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Short Term Disability, Long Term Disability & Unum paid Disability Insurance with no FMLA

Forums General Melanoma Community Short Term Disability, Long Term Disability & Unum paid Disability Insurance with no FMLA

  • Post
    lrkg1234
    Participant

      Ok, need help.  This is really confusing.  My husband is planning on starting short term disability from work on Monday.  His job is NOT protected by the FMLA.  We have to get the paperwork filled out by the doctor and are not quite sure of the best answers.  We were thinking that it would be best to say unknown about returning back to work, so that he could get his 12 weeks pay and maybe they will pay the health insurance premium instead of making us pay COBRA right away.  He would also like to keep his job if possible, just in case of a miracle.

      Ok, need help.  This is really confusing.  My husband is planning on starting short term disability from work on Monday.  His job is NOT protected by the FMLA.  We have to get the paperwork filled out by the doctor and are not quite sure of the best answers.  We were thinking that it would be best to say unknown about returning back to work, so that he could get his 12 weeks pay and maybe they will pay the health insurance premium instead of making us pay COBRA right away.  He would also like to keep his job if possible, just in case of a miracle.

      But, then on the otherhand I heard that you should apply for SSDI right away, even if you are on short term disability.  How can you say that you might return to your job on one form and then a week later fill out another that says you are permanantly disabled? 

      Also, it's quite possible that they will just lay him off during the 12 week short term period right?  Has that happened to anyone?  Then what happens?  Can they take away your long term disability plan that you paid for when you were employed now that you are no longer an employee?

      Do you ever just get to skip short term disability and go straight to long term disability? I'm not talking SSDI, but Unum Long Term Disability? There seems to be some protection there.  It would help him with keeping his life insurance too, then he could get a premium of waiver and it wouldn't matter about not having the job to keep the benefits.  He paid for the life insurance, but it's through the company with Unum. If you could just skip the short term disability that would seem safest.  Everything is though Unum and work.  We don't really trust anyone and no attorneys around here know the answers. 

      The best idea seems to be get approved for short term disability, apply for SSDI, then get approved by Unum for LTD and get a premium of waiver. Plus do all this before you may get laid off/fired or whatever.  Am I on the right track?

      Sorry, this is a head full.  What can I say my head is full!  Not even sure if I made much sense.

    Viewing 12 reply threads
    • Replies
        POW
        Participant

          You are asking some great questions here and the outcome may well affect the rest of your lives, includng possible legal/criminal actions. This is one situation where I would definitely consult an attorney. Google "Disability Attorney" or "SSDI Attorney" in your area and ask around for referrals. 

          POW
          Participant

            You are asking some great questions here and the outcome may well affect the rest of your lives, includng possible legal/criminal actions. This is one situation where I would definitely consult an attorney. Google "Disability Attorney" or "SSDI Attorney" in your area and ask around for referrals. 

            POW
            Participant

              You are asking some great questions here and the outcome may well affect the rest of your lives, includng possible legal/criminal actions. This is one situation where I would definitely consult an attorney. Google "Disability Attorney" or "SSDI Attorney" in your area and ask around for referrals. 

                POW
                Participant

                  Have you actually spoken with these attorenys? Many attorneys will give you a free initial consultation either in person or over the telephone. Don't assume that they only fill out the paperwork and file SSDI for you; try to explain your problem to them and see what they say. You might just come across one who knows something useful. You could also call labor relations attorneys and ask your questions. 

                  You could also try the Patient Advocate Foundation ( http://www.patientadvocate.org/patient_services.php?p=763 ). You can also talk to the social worker at your melanoma treatment center and ask who can help you with the SSDI. They might  not be able to give you much advice about what to do about your current employer or employment benefits situation, but I can't believe you are the only cancer patient who has had to grapple with such decisions. 

                  Basically, the more you get on the phone and ask your questions, the more information you will get and the more likely it is that someone will eventually put you in touch with a person or organization who really can help you.

                  As with melanoma itself, don't give up! You are your own best advocate. 

                  POW
                  Participant

                    Have you actually spoken with these attorenys? Many attorneys will give you a free initial consultation either in person or over the telephone. Don't assume that they only fill out the paperwork and file SSDI for you; try to explain your problem to them and see what they say. You might just come across one who knows something useful. You could also call labor relations attorneys and ask your questions. 

                    You could also try the Patient Advocate Foundation ( http://www.patientadvocate.org/patient_services.php?p=763 ). You can also talk to the social worker at your melanoma treatment center and ask who can help you with the SSDI. They might  not be able to give you much advice about what to do about your current employer or employment benefits situation, but I can't believe you are the only cancer patient who has had to grapple with such decisions. 

                    Basically, the more you get on the phone and ask your questions, the more information you will get and the more likely it is that someone will eventually put you in touch with a person or organization who really can help you.

                    As with melanoma itself, don't give up! You are your own best advocate. 

                    POW
                    Participant

                      Have you actually spoken with these attorenys? Many attorneys will give you a free initial consultation either in person or over the telephone. Don't assume that they only fill out the paperwork and file SSDI for you; try to explain your problem to them and see what they say. You might just come across one who knows something useful. You could also call labor relations attorneys and ask your questions. 

                      You could also try the Patient Advocate Foundation ( http://www.patientadvocate.org/patient_services.php?p=763 ). You can also talk to the social worker at your melanoma treatment center and ask who can help you with the SSDI. They might  not be able to give you much advice about what to do about your current employer or employment benefits situation, but I can't believe you are the only cancer patient who has had to grapple with such decisions. 

                      Basically, the more you get on the phone and ask your questions, the more information you will get and the more likely it is that someone will eventually put you in touch with a person or organization who really can help you.

                      As with melanoma itself, don't give up! You are your own best advocate. 

