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Old 01-08-2012, 10:16 PM #1
AllAmericanAmy AllAmericanAmy is offline
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AllAmericanAmy AllAmericanAmy is offline
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Default advice needed... do we file?

Hi all -

My hubby had a ski accident 1/31/11 and has a TBI (traumatic brain injury).
He has been completely unable to work since his accident. I've been following the forums in the head injury section and just noticed you folks over here. Since the other forums have been such a blessing, thought I'd ask you folks for some help too!

Hubby is 52 and has run CNC machines in a factory for 25 years.
Completely unable to function 90% of the time - simply lies in bed watching tv (he feels best in a prone position). Symptoms are extreme dizziness, brain fog, light and noise sensitivity, cognitive thinking issues, etc...

His employer has been wonderful and is holding his job until 2/1/12. Based on his recovery thus far - there is no way (short of a God given miracle) he will return to work Feb 1.

Praise the Lord --- hubby had purchased the optional Long Term Disability Insurance offered thru his employer and we applied this past summer when his short term disability insurance ran out. The long term Insurance company stalled us for 3 months but in November notified us they are not going to dispute our doctors statements and agree hubby is disabled and began paying monthly.

The insurance company had informed me that they pay until hubby reaches 59 1/2 or something weird like that. Obviously, subject to bi-monthly reports from doctors, etc. I've seen some nightmare stuff online in forums regarding abrupt stopping of payments irregardless of doctor reports, etc.

They also said that after paying out for 24 months they will then help us (force us?) to begin application for gov't disability. It sounds like they pay a guaranteed xxxx amount per month (based on hubby past 3 months of employment) and then if hubby begins receiving gov't disability payments the insurance company will then reduce the amount they pay us and will make up the difference if the gov't pays less than their guaranteed amount.

Anyway, my question is this.... shouldn't we file for gov't disability immediately when he officially loses his job?

What would be the advantage of NOT filing for gov't disability immediately?

BTW, insurance right now will not be a problem Although hubby has always maintained insurance on us and our 2 teenagers, my employer will immediately add all 4 of us to their health insurance policy and cover all pre-existing conditions with no problem as soon as hubby loses his job and insurance.

Sorry for the long post! Thanks for any insight you can give us. Making decisions like this is scary stuff!

Blessings to you all...
Amy
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Old 01-08-2012, 10:54 PM #2
Babyboomer15 Babyboomer15 is offline
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File ASAP. You need to file so he can qualify for Medicare(takes 2 yrs after declared SSDI disabled).
The LTD carrier benefits if your husband wins SSDI because they would get their money back(except for probably 100 dollars a month-check your policy).
My LTD pays till I'm 65. I get reviewed once a year.
If your husband has a standing job and can't stand for 6 out of 8 hrs,that's usually a slam dunk for SSDI.Plus since he's in his 50's-it's much easier to win SSDI.
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AllAmericanAmy (01-09-2012)
Old 01-08-2012, 11:00 PM #3
Ironbutterfly Ironbutterfly is offline
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Hi - New here as well..

Hus is going thru same situation, but diff conditions then your husband. His employer just put him on LTD and they will hold his job until June this year.

I believe if I am understanding all of this with LTD and SSDI is this:

LTD wants you to qualify asap for SSDI so they only have to make up the difference and they are not paying full amount. It is mandatory via our LTD carrier that hus applies for SSDI. They will continue to review over next 24mos and can at any time deny him LTD. So we thought it best to just get it done and go from there vs. waiting until they review him again every few months. They also said they will provide assistance should we apply and get denied free of charge. Of course, this comes as a credit should the claim go on for years and would involve a lumpsum back pay amount. LTD requires that we pay them back out of any lump sum from SSDI. So keep that in mind as far as deciding when to file a claim with SSDI and get the ball rolling.

As I have been reading, SSDI can take years to get approved....some are lucky and get approved in short time, but not the norm....
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AllAmericanAmy (01-09-2012)
Old 01-09-2012, 11:31 AM #4
Mz Migraine Mz Migraine is offline
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Quote:
Originally Posted by AllAmericanAmy View Post
Hi all -


Anyway, my question is this.... shouldn't we file for gov't disability immediately when he officially loses his job?
As Babyboomer already stated - File for SSDI ASAP!!!!!

To qualify for benefits, you must first have worked in jobs covered by Social Security. Then you must have a medical condition that meets Social Security's definition of disability. In general, we pay monthly cash benefits to people who are unable to work for a year or more because of a disability.

http://www.ssa.gov/disability/
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Old 01-09-2012, 11:40 AM #5
Mz Migraine Mz Migraine is offline
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Quote:
Originally Posted by Ironbutterfly View Post

As I have been reading, SSDI can take years to get approved....some are lucky and get approved in short time, but not the norm....
No it is NOT the norm. It depends on the backlog of the state you reside in. Some states are more backlogged than others, and some have no backlogs.

If you decide to hire an attorney, ask about the SSD backlog in your state. The attorney will have some idea of how long it will take from beginning to end.

If your state has a backlog, I strongly recommend that you start saving $$ now AND start checking your county, city and/or state programs long before your "savings" are exhausted.
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Old 01-09-2012, 07:54 PM #6
Ironbutterfly Ironbutterfly is offline
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Quote:
Originally Posted by Mz Migraine View Post
No it is NOT the norm. It depends on the backlog of the state you reside in. Some states are more backlogged than others, and some have no backlogs.

If you decide to hire an attorney, ask about the SSD backlog in your state. The attorney will have some idea of how long it will take from beginning to end.

If your state has a backlog, I strongly recommend that you start saving $$ now AND start checking your county, city and/or state programs long before your "savings" are exhausted.
Ok will do...thank you.
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