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Update for spoonie patients on Long-term Disability Insurance & Social Security Disability (in US)

Discussion in 'General ME/CFS Discussion' started by Dolphin, Oct 26, 2014.

  1. Dolphin

    Dolphin Senior Member

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    This is about the situation in the US. I'm not sure how much it applies in other countries e.g. are there insurance policies in other countries where payments are restricted to two (say) years if the impairments are partly or solely due to mental impairments e.g. depression, anxiety?
     
    Last edited: Oct 26, 2014
  2. minkeygirl

    minkeygirl But I Look So Good.

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    Left Coast
    I've been on LTD since I got sick in 95. There has almost always been a 2 year limit on "psych" issues but it does depend on your carrier and your policy. If you do get disability with a medical claim they will try to change it to a psych claim and then institute the 2 year limit and then drop you.

    I can't read the article but there were a certain number of psych diagnosis that were considered. 12 sticks in my head.

    I just got my review paperwork from Unum last week and this is the first year they didn't specifically ask for psychological issues to be documented separate from the area asking for DSM diagnostic codes.

    LTD companies are in the business to deny claims and they will do whatever they can to get you off the books.

    I just read on Linda Nee's blog that they do a ton of reviews at the end of the year to try do deny people so their fiscal year looks good.
     
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  3. barbc56

    barbc56 Senior Member

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    @Dolphin

    I just posted a similar article. Yours is more detailed.;)

    Barb

    ETA

    What is a spoonie?
     
    Last edited: Oct 26, 2014
  4. caledonia

    caledonia

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    Cincinnati, OH, USA
    Good article with updates for current times, when LTDs and SS are being flooded with disability applicants, and things are getting more stringent.

    Executive summary:

    The article suggests the same three pieces of evidence that I used for both SSDI and LTD -
    • a functional capacity evaluation (FCE)
    • a neuropysch test
    • a record of continuing disability achieved by going to your doctor every three months and documenting that you're still disabled.

    However, they are suggesting that even though the neuropsych test is helpful for SSDI, nowadays a neuropysch test will likely be used against you in an LTD case - but there is certain language use can use to hopefully deflect that.

    Your other option is not to do a neuropsych test at all.
     
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  5. Denise

    Denise Senior Member

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  6. Denise

    Denise Senior Member

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    However, they are suggesting that even though the neuropsych test is helpful for SSDI, nowadays a neuropysch test will likely be used against you in an LTD case - but there is certain language use can use to hopefully deflect that.

    Your other option is not to do a neuropsych test at all.[/quote]


    I would like to know more about neuropsych testing being used against people in an LTD case. (I am somewhat surprised by this as it has (had?) been known to be helpful for patients.)
     
  7. WillowJ

    WillowJ คภภเє ɠรค๓թєl

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    It sounded like this was operator error on the part of the neuropsych evaluator?
     
  8. SDSue

    SDSue Southeast

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  9. barbc56

    barbc56 Senior Member

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    @Denise

    Thanks! I am very familiar with the spoon theory and have shown it to others. I've never heard it used in this context.

    Thanks!

    Barb
     
  10. minkeygirl

    minkeygirl But I Look So Good.

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    Left Coast
    IMO Linda Nee is THE go to for information on dealing with LTD, filling out forms, what they are fixing for when they ask you questions, why you should never talk to them on the phone and more.

    Her invaluable information has guided me in the past and has been helpful while filling out paperwork now.
     
  11. SWNative

    SWNative

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    So wish I'd had this info 18 months ago when CIGNA denied my STD claim and subsequent appeals. I didn't even have the energy to apply for LTD. Am awaiting SSDI appeal filed August 2014. This will help so many people; I still appreciate the info!
     
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  12. ahimsa

    ahimsa Rarely on PR now

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    The two year limit is quite common but not universal. My own company's long term disability policy had zero coverage for mental illness or mental impairment (not sure of the wording). Disability caused by depression, bipolar disorder, schizophrenia, etc., would not have been covered at all by my employer's policy. That means most LTD policies with a 2 year limit were actually better than my own policy.

    The main point is to know what is covered by your own long term disability policy. I forget the name of the document but you need to ask your company for a copy of the document showing what the LTD policy covers.

    And also make sure to get a lawyer pronto if your LTD policy falls under ERISA law. I think most policies provided as a part of employee benefits, not paid for by the employee as a private LTD policy, fall under ERISA law.
     
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