                    Jamietk
                    Participant

                      Hello,

                      I work for an insurance company, specifically in the department that pays the STD/LTD/Life insurance claims. I do the tax reporting and not claims management, but I know a little about it. Here's what I know: Your husband will NOT be ineligible for the LTD plan if he goes out on STD and gets terminated. The policies go by the onset date and regardless of whether he is terminated during STD or not, his onset date would be prior to his termination date so he would still be eligible for the LTD benefits (assuming he meets the definition of disability, which he should, but I just have to note this technicality in policy terms). This is pretty common. I am not sure if it is a law. But if not, I can't imagine any policy not having this provision. Otherwise, what would be the point in paying for LTD insurance if termination while on STD disqualified you from LTD. Most employers have a pretty set standard time that they terminate someone once they go out on disability. One benefit to going out on STD is that they may be less likely to terminate him quickly. And they may require him to go out on STD first and then "link" to LTD.  His Benefit Administrator should be able to confirm how it works. I assume it is a smaller company since you say they are not required to adhere to FMLA regulations. So you never know how a small company will behave. You are correct about waiver of Life insurance premiums once you go on LTD. As far as the dliema of whether or not it is ok to apply for STD and indicate an intent to return to work, yet applying for SSDI, yes it is ok to do that. They would probably encourage he apply for SSDI because it is likely an offset of the insurance company's benefits they'd pay him and it would save them money. My company actually pays a consultant firm who specializes in helping you get your SSDI quicker so you might ask if they offer that service. It can be a HUGE help to you in getting SSDI and minimizing the hassle. And the insurance companies pay the cost of the service. And most of the insurance companies care about their claimants too and really would want you to apply for SSDI for your own benefit.  It is a time consuming process. If you have dependents, you could also get dependent benefits. Unfortunately, melanoma is not on the compassionate list of diseases that automatically qualify for SSDI approval. Even if you do get approved quickly, there is a 5 month waiting period from date of onset. I don't know what they'd use for your husband's date of onset but if you are more than 5 months from date of onset, your benefits would be retro with SSDI and your private STD/LTD. So you could have some back pay coming to you. Another point to make regarding applying for STD on one hand as if he's returning to work (to try to save his job), and yet applying for SSDI, don't worry about that. SSDI and private disability insurance actually can use very different guidelines of what constitutes being disabled. Just because you're approved or denied for one, doesn't mean the other one will have the same determination so apply for both. You'll probably find SSDI is more lenient, but takes longer. Your private insurance will likely go by an occupation test (whether he can perform his occupation for a specified amount of time each day), and an earnings test (whether he can make a specified percentage of his salary). They could have other requirements, but these are pretty common. Just be sure to advise them of all doctor's records they need to gather to help your case. I hope this helped a little. Good Luck.

                      Jamietk
                      Participant

                        Hello,

                        I work for an insurance company, specifically in the department that pays the STD/LTD/Life insurance claims. I do the tax reporting and not claims management, but I know a little about it. Here's what I know: Your husband will NOT be ineligible for the LTD plan if he goes out on STD and gets terminated. The policies go by the onset date and regardless of whether he is terminated during STD or not, his onset date would be prior to his termination date so he would still be eligible for the LTD benefits (assuming he meets the definition of disability, which he should, but I just have to note this technicality in policy terms). This is pretty common. I am not sure if it is a law. But if not, I can't imagine any policy not having this provision. Otherwise, what would be the point in paying for LTD insurance if termination while on STD disqualified you from LTD. Most employers have a pretty set standard time that they terminate someone once they go out on disability. One benefit to going out on STD is that they may be less likely to terminate him quickly. And they may require him to go out on STD first and then "link" to LTD.  His Benefit Administrator should be able to confirm how it works. I assume it is a smaller company since you say they are not required to adhere to FMLA regulations. So you never know how a small company will behave. You are correct about waiver of Life insurance premiums once you go on LTD. As far as the dliema of whether or not it is ok to apply for STD and indicate an intent to return to work, yet applying for SSDI, yes it is ok to do that. They would probably encourage he apply for SSDI because it is likely an offset of the insurance company's benefits they'd pay him and it would save them money. My company actually pays a consultant firm who specializes in helping you get your SSDI quicker so you might ask if they offer that service. It can be a HUGE help to you in getting SSDI and minimizing the hassle. And the insurance companies pay the cost of the service. And most of the insurance companies care about their claimants too and really would want you to apply for SSDI for your own benefit.  It is a time consuming process. If you have dependents, you could also get dependent benefits. Unfortunately, melanoma is not on the compassionate list of diseases that automatically qualify for SSDI approval. Even if you do get approved quickly, there is a 5 month waiting period from date of onset. I don't know what they'd use for your husband's date of onset but if you are more than 5 months from date of onset, your benefits would be retro with SSDI and your private STD/LTD. So you could have some back pay coming to you. Another point to make regarding applying for STD on one hand as if he's returning to work (to try to save his job), and yet applying for SSDI, don't worry about that. SSDI and private disability insurance actually can use very different guidelines of what constitutes being disabled. Just because you're approved or denied for one, doesn't mean the other one will have the same determination so apply for both. You'll probably find SSDI is more lenient, but takes longer. Your private insurance will likely go by an occupation test (whether he can perform his occupation for a specified amount of time each day), and an earnings test (whether he can make a specified percentage of his salary). They could have other requirements, but these are pretty common. Just be sure to advise them of all doctor's records they need to gather to help your case. I hope this helped a little. Good Luck.

