It appears you have not yet Signed Up with our community. To Sign Up for free, please click here....



Disabilities Message Board
Post New Thread   Closed Thread
LinkBack Thread Tools
Old 02-12-2010, 09:37 PM   #1
Junior Member
(female)
 
Join Date: Oct 2009
Posts: 15
rkmgkm HB User
Long term disability approved by Metlife- Employer asking job accomodation Q-naire ?

Hi

I have been on short term disability since june( reumy doc put me on disability) as I was in lot of pain. I am suffering from fibro and lupus. I was going through Performance Improvement Plan(PIP), when I was put on disability. My manager did not accomodate telecommuting when I returned to work after 3 months STD and asked me to stay on leave till I can return in full capacity. I cannot perform my job at full capacity as I have chronic pain and fatigue and require frequent acupunture treaments/ massage and have difficulty going through the day's activities. My doc continued my disability and now my long term disability is approved through metlife. My last doctor visit form stated that I can return to full capacity on march 2009. I guess this is how the doctor gives the letter and every time I go on followup visit then he either extends the leave/puts restrictions/accomodation. He has extended me from June 2009 to March 2010

My question is- Why is my employer approaching me now(after metlife approved my LTD) with a job accomodation questionaire to provide reasonable accomodation at work? They did not approach me earlier while on disability last 8 months and when i did try to return to work just after 3 months on STD requesting permission to telecommute. My manager refused to accomodate and said that she cannot monitor my performance as I was in PIP. Now the Disability manager has contacted me to get the questionaire - Reasonable accomodation to work - to be filled from my doctor.

Please advise me what is my employer intention - will they force me to get back to work ? can they put me back on PIP ? can they fire me for poor performance in case I have to return to work?

what are my options?

 
Sponsors Lightbulb
   
Old 02-13-2010, 01:33 AM   #2
Facilitator
(female)
 
SpineAZ's Avatar
 
Join Date: Oct 2005
Location: Wisconsin
Posts: 5,097
SpineAZ HB UserSpineAZ HB UserSpineAZ HB UserSpineAZ HB UserSpineAZ HB UserSpineAZ HB UserSpineAZ HB UserSpineAZ HB UserSpineAZ HB UserSpineAZ HB UserSpineAZ HB User
Re: Long term disability approved by Metlife- Employer asking job accomodation Q-nair

First, be sure to get a copy of the exact LTD policy under which you are covered so you can have it for future reference.

I have 15+ years in the disability claim industry, and my guess is that your employer is trying to determine if there is any way you could be accommodated. If not they may remove you as an employee. Many employers sever the employment of someone out on LTD. So since your LTD has been approved ( has it already begun?) it may be that your employer has an internal protocol in which they must verify that they are able or unable to accommodate your needs.

Do you have any information on what your standing is as an employee? Any correspondence from your employer as to your status?

Personally I have used STD a few times in the last 15 years but usually for a max of 6 weeks following a surgery. In April of 2009 I had severe back pain and have a history of significant low back surgery in 1987 and 1993. Along with cervical spine surgery in 2006 and 2008. As an insurance account manager my job required travel (local within the entire state and air travel on day trips or longer on an occasional basis). The back pain was so bad and my boss said he could not accommodate me for working at home as much as I needed. Very similar to what you said I was kind of told to go out on STD until I could return to work full duty OR if they could determine if they could accommodate me. I went out on STD. Later in the summer when I hoped to maybe go back to work part time they did a more thorough evaluation and much as you are experiencing were verifying what the job required and what I could do at the time (and what my permanent restrictions would be). It was determined that since we were a 2 person department they would not be able to accommodate my need for telecommuting on a frequent basis and would also not be able to avoid the required air and car travel. Actually in my case it made sense they could not accomodate me. I was teh only one in Airzona doing my job. If I could not fly to my customer in our regions (Nevada, Texas, New Mexico, and Arizona) then I was impeding the company's ability to get my job functions completed. I have been on LTD since November of 2009.

If you have an LTD approval letter from Met and if LTD benefits have begun, you may want to first call your employer ans ask them, in the sweetest kindest voice, "As you may be aware I have been approved for Long Term Disability by MetLife and my LTD began on (date). I then received a letter from you dated (date) and am wondering if you truly require that this form be completed and if so perhaps you can help me understand why."

Keep in mind that even though you have been approved for LTD at this time that does not mean Met is saying that you will be paid forever, just that they will pay you for as long as you are disabled from doing your job. So also check any approval letter from MetLife to see if they mention possible accommodation forms from them or your employer, etc. And if your employer has indeed terminated you then I don't know that you'd be required to fill out the form as it's not from Met.

In my case my employer retains anyone on LTD as an employee in terms of benefits. I pay retiree level premiums for medical insurance and legally they retain me under their list of disabled employees. If my LTD were to end due to me being deemed able to return to work and I could not return to my employer at that time, then my employment would end.

But for fiscal reasons many employers have to terminate employees upon the approval of the employee's LTD. Sometimes with a letter saying "We must terminate your employment now that your LTD has been approved but should you become able to return to work at a later date please contact us and we will see if we have any applicable positions for which you may be qualified."


