Hi my tribe!
I know that I have been inundating you with medical information since I began this blog. I wanted to take a day to provide updates on my appeal for long-term disability and Social Security Disability benefits.
Guardian (Long-term Disability Carrier)
First, I am in the final-level appeal process with Guardian. They are the long-term disability insurance carrier. If you remember from my Facebook posts, I was initially approved for short-term disability beginning in November 2017 - April 2018. Then, suddenly, the approvals and pay stopped. From what I can gather, a different team had engaged within Guardian and they deemed that my medical condition did not rise to the level of needing to be on a full-time leave of absence/disability. However, there were zero changes to my health status in the April 2018 timeframe.
Now, I paid for long-term disability insurance benefits through my previous employer - I even had "upgraded" to the higher tier benefit - which was supposed to provide wage replacement up to 70% of my past wages through retirement age (if disabled).
I appealed... Was denied. Now, I am at the "final-level" appeal - meaning if Guardian denies my claim this time, my only other avenue would be to hire an attorney and sue Guardian. I received an email yesterday from most recent "primary contact" within Guardian... basically, the email included a pdf copy of a letter that is to be mailed to me... it stated that Guardian was exercising its' right under ERISA to extend their review period by up to 45 MORE days and required MORE information from my health care providers.
Folks, as you can imagine, I am beyond frustrated with this entire process. I feel that I have done everything "right." I am med compliant; I attend my scheduled doctor appointments; I provide Guardian with updates every single step of the way. I reached out to two of my specialists to ask whether they would complete the additional form that Guardian supplied. Unfortunately, my rheumatologist declined to do so because she does not perform that level of mobility/physical capability testing and besides, she is retiring within the next month - so it would be impossible to see her before then. I am anxiously waiting for a response from my geneticist. In the interim, I plan to email a copy to my local physical therapist's office to see whether they would be able to assist me with completing this additional paperwork.
Social Security Disability (SSD)
I initially applied for Social Security Disability (SSD) to help offset payments that I expected to receive from Guardian (70% of my salary). This is a common practice in the disability insurance arena - apply for both - the private disability insurance and the government provided insurance. Your private disability insurance benefits are reduced by the amount they expect you to receive from SSD.
My initial application was denied - the letter stated that I was "not disabled under our rules." And, that "we have determined that your condition is not severe enough to keep you from working."
I am in the process of re-filing for SSD utilizing an attorney from Schott & Mauss. So far, I have been impressed by her professionalism and compassion. The average length of time that the State of Iowa is backlogged to hear cases (actually goes in front of a judge - if appealed that far) is 17 months. Yep - you read that right - seventeen months! That figure comes from https://www.ssa.gov/appeals/DataSets/01_NetStat_Report.html. Ridiculous!
I'll play the same tune again - man, oh man, am I ever frustrated with the whole process and systems. I feel it truly penalizes those who are already in a bad way.