                        Jamietk
                        Participant

                          Hello,

                          I work for an insurance company, specifically in the department that pays the STD/LTD/Life insurance claims. I do the tax reporting and not claims management, but I know a little about it. Here's what I know: Your husband will NOT be ineligible for the LTD plan if he goes out on STD and gets terminated. The policies go by the onset date and regardless of whether he is terminated during STD or not, his onset date would be prior to his termination date so he would still be eligible for the LTD benefits (assuming he meets the definition of disability, which he should, but I just have to note this technicality in policy terms). This is pretty common. I am not sure if it is a law. But if not, I can't imagine any policy not having this provision. Otherwise, what would be the point in paying for LTD insurance if termination while on STD disqualified you from LTD. Most employers have a pretty set standard time that they terminate someone once they go out on disability. One benefit to going out on STD is that they may be less likely to terminate him quickly. And they may require him to go out on STD first and then "link" to LTD.  His Benefit Administrator should be able to confirm how it works. I assume it is a smaller company since you say they are not required to adhere to FMLA regulations. So you never know how a small company will behave. You are correct about waiver of Life insurance premiums once you go on LTD. As far as the dliema of whether or not it is ok to apply for STD and indicate an intent to return to work, yet applying for SSDI, yes it is ok to do that. They would probably encourage he apply for SSDI because it is likely an offset of the insurance company's benefits they'd pay him and it would save them money. My company actually pays a consultant firm who specializes in helping you get your SSDI quicker so you might ask if they offer that service. It can be a HUGE help to you in getting SSDI and minimizing the hassle. And the insurance companies pay the cost of the service. And most of the insurance companies care about their claimants too and really would want you to apply for SSDI for your own benefit.  It is a time consuming process. If you have dependents, you could also get dependent benefits. Unfortunately, melanoma is not on the compassionate list of diseases that automatically qualify for SSDI approval. Even if you do get approved quickly, there is a 5 month waiting period from date of onset. I don't know what they'd use for your husband's date of onset but if you are more than 5 months from date of onset, your benefits would be retro with SSDI and your private STD/LTD. So you could have some back pay coming to you. Another point to make regarding applying for STD on one hand as if he's returning to work (to try to save his job), and yet applying for SSDI, don't worry about that. SSDI and private disability insurance actually can use very different guidelines of what constitutes being disabled. Just because you're approved or denied for one, doesn't mean the other one will have the same determination so apply for both. You'll probably find SSDI is more lenient, but takes longer. Your private insurance will likely go by an occupation test (whether he can perform his occupation for a specified amount of time each day), and an earnings test (whether he can make a specified percentage of his salary). They could have other requirements, but these are pretty common. Just be sure to advise them of all doctor's records they need to gather to help your case. I hope this helped a little. Good Luck.

                          Jamietk
                          Participant

                            Forgot one more note. If he works part time, he can still qualify for STD/LTD/SSDI. They just offset that amount from benefits. So this might be one way for him to keep his job to keep his medical insurance and lower rates than cobra, yet not work full time and still get disability. Please forgive me if he's not able to work at all. I have not read your entire background.

                              Jamietk
                              Participant

                                Forgot one more note. If he works part time, he can still qualify for STD/LTD/SSDI. They just offset that amount from benefits. So this might be one way for him to keep his job to keep his medical insurance and lower rates than cobra, yet not work full time and still get disability. Please forgive me if he's not able to work at all. I have not read your entire background.

                                Jamietk
                                Participant

                                  Forgot one more note. If he works part time, he can still qualify for STD/LTD/SSDI. They just offset that amount from benefits. So this might be one way for him to keep his job to keep his medical insurance and lower rates than cobra, yet not work full time and still get disability. Please forgive me if he's not able to work at all. I have not read your entire background.

                                  lrkg1234
                                  Participant

                                    Thank ANON and POW-

                                    That information makes me feel a lot better.  I think we have a plan now.  The STD claim is in.  We will see what happens.  He had a little time off that he took during IL-2 treatment, and an emergency hospital stay related to IPI side effects so that will be part of the 12 weeks, but he does not have FMLA.

                                    I am hoping that the LTD will just roll over and feel much better about the protection that you mentioned in already being on STD.  The only bad part was that I just read about a 180 day elimination period with the LTD with UNUM. If that's what I think it is then it means you have to be disabled or either out of work for 180 days before they pay anything so there could be a gap.  His actual diagnosis day was in August 2012, but he just stopped working last Friday, so not sure. 

                                    I have the SSDI application and am ready to do that in the next few days.  He has mucosal melanoma stage IV and it DID look like it was on the compassionate list for SSDI.  I hope it's true and he can get approved quickly.  I have no idea about the onset date/diagnosis date VS the date he actually stopped working. 

                                    Do you know what happens if by miracle you get approved for SSDI while you are on STD?  Is that OK?

                                    We got real and accepted that he is just not going back to his job, even though we are not going to say that.  He was given 6 months to live and if he doesn't get into an anti-PD1 trial soon then he may only have a couple months.  Things are going downhill quickly. 

                                    I have freaked out about as much as I can and need to rest by brain no matter what happens.  Thanks so much for your help. 

                                    This is the best info that I have gotten so far and really appreciate it. 

                                    lrkg1234
                                    Participant

                                      Thank ANON and POW-

                                      That information makes me feel a lot better.  I think we have a plan now.  The STD claim is in.  We will see what happens.  He had a little time off that he took during IL-2 treatment, and an emergency hospital stay related to IPI side effects so that will be part of the 12 weeks, but he does not have FMLA.

                                      I am hoping that the LTD will just roll over and feel much better about the protection that you mentioned in already being on STD.  The only bad part was that I just read about a 180 day elimination period with the LTD with UNUM. If that's what I think it is then it means you have to be disabled or either out of work for 180 days before they pay anything so there could be a gap.  His actual diagnosis day was in August 2012, but he just stopped working last Friday, so not sure. 

                                      I have the SSDI application and am ready to do that in the next few days.  He has mucosal melanoma stage IV and it DID look like it was on the compassionate list for SSDI.  I hope it's true and he can get approved quickly.  I have no idea about the onset date/diagnosis date VS the date he actually stopped working. 

