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Old 03-12-2015, 11:03 PM #1
Nellyzen Nellyzen is offline
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Default LTD issues

Hello everyone!

I've been on disability for a few months for thoracic outlet syndrome and I feel like they are trying to find reasons to close my claim.

They requested medical records from the hospital that misteriously never made to them, not sure where they got lost and nobody told me they are about to close my claim. I did follow up and made it happen last minute but nobody is keeping me informed. I am also getting an attitude from the claim adjuster when I tell her my dr is still keeping me off work. I had 2 surgeries for this condition and still have a lot of pain.

Should I be asking for a supervisor or talk to a lawyer...? Any advice appreciated.
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Old 03-13-2015, 01:08 AM #2
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Originally Posted by Nellyzen View Post
Hello everyone!

I've been on disability for a few months for thoracic outlet syndrome and I feel like they are trying to find reasons to close my claim.

They requested medical records from the hospital that misteriously never made to them, not sure where they got lost and nobody told me they are about to close my claim. I did follow up and made it happen last minute but nobody is keeping me informed. I am also getting an attitude from the claim adjuster when I tell her my dr is still keeping me off work. I had 2 surgeries for this condition and still have a lot of pain.

Should I be asking for a supervisor or talk to a lawyer...? Any advice appreciated.
Fairly expensive to bring an attorney in but do what you have to do.

Is it an ERISA claim?

If you read your policy closely and respond to everything promptly, you might be able to handle it on your own.

Here's a good link to start reading:
http://www.nolo.com/legal-encycloped...erm-disability
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Old 03-13-2015, 12:21 PM #3
Mz Migraine Mz Migraine is offline
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Should I be asking for a supervisor or talk to a lawyer...? Any advice appreciated.
YUP!



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Old 03-13-2015, 09:18 PM #4
Nellyzen Nellyzen is offline
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I talk to them today and they said a nurse will be reviewing my medical records to see if it's still necessary for me to be at home recovering or not.

How can a nurse make that determination when she doesn't have the training to make that decision? Is her decision higher than a surgeon's? What the heck is wrong with this picture?
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Old 03-13-2015, 10:09 PM #5
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ERISA laws were, in theory, created to protect beneficiaries, but they've have the opposite effect. Work Comp laws are just as bad in many states.

Have you applied for SSDI yet? Has your insurance company made that demand, yet?

My very inexpert observation is that they seem to tend to stack paperwork with deadlines that you need to comply with for both SSDI AND your LTD policy simultaneously to overwhelm beneficiaries.

Be very careful what you put in writing and say in interviews to the LTD company. Do not do anything that might look remotely questionable outside of your home. They will hire private investigators to follow you and video your activities. They tend to ramp up these type of investigations when they are determining if benefits will be ongoing.

Doctors are not any better making these kinds of decisions either, btw. They tend to err on the side providing a paycheck and their reports are often full of glaring errors. Utilize your appeal system or whatever the system allows and make sure you do it in a timely manner.
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Old 03-14-2015, 01:17 AM #6
Nellyzen Nellyzen is offline
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I haven't applied for SSDI yet, they told me that will be the next step if I'm not back to work by April. I had two rib resections and it's only been 4 months since the last surgery. My disease is pretty rare and I just don't see how a nurse who doesn't know anything about it can make a decision.

I sent them the paperwork via overnight mail requesting a signature and nobody has picked it up yet. Very frustrating.

I do know they use surveillance and they are welcome to. I don't even do grocery shopping by myself, my husband does that because I can't carry them.
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Old 03-16-2015, 11:53 AM #7
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My disease is pretty rare and I just don't see how a nurse who doesn't know anything about it can make a decision.
Nurses who review medical documentations will confur w/your treating drs, surgeons, etc. if they have any questions and/or concerns.
Never underestimate nurses-male or female. If your disease is rare, the nurse assigned to your case for review may have their masters and/or PH.d in rare diseases.




I do know they use surveillance and they are welcome to. I don't even do grocery shopping by myself, my husband does that because I can't carry them.
I love watching those fraud surveillance episodes on Dateline, 20/20, 60 Minutes, MSNBC. California is the worse when it comes to WC & SSDI fraud.



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Old 03-17-2015, 08:58 PM #8
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Well it looks like things are ok for now, my claim has not been closed. What a stressful week!
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Old 04-24-2015, 08:01 AM #9
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Default ltd is worse than WC

Knowing what I do now I would have never spent my money on an ltd policy. these ****** are worse than WC in harassing your doctors constantly requesting medicals every quarter and they never want to pay.

I want to know if they can interfere with your ssdi - I was awarded first time due to my condition and I seems to be getting more hassles from LTD than anywhere at this point
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Old 04-24-2015, 09:25 PM #10
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Knowing what I do now I would have never spent my money on an ltd policy. these ****** are worse than WC in harassing your doctors constantly requesting medicals every quarter and they never want to pay.

I want to know if they can interfere with your ssdi - I was awarded first time due to my condition and I seems to be getting more hassles from LTD than anywhere at this point
Please start a NEW thread as Jo mar has already requested.
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