm, etc. - just an expression of my feelings on the 'system' as it exists.....

I am retired (forced by termination in not being able to do my job - see my sig - after a 45 year Health career) so I understand your feelings. I am still dealing with the Employer's Insurance company, and the Work Comp issues. However, I already dealt with SSDI, received Disability and am now on Medicare, retired, and disabled thru the SSDI system.... and 65 y/o.

Hang in there Music-in-Me, continue with your supporting practitioners, follow their care, and recommendations; don't let any negativity get to you from the Employer Insurance Company side.

I've read your previous posts, not sure on all your cognitive issues.

When you are scheduled for anything, make sure someone else from your family, or close support , is present to assure the appointment is made to fit your schedule (best time of day for you, if there is a frame of time you have the worse symptomatology would be better - so they actually see the issues you are having, as will your support person witness) - assure they send you notice in writing, with long enough time to prepare to have someone with you.

Assure someone can be with you, since your cognitive issues will need support throughout the time of the appointment; you might even let the people know that you want that support person in the exam room with you if that is what you want, if you have problems with following conversations, etc. - there are many aspects of that process you can control to keep the balance on your side, even though it is their 'turn' to evaluate your problem.

Best Wishes.................... :grouphug:

Hello again, and thanks to all of you who have already responded. Mark, thanks for the typing tip, and I did not know about the criminal system,

and I apologize for the reference. To answer your questions about my status, I was in an MVA last October, and we were rear ended while stopped

in traffic. I almost passed out at the accident scene, but was taken by ambulance to the ER and released later that evening.

My injuries were 3 herniated cervical discs, and PCS with daily headaches, noise/light sensitivity, blurred vision, speech problems, attention deficits/ADD

concentration deficits, multi-tasking problems, "spells" vs. seizures, flooding,ataxia and graphomotor ataxia, and balance issues.

I was given Neuropsychology test in August, and the determination was for me to enter a brain rehab program, but I am still wainting for the lawyers to

work out payment for this. I tried to return to work in March under a work hardeining program, but wasn't allowed to try because my workplace said

I didn't meet the minimum requirements of my job description. I lost my job at the end of March.

I took my first job at 12 years old, and have worked full-time since I was 18 years old, so I am not a stranger to working to earn my keep.

I am not accustomed to not working. I would not "lean on the system" if it were not fully necessatry right now.

I thank you all once again for your comments and encouragement.:hug:

I think many of us can appreciate this - I know I do - I had no plans of not working until past 70.......... well that changed quickly.

Good Luck with your assessments.

:grouphug:

Hello concussion,
I need to make a correction, as I have worked full time since I was 22 years old, and some part time before that while attending classes in college. I am glad you and others have responded, and given me a reason to just relax and let things work out as they will.

I think I have high expectations and too little personal experience to deal with all that has happened. I am kind of in a holding pattern, but I have good doctors, a good attorney and my family has been awesome. I am much more comfortable when there is a plan or goal in place and I can see things progressing towards them. The unknown is uncomfortable, and that is where I am currently.

My faith has sustained me mostly, and I rely on it a great deal. I know I would be in worse shape if I didn't believe as strongly as I do that there are" plans to prosper me and not to harm me; plans to give me a hope and a future (Jeremiah 29:11).

Thanks again for all your good advice. m-i-m

Education is needed in Ins Co's...be an educator
 

I empathize with your frustration!

I've been in your shoes and it's not an enviable position. My own HR people (state employee) were even frustrated with the separate STD and LTD insurance companies. I qualified for STD, but the LTD company denied my claim. They even went to the trouble of having an investigator follow me to "prove" I wasn't injured.

The investigating report cited that I washed my car (9 mo post injury & proud of it), noted posts from classmates welcoming me back to school (w/ADA help) on MySpace and watching my doctor's office for me to show up and reporting I did not attend my appointment - because I went to his main office. Every point they brought up was easily defensible.

I was given 30 days to fight the ruling, but suffering from PCS I was incapable and lost track of time - thereby lost the additional income I was actually due.

Nearing the end of the STD limits the company rep filled out and qualified me for retirement disability - without me even asking. (You'd think this a nice thing, but I was 38 back then and it devastated me.)

Two years later the managing insurance company for STD and disability retirement benefits lost the contract. The company that denied my LTD benefits took over. Oh yes...they immediately sent me papers to fill out asking for all sorts of testing to once again "prove" I was disabled - since they "proved" I was lying before. They mainly requested physical testing - which didn't apply to MTBI/PCS.

Thinking clearer 4 yrs later, I asked for the representative's manager (somebody they couldn't change on me) and sent her a letter explaining my situation. I explained brain injury and asked for MTBI/PCS specific testing - they had none. However, she didn't require me do the physical testing after that request. I also explained the 3 different "me's" post injury - One without med's, me on med's and me on med's and the side effects they cause. I also spoke to the manager by phone explaining that physically I'm fine to do things like ride a horse, drive a tractor or wash a car. I can push, pull and lift. Physical isn't the issue. It's cognitive. It's my brain being rewired.

I told her: I can drive the tractor, but not without hitting the barn - did it twice because I lost my focus; I can saddle a horse, but it takes me 2 hours because I forget the steps or can't decide which harness to use; I can wash my car, but I don't remember where I put the soap and bucket, - it's not if I can soap it up and hose it off. My job was thinking. I created and managed websites - every required skill my brain injury took away.

That was a Game Changing discussion. Three weeks later I was qualified AND told I can actually get a job earning up to $18/hr (lol) without impacting my benefits. She also suggested that I could volunteer somewhere to feel valuable again. I became a human being that lost so much, but was fighting to build a new life. I was no longer just a case number.

Now I just fill out yearly updates and give my doc's their portion without a problem. I understand they want physical proof of a brain injury, but that isn't always possible. Education is needed, give it yourself. Send them pamphlets with your paperwork. :winky:

Best wishes to you along your journey!

Kris

Hello ReWired Kris,

I have read a few previous posts done by you, and have found you to be incredibly insightful and compassionate. Wow, I almost can't believe all the things you had to go through just to get what you deserved. I am glad to know that all things did work out for you, and you finally found an empathetic listener at the other end, who took the time to understand all you have been through.

In the paperwork I filled out, I listed activities I could do everyday, like light housework , depending on my fatigue level. But my job required " a minimum lifting of 50 lbs. or greater on a consistent basis" and I haven't been able to lift anywhere close to this amount, much less do all the critical thinking, quick decision making also required of my profession, all while performing hands-on patient care with people who are usually at least physically compromised, if not cognitively as well.

So, there is a big difference between being able to sweep or vacuum in a limited area with sufficient time and rest periods vs. do what I once did at work. If I try to do more at all, the tremors."freezing up" and brain fog all begin. I truly can relate to your examples of riding a horse, driving a tractor ( although I can't drive right now) and washing a car. You never know just what it takes to do anything when you have a brain injury. Like you said, " every required skill my brain injury took away."

You are right...Education is needed. Trying to educate those I know. Will bring info. as you said to every appt. if necessary. Thanks so much! m-i-m