                                      Do you know what happens if by miracle you get approved for SSDI while you are on STD?  Is that OK?

                                      We got real and accepted that he is just not going back to his job, even though we are not going to say that.  He was given 6 months to live and if he doesn't get into an anti-PD1 trial soon then he may only have a couple months.  Things are going downhill quickly. 

                                      I have freaked out about as much as I can and need to rest by brain no matter what happens.  Thanks so much for your help. 

                                      This is the best info that I have gotten so far and really appreciate it. 

                                      lrkg1234
                                      Participant

                                        Thank ANON and POW-

                                        That information makes me feel a lot better.  I think we have a plan now.  The STD claim is in.  We will see what happens.  He had a little time off that he took during IL-2 treatment, and an emergency hospital stay related to IPI side effects so that will be part of the 12 weeks, but he does not have FMLA.

                                        I am hoping that the LTD will just roll over and feel much better about the protection that you mentioned in already being on STD.  The only bad part was that I just read about a 180 day elimination period with the LTD with UNUM. If that's what I think it is then it means you have to be disabled or either out of work for 180 days before they pay anything so there could be a gap.  His actual diagnosis day was in August 2012, but he just stopped working last Friday, so not sure. 

                                        I have the SSDI application and am ready to do that in the next few days.  He has mucosal melanoma stage IV and it DID look like it was on the compassionate list for SSDI.  I hope it's true and he can get approved quickly.  I have no idea about the onset date/diagnosis date VS the date he actually stopped working. 

                                        Do you know what happens if by miracle you get approved for SSDI while you are on STD?  Is that OK?

                                        We got real and accepted that he is just not going back to his job, even though we are not going to say that.  He was given 6 months to live and if he doesn't get into an anti-PD1 trial soon then he may only have a couple months.  Things are going downhill quickly. 

                                        I have freaked out about as much as I can and need to rest by brain no matter what happens.  Thanks so much for your help. 

                                        This is the best info that I have gotten so far and really appreciate it. 

                                      jmmm
                                      Participant
                                        Not sure if this helps, but this is our experience…my husband did not qualify for STD or LTD because he had a waiver on the policies for melanoma (he had stage 1 in 1998). We were told to fill out the social security disability paperwork out immediately. Stage 4 melanoma is a “gimme” diagnosis. Meaning, he’ll qualify without any fight. The big issue is that SSDI payments don’t kick in for 6 months and during that time, he cannot have earned more than $1000 a month (they’re assuming he’s unable to work). I would assume your STD could work into this scenario. Fortunately, my husband is part owner in his small company, so it made things easier with the pay, he made less than $1000 each month and 7 months after applying, we started receiving the SSDI (for him, me and our kids). It’s enough to pay basic bills, but nothing more.
                                        In terns if health insurance, he went on short term disability (no pay, but that’s what they called it) for 3 months and the company continued to pay his premiums for health insurance. After that, he switched to COBRA and we had to pay out of pocket. Even if your husband is fired, you can continue to receive health insurance (as long as you pay cobra payments). Just an FYI…we found it was cheaper for the kids and me to switch to a private policy than to pay our portion of cobra.

                                        So, like I said, not sure if thats helpful of not. The SSDI paperwork was easy and a decision was made within a few weeks…unfortunately the pay takes a lot longer. We were fortunate to have savings and some generous friends and family to help with our bills over the 6 month period between qualifying and starting to receive payments.

                                        jmmm
                                        Participant
                                          Not sure if this helps, but this is our experience…my husband did not qualify for STD or LTD because he had a waiver on the policies for melanoma (he had stage 1 in 1998). We were told to fill out the social security disability paperwork out immediately. Stage 4 melanoma is a “gimme” diagnosis. Meaning, he’ll qualify without any fight. The big issue is that SSDI payments don’t kick in for 6 months and during that time, he cannot have earned more than $1000 a month (they’re assuming he’s unable to work). I would assume your STD could work into this scenario. Fortunately, my husband is part owner in his small company, so it made things easier with the pay, he made less than $1000 each month and 7 months after applying, we started receiving the SSDI (for him, me and our kids). It’s enough to pay basic bills, but nothing more.
                                          In terns if health insurance, he went on short term disability (no pay, but that’s what they called it) for 3 months and the company continued to pay his premiums for health insurance. After that, he switched to COBRA and we had to pay out of pocket. Even if your husband is fired, you can continue to receive health insurance (as long as you pay cobra payments). Just an FYI…we found it was cheaper for the kids and me to switch to a private policy than to pay our portion of cobra.

                                          So, like I said, not sure if thats helpful of not. The SSDI paperwork was easy and a decision was made within a few weeks…unfortunately the pay takes a lot longer. We were fortunate to have savings and some generous friends and family to help with our bills over the 6 month period between qualifying and starting to receive payments.

                                          jmmm
                                          Participant
                                            Not sure if this helps, but this is our experience…my husband did not qualify for STD or LTD because he had a waiver on the policies for melanoma (he had stage 1 in 1998). We were told to fill out the social security disability paperwork out immediately. Stage 4 melanoma is a “gimme” diagnosis. Meaning, he’ll qualify without any fight. The big issue is that SSDI payments don’t kick in for 6 months and during that time, he cannot have earned more than $1000 a month (they’re assuming he’s unable to work). I would assume your STD could work into this scenario. Fortunately, my husband is part owner in his small company, so it made things easier with the pay, he made less than $1000 each month and 7 months after applying, we started receiving the SSDI (for him, me and our kids). It’s enough to pay basic bills, but nothing more.
                                            In terns if health insurance, he went on short term disability (no pay, but that’s what they called it) for 3 months and the company continued to pay his premiums for health insurance. After that, he switched to COBRA and we had to pay out of pocket. Even if your husband is fired, you can continue to receive health insurance (as long as you pay cobra payments). Just an FYI…we found it was cheaper for the kids and me to switch to a private policy than to pay our portion of cobra.

                                            So, like I said, not sure if thats helpful of not. The SSDI paperwork was easy and a decision was made within a few weeks…unfortunately the pay takes a lot longer. We were fortunate to have savings and some generous friends and family to help with our bills over the 6 month period between qualifying and starting to receive payments.

                                            LuckyMan51
                                            Participant

                                              If your husband is stage IV Mefastasized Melanoma he will be fast tracked at Social Security and likely get a speedy answer with approval as the diagnosis is on the Compassionate Allowances list. 

                                              DI 23022.810 Malignant Melanoma – with metastases
                                               
                                              You will likely want to go on short term disability and then file for long term disability quickly as there is usually an elimination period (mine is 6 mos which is a long time to live of savings while waiting).  
                                               
                                              After having melanoma on the skin metastisized to the lung and then the brain and had surgical removal, yervoy and stereotactic radiation therapy treatments I seem physically ok but have had cognitive issues develop from the surgery and the radiation.  I think you are insane if you try to apply for LTD without an attorney. You need a specialty attorney who specializes in dealing with insurance companies. They are very different than the ones who deal with the Social Security agency. Soc Security is a breeze vs the Insurance company process. You need to prove a legitimate disability vs the almost automatic approval Soc Sec gives to people with the metastized melanoma diagnosis. Google up UNUM and you will be horrified to read what they do to dodge paying out claims. If your a scammer you deserve the run around but unfortunately it makes the process very hard for the people with real disability. Good luck but get good legal guidance or you will be tortured beyond belief.  Don't go with the first lawyer you find. Go online and research some and also ask any friends who are insurance agents etc.  
                                              LuckyMan51
                                              Participant

                                                If your husband is stage IV Mefastasized Melanoma he will be fast tracked at Social Security and likely get a speedy answer with approval as the diagnosis is on the Compassionate Allowances list. 

                                                DI 23022.810 Malignant Melanoma – with metastases
                                                 
                                                You will likely want to go on short term disability and then file for long term disability quickly as there is usually an elimination period (mine is 6 mos which is a long time to live of savings while waiting).  
                                                 
                                                After having melanoma on the skin metastisized to the lung and then the brain and had surgical removal, yervoy and stereotactic radiation therapy treatments I seem physically ok but have had cognitive issues develop from the surgery and the radiation.  I think you are insane if you try to apply for LTD without an attorney. You need a specialty attorney who specializes in dealing with insurance companies. They are very different than the ones who deal with the Social Security agency. Soc Security is a breeze vs the Insurance company process. You need to prove a legitimate disability vs the almost automatic approval Soc Sec gives to people with the metastized melanoma diagnosis. Google up UNUM and you will be horrified to read what they do to dodge paying out claims. If your a scammer you deserve the run around but unfortunately it makes the process very hard for the people with real disability. Good luck but get good legal guidance or you will be tortured beyond belief.  Don't go with the first lawyer you find. Go online and research some and also ask any friends who are insurance agents etc.  
                                                LuckyMan51
                                                Participant

                                                  If your husband is stage IV Mefastasized Melanoma he will be fast tracked at Social Security and likely get a speedy answer with approval as the diagnosis is on the Compassionate Allowances list. 

                                                  DI 23022.810 Malignant Melanoma – with metastases
                                                   
                                                  You will likely want to go on short term disability and then file for long term disability quickly as there is usually an elimination period (mine is 6 mos which is a long time to live of savings while waiting).  
                                                   
                                                  After having melanoma on the skin metastisized to the lung and then the brain and had surgical removal, yervoy and stereotactic radiation therapy treatments I seem physically ok but have had cognitive issues develop from the surgery and the radiation.  I think you are insane if you try to apply for LTD without an attorney. You need a specialty attorney who specializes in dealing with insurance companies. They are very different than the ones who deal with the Social Security agency. Soc Security is a breeze vs the Insurance company process. You need to prove a legitimate disability vs the almost automatic approval Soc Sec gives to people with the metastized melanoma diagnosis. Google up UNUM and you will be horrified to read what they do to dodge paying out claims. If your a scammer you deserve the run around but unfortunately it makes the process very hard for the people with real disability. Good luck but get good legal guidance or you will be tortured beyond belief.  Don't go with the first lawyer you find. Go online and research some and also ask any friends who are insurance agents etc.  
                                                  lrkg1234
                                                  Participant

                                                    Unfortunately I have googled for hours and all that I come up with is attorneys that simply file SSDI for you or will represent you in a denial.  No one has any idea about how to deal with the employer relationship or making good decisions before litigation.  It's really frustrating.  I guess there's not much money in giving complicated advice by the hour when you could just take 25% of someones claim and deal with practically the same thing over and over. 

                                                    lrkg1234
                                                    Participant

                                                      Unfortunately I have googled for hours and all that I come up with is attorneys that simply file SSDI for you or will represent you in a denial.  No one has any idea about how to deal with the employer relationship or making good decisions before litigation.  It's really frustrating.  I guess there's not much money in giving complicated advice by the hour when you could just take 25% of someones claim and deal with practically the same thing over and over. 

                                                      lrkg1234
                                                      Participant

                                                        Unfortunately I have googled for hours and all that I come up with is attorneys that simply file SSDI for you or will represent you in a denial.  No one has any idea about how to deal with the employer relationship or making good decisions before litigation.  It's really frustrating.  I guess there's not much money in giving complicated advice by the hour when you could just take 25% of someones claim and deal with practically the same thing over and over. 

                                                        lrkg1234
                                                        Participant

                                                          Thanks POW….

                                                          I wlll try the patient advocate source that you listed.  I have been in touch with a legal resource center out of Loyola University.  We have been playing phone tag. Maybe they will have ideas once we actually speak.

                                                          I actually did call a local attorney that looked like a good match in the web ad.  She was super nice and generous with her time, but offered no answers. She didn't seem eager to take on any new clients and suggested that we ask more questions from HR.  I'm sort of leery of both HR and Insurance companies.  We definitely prefer an uninvolved party. The situation is sort of different when all of your benefits are tied to your employment.  It would be perfect if all insurance connections in this issue were not through work. Hindsight is 20/20.

                                                          You are so right.  It hardly seems like an original situation !  Yet, no one seems to want to help until you have been run over by a truck or something. Not so much advice available to prevent the truck accident, just help after the truck runs you over.

                                                          I have been through some paperwork issues with our social worker at my husbands' oncologist and she is not very savvy in this regard. Some of the correspondance that she faxed out (without our approval) was overly wordy and practically guaranteed to cause a delay.  Sort of bad judgement.  She suggested attorneys but they were all litigation specialists.

                                                          I appreciate the encouragement that you have given me and I won't give up.  I'm not the giving up type. No one on here is! This board is full of people that want answers. That's why we talk. Maybe I'll contact the social workers at MD Anderson and see if they have any ideas.  They are probably one of the most experienced in this matter. 

                                                          Appreciate your response. 

                                                          lrkg1234
                                                          Participant

                                                            Thanks POW….

                                                            I wlll try the patient advocate source that you listed.  I have been in touch with a legal resource center out of Loyola University.  We have been playing phone tag. Maybe they will have ideas once we actually speak.

                                                            I actually did call a local attorney that looked like a good match in the web ad.  She was super nice and generous with her time, but offered no answers. She didn't seem eager to take on any new clients and suggested that we ask more questions from HR.  I'm sort of leery of both HR and Insurance companies.  We definitely prefer an uninvolved party. The situation is sort of different when all of your benefits are tied to your employment.  It would be perfect if all insurance connections in this issue were not through work. Hindsight is 20/20.

                                                            You are so right.  It hardly seems like an original situation !  Yet, no one seems to want to help until you have been run over by a truck or something. Not so much advice available to prevent the truck accident, just help after the truck runs you over.

                                                            I have been through some paperwork issues with our social worker at my husbands' oncologist and she is not very savvy in this regard. Some of the correspondance that she faxed out (without our approval) was overly wordy and practically guaranteed to cause a delay.  Sort of bad judgement.  She suggested attorneys but they were all litigation specialists.

                                                            I appreciate the encouragement that you have given me and I won't give up.  I'm not the giving up type. No one on here is! This board is full of people that want answers. That's why we talk. Maybe I'll contact the social workers at MD Anderson and see if they have any ideas.  They are probably one of the most experienced in this matter. 

                                                            Appreciate your response. 

                                                            lrkg1234
                                                            Participant

                                                              Thanks POW….

                                                              I wlll try the patient advocate source that you listed.  I have been in touch with a legal resource center out of Loyola University.  We have been playing phone tag. Maybe they will have ideas once we actually speak.

                                                              I actually did call a local attorney that looked like a good match in the web ad.  She was super nice and generous with her time, but offered no answers. She didn't seem eager to take on any new clients and suggested that we ask more questions from HR.  I'm sort of leery of both HR and Insurance companies.  We definitely prefer an uninvolved party. The situation is sort of different when all of your benefits are tied to your employment.  It would be perfect if all insurance connections in this issue were not through work. Hindsight is 20/20.

                                                              You are so right.  It hardly seems like an original situation !  Yet, no one seems to want to help until you have been run over by a truck or something. Not so much advice available to prevent the truck accident, just help after the truck runs you over.

                                                              I have been through some paperwork issues with our social worker at my husbands' oncologist and she is not very savvy in this regard. Some of the correspondance that she faxed out (without our approval) was overly wordy and practically guaranteed to cause a delay.  Sort of bad judgement.  She suggested attorneys but they were all litigation specialists.

                                                              I appreciate the encouragement that you have given me and I won't give up.  I'm not the giving up type. No one on here is! This board is full of people that want answers. That's why we talk. Maybe I'll contact the social workers at MD Anderson and see if they have any ideas.  They are probably one of the most experienced in this matter. 

                                                              Appreciate your response. 

                                                              POW
                                                              Participant

                                                                I think that it is just disgusting that people who are so sick and fighting for their lives have to deal with our rotten health insurance industry, too. What crap! I'm sorry that I can't be of more assistance about this but my brother was retired and on Medicare when he was diagnosed, so he didn't have to deal with a private insurer. Hopefully, others on this board will have more specific information for you. Being a holiday weekend, the board is pretty quiet. If you don't get some good responses in a couple of days, post your question again in a new thread next week. I'm sure you will get some good advice.

                                                                Meanwhile, I did search this forum for "SSDI" and found some good threads. Vermont_Karen, in particular, seems to know a lot about what you are dealing with. You might want to message her through her profile so you can establish email contact with her. At one point, Karen said:

                                                                "People have a point with stopping work for now, as your body uses a lot of energy to heal and cancer treatments are hard on us. Rest is important, essential actually. I believe short term disability is usually a higher percentage of your salary and is used first, then long term disability is at a lesser percentage of your salary and for a longer period of time. I got 23 weeks of short term disability at 67% of my pay and was able to still get SSDI as SSDI counts EARNED income. I have not been found eligible for long term disability through my employer (some silly rule about being treated in the previous 12 months for the disorder I am out on leave for..I know, stupid, but when I did get it before, it was 60% of my pay, and they counted my SSDI so they reduced the amount and then only paid me monthly. My employer contracts with this company for the short and long term disability and I am not sure even they KNEW of all these rules when it comes to being out multiple times and how things are looked at…..the company is UNUM by the way. Anyways, if you go out on medical leave (you have 12 weeks of FMLA) you can apply for SSDI and apply for your short term disability and once you go back to work, and are making more than $1000 a month, your SSDI would stop (you have to notify SS)."

                                                                POW
                                                                Participant

                                                                  I think that it is just disgusting that people who are so sick and fighting for their lives have to deal with our rotten health insurance industry, too. What crap! I'm sorry that I can't be of more assistance about this but my brother was retired and on Medicare when he was diagnosed, so he didn't have to deal with a private insurer. Hopefully, others on this board will have more specific information for you. Being a holiday weekend, the board is pretty quiet. If you don't get some good responses in a couple of days, post your question again in a new thread next week. I'm sure you will get some good advice.

                                                                  Meanwhile, I did search this forum for "SSDI" and found some good threads. Vermont_Karen, in particular, seems to know a lot about what you are dealing with. You might want to message her through her profile so you can establish email contact with her. At one point, Karen said:

                                                                  "People have a point with stopping work for now, as your body uses a lot of energy to heal and cancer treatments are hard on us. Rest is important, essential actually. I believe short term disability is usually a higher percentage of your salary and is used first, then long term disability is at a lesser percentage of your salary and for a longer period of time. I got 23 weeks of short term disability at 67% of my pay and was able to still get SSDI as SSDI counts EARNED income. I have not been found eligible for long term disability through my employer (some silly rule about being treated in the previous 12 months for the disorder I am out on leave for..I know, stupid, but when I did get it before, it was 60% of my pay, and they counted my SSDI so they reduced the amount and then only paid me monthly. My employer contracts with this company for the short and long term disability and I am not sure even they KNEW of all these rules when it comes to being out multiple times and how things are looked at…..the company is UNUM by the way. Anyways, if you go out on medical leave (you have 12 weeks of FMLA) you can apply for SSDI and apply for your short term disability and once you go back to work, and are making more than $1000 a month, your SSDI would stop (you have to notify SS)."

                                                                  POW
                                                                  Participant

                                                                    I think that it is just disgusting that people who are so sick and fighting for their lives have to deal with our rotten health insurance industry, too. What crap! I'm sorry that I can't be of more assistance about this but my brother was retired and on Medicare when he was diagnosed, so he didn't have to deal with a private insurer. Hopefully, others on this board will have more specific information for you. Being a holiday weekend, the board is pretty quiet. If you don't get some good responses in a couple of days, post your question again in a new thread next week. I'm sure you will get some good advice.

                                                                    Meanwhile, I did search this forum for "SSDI" and found some good threads. Vermont_Karen, in particular, seems to know a lot about what you are dealing with. You might want to message her through her profile so you can establish email contact with her. At one point, Karen said:

                                                                    "People have a point with stopping work for now, as your body uses a lot of energy to heal and cancer treatments are hard on us. Rest is important, essential actually. I believe short term disability is usually a higher percentage of your salary and is used first, then long term disability is at a lesser percentage of your salary and for a longer period of time. I got 23 weeks of short term disability at 67% of my pay and was able to still get SSDI as SSDI counts EARNED income. I have not been found eligible for long term disability through my employer (some silly rule about being treated in the previous 12 months for the disorder I am out on leave for..I know, stupid, but when I did get it before, it was 60% of my pay, and they counted my SSDI so they reduced the amount and then only paid me monthly. My employer contracts with this company for the short and long term disability and I am not sure even they KNEW of all these rules when it comes to being out multiple times and how things are looked at…..the company is UNUM by the way. Anyways, if you go out on medical leave (you have 12 weeks of FMLA) you can apply for SSDI and apply for your short term disability and once you go back to work, and are making more than $1000 a month, your SSDI would stop (you have to notify SS)."

                                                                    POW
                                                                    Participant

                                                                      Oops! The author of that quotation was Vermont_Donna, not Vermont_Karen. I think I got mixed up with NY_Karen. Sorry about that. 

                                                                      POW
                                                                      Participant

                                                                        Oops! The author of that quotation was Vermont_Donna, not Vermont_Karen. I think I got mixed up with NY_Karen. Sorry about that. 

                                                                        POW
                                                                        Participant

                                                                          Oops! The author of that quotation was Vermont_Donna, not Vermont_Karen. I think I got mixed up with NY_Karen. Sorry about that. 

                                                                          POW
                                                                          Participant

                                                                            Thank you for this excellent and informative post! Disability insurance is such an important topic, yet so complex for most of us to understand. Your post will help a lot of people in the future. Thanks!

                                                                            POW
                                                                            Participant

                                                                              Thank you for this excellent and informative post! Disability insurance is such an important topic, yet so complex for most of us to understand. Your post will help a lot of people in the future. Thanks!

                                                                              POW
                                                                              Participant

                                                                                Thank you for this excellent and informative post! Disability insurance is such an important topic, yet so complex for most of us to understand. Your post will help a lot of people in the future. Thanks!

                                                                                Jamietk
                                                                                Participant

                                                                                  Hello,

                                                                                  It's me again, the insurance/disability person. If he gets approved for SSDI while he is on STD, it would likely just be an offset of his STD benefit. Most policies work that way. So it doesn't give you both amounts in full, but being approved for both does get you a little more money than just getting STD/LTD or SSDI. The elimination period is your waiting period, and it goes by onset date. Onset date of disability is typically the last day worked. But it is not 180 days from the date STD ends. STD and LTD share the same onset date. So you do have STD you can be paid for 12 weeks (?). That covers the first 3 months. Then if approved by SSDI, their waiting period is only 5 months. So you'd have a 2 month period without any benefits. Month 5 would only be SSDI payments. And month 6 would start the LTD payment. Again, most STD and LTD policies will reduce their benefits by SSDI. Now the part I am not sure about is how SSDI determines their onset date. But assuming they determine it the same as STD/LTD does, then my timeline I've listed should be somewhat accurate. I am so glad to know that mucosal melanoma stage iv is on the compassionate list of immediate SSDI approval. Again, you may want to check with your benefits administrator. I am just telling you how our plans work, and I think they are pretty common. I'm sorry you're going through this. This disease stinks. I am almost 10 years out and having some things going on that my regular doctors can't figure out. I'm having some tests done soon to rule out some other things, but melanoma always has to be in our minds. My uncle and grandma both died from it so my family has dealt with it for years. Heartbreaking. I wish you the best and hope I've helped a little, even if just to bring some questions to light that you might want to ask the Benefits Administrator.

                                                                                  Jamietk
                                                                                  Participant

                                                                                    Hello,

                                                                                    It's me again, the insurance/disability person. If he gets approved for SSDI while he is on STD, it would likely just be an offset of his STD benefit. Most policies work that way. So it doesn't give you both amounts in full, but being approved for both does get you a little more money than just getting STD/LTD or SSDI. The elimination period is your waiting period, and it goes by onset date. Onset date of disability is typically the last day worked. But it is not 180 days from the date STD ends. STD and LTD share the same onset date. So you do have STD you can be paid for 12 weeks (?). That covers the first 3 months. Then if approved by SSDI, their waiting period is only 5 months. So you'd have a 2 month period without any benefits. Month 5 would only be SSDI payments. And month 6 would start the LTD payment. Again, most STD and LTD policies will reduce their benefits by SSDI. Now the part I am not sure about is how SSDI determines their onset date. But assuming they determine it the same as STD/LTD does, then my timeline I've listed should be somewhat accurate. I am so glad to know that mucosal melanoma stage iv is on the compassionate list of immediate SSDI approval. Again, you may want to check with your benefits administrator. I am just telling you how our plans work, and I think they are pretty common. I'm sorry you're going through this. This disease stinks. I am almost 10 years out and having some things going on that my regular doctors can't figure out. I'm having some tests done soon to rule out some other things, but melanoma always has to be in our minds. My uncle and grandma both died from it so my family has dealt with it for years. Heartbreaking. I wish you the best and hope I've helped a little, even if just to bring some questions to light that you might want to ask the Benefits Administrator.

                                                                                    Jamietk
                                                                                    Participant

                                                                                      Hello,

                                                                                      It's me again, the insurance/disability person. If he gets approved for SSDI while he is on STD, it would likely just be an offset of his STD benefit. Most policies work that way. So it doesn't give you both amounts in full, but being approved for both does get you a little more money than just getting STD/LTD or SSDI. The elimination period is your waiting period, and it goes by onset date. Onset date of disability is typically the last day worked. But it is not 180 days from the date STD ends. STD and LTD share the same onset date. So you do have STD you can be paid for 12 weeks (?). That covers the first 3 months. Then if approved by SSDI, their waiting period is only 5 months. So you'd have a 2 month period without any benefits. Month 5 would only be SSDI payments. And month 6 would start the LTD payment. Again, most STD and LTD policies will reduce their benefits by SSDI. Now the part I am not sure about is how SSDI determines their onset date. But assuming they determine it the same as STD/LTD does, then my timeline I've listed should be somewhat accurate. I am so glad to know that mucosal melanoma stage iv is on the compassionate list of immediate SSDI approval. Again, you may want to check with your benefits administrator. I am just telling you how our plans work, and I think they are pretty common. I'm sorry you're going through this. This disease stinks. I am almost 10 years out and having some things going on that my regular doctors can't figure out. I'm having some tests done soon to rule out some other things, but melanoma always has to be in our minds. My uncle and grandma both died from it so my family has dealt with it for years. Heartbreaking. I wish you the best and hope I've helped a little, even if just to bring some questions to light that you might want to ask the Benefits Administrator.

                                                                                      Vermont_Donna
                                                                                      Participant

                                                                                        Hi,

                                                                                          I am a melanoma survivor for 7 years…have been on Unum short term, long term and also currently on SSDI. I wouldnt necessarily go to one of those lawyers to help you get on SSDI. Depending on the staging of the disease there may be no problem and the lawyers will just want part of the money.

                                                                                        If you want to privately email me at [email protected] to ask more questions specifically be sure to put something in the subject line to flag it for me…like MPIP and melanoma SSDI questions. I will be happy to discuss what I learned along the way.

                                                                                        Good luck with everything,

                                                                                        Vermont_Donna

                                                                                        Stage 3a, NED 2 years 5 months

                                                                                        Vermont_Donna
                                                                                        Participant

                                                                                          Hi,

                                                                                            I am a melanoma survivor for 7 years…have been on Unum short term, long term and also currently on SSDI. I wouldnt necessarily go to one of those lawyers to help you get on SSDI. Depending on the staging of the disease there may be no problem and the lawyers will just want part of the money.

                                                                                          If you want to privately email me at [email protected] to ask more questions specifically be sure to put something in the subject line to flag it for me…like MPIP and melanoma SSDI questions. I will be happy to discuss what I learned along the way.

                                                                                          Good luck with everything,

                                                                                          Vermont_Donna

                                                                                          Stage 3a, NED 2 years 5 months

                                                                                          Vermont_Donna
                                                                                          Participant

                                                                                            Hi,

                                                                                              I am a melanoma survivor for 7 years…have been on Unum short term, long term and also currently on SSDI. I wouldnt necessarily go to one of those lawyers to help you get on SSDI. Depending on the staging of the disease there may be no problem and the lawyers will just want part of the money.

                                                                                            If you want to privately email me at [email protected] to ask more questions specifically be sure to put something in the subject line to flag it for me…like MPIP and melanoma SSDI questions. I will be happy to discuss what I learned along the way.

                                                                                            Good luck with everything,

                                                                                            Vermont_Donna

                                                                                            Stage 3a, NED 2 years 5 months

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