Let me know if I can be of further assistance. My brain is a bit foggy as I 'm just out of the hospital a few days so if I've confused you in any way please don't hesitate to ask for more help.
__________________
Rt&Lt thumb arthroplasty 2012 ; RT TKR & Bilat CTS 2011
Fusions: L5-S1 (87), L4-S1 (93), C5-C7 ('06), L3-S1 ('10)
C5-C7 foraminotomy 08

 
Old 02-13-2010, 08:51 AM   #3
Inactive
(male)
 
Join Date: Jan 2008
Posts: 4,017
Executor HB UserExecutor HB UserExecutor HB UserExecutor HB UserExecutor HB UserExecutor HB User
Re: Long term disability approved by Metlife- Employer asking job accomodation Q-nair

Welcome to Healthboards. This is a great site where lots of people with diverse experiences can really help. For example, Spine is an expert at this, so I would definitely listen to everything she has to say.

I'm intrigued by your case because its sounds extremely familiar to the large Fortune 500 company that I worked for. They use both Met Life and the terminology PIP. If in fact it is the same company that I suspect, you can not be careful enough. Their HR dept is like the mafia. In fact, the PIP is used to weed people out....Especially those who they know have medical issues. It's all about cost control.

Typcially, the PIP includes criteria that are practically impossible to meet and overall, is a set up. Your post wasn't quite clear....Were you on PIP before STD or did they put you on PIP after starting STD? Nothing would surprise me with this company...I've seen it all. I've even seen someone put on PIP right as they were being deployed to Iraq! Talk about gutless!

Regardless of who the company is, I would be very careful of anything I told them.....Either HR or Met Life. The STD and LTD people are tied in very closely with the company and you have to know that the primary goal they all have is to get you off of disability....It's a HUGE cost to them. I hate to be so crass about it, but you need to know the truth so you can protect yourself. Many people make the mistake of thinking these people are there to help them.

As long as you get all your paperwork filled out and stay with the terms of your policy, you'll be fine. At this point, I would do what Spine says and call HR and just nicely ask if they are aware that you've been approved for LTD. See what they say, and then I wouldn't respond....Come back here and tell either me or Spine what they say. Once the respond, just say "ok, thank you for the information." One or both of us can advise you what to do next. I don't think you're required to fill out that form, but I'd like to hear what they have to say. HR could just be fishing...Or it could have been sent out before your LTD was approved.

Congrats on being approved for LTD....It's a great feeling to have the security of such. Very few people have such a robust plan, so you are extremely fortunate. Unfortunately, you have to deal with an un-compassionate company, but that's the way life is sometimes.

I had the exact same issue and got through it. Sounds as if you have a great Doc who will continue to back you. It would be nice if at some point he could make it permanent. I'm sure he knows what he's doing in terms of laying all the groundwork. At this point, there is no way you could return....You'd be terminated or laid off.

We're here to help!

Regards,

Ex

Last edited by Executor; 02-13-2010 at 08:54 AM.

 
Old 02-13-2010, 09:51 AM   #4
Junior Member
(female)
 
Join Date: Oct 2009
Posts: 15
rkmgkm HB User
Re: Long term disability approved by Metlife- Employer asking job accomodation Q-nair

Thanks to Spine and Executor,

I was going through PIP when I went out first time on STD. I had finished 60 days and I had 30 more days to complete my PIP. I have brain fog and cannot perform at my peak everyday and my pain was getting worst due to stress. I have a very understanding doctor who adviced me to go on disability. I knew that I could no longer work for that dept as things had got worst. I took my doc advice and went on disability. The HR did not contact me all along and refused to accomodate me during last 8 months. I informed the manager everytime I got an extension from doctor and even communicated about the long term disability approval. She said she will talk to my disability manager-HR and get back to me if I need to complete any formalities. d.manager called me and said I will receive a letter by mail and did not mention anything else. I was guessing it should be something about my benefits, but this Questionaire totally surpirsed me.

I thank all of you helping out. Its a great help

Last edited by rkmgkm; 02-15-2010 at 12:39 AM.

 
Old 02-13-2010, 10:30 AM   #5
Facilitator
(female)
 
SpineAZ's Avatar
 
Join Date: Oct 2005
Location: Wisconsin
Posts: 5,097
SpineAZ HB UserSpineAZ HB UserSpineAZ HB UserSpineAZ HB UserSpineAZ HB UserSpineAZ HB UserSpineAZ HB UserSpineAZ HB UserSpineAZ HB UserSpineAZ HB UserSpineAZ HB User
Re: Long term disability approved by Metlife- Employer asking job accomodation Q-nair

I would still suggest you make brief contact to see if the form you received from your employer needs to be completed and if so why.

The hard part is knowing exactly what your employer's intentions are. It is very common for HR/Benefits to be in constant communication with the staff at the insurance company that do claims. This is only for the status of the claim and whether any upcoming changes are foreseen by the insurance claim adjuster. However, HIPPA (privacy law) would prohibit the insurance company from sharing any confidential medical information with the employer.

For example, I'd have employers who were close to terminating an employee out on STD/LTD as their FMLA time was expiring. FMLA provides job protection but after FMLA expires (12 weeks) an employer no longer has to provide job protection for the employee. The employer would ask in a very generic way if there was anything in the near future that would change. If we said the claim may end soon then the employer may need to consider if they could accommodate returning the person to work. Many employers don't want to go through the employment termination process if the employee may be able to return to work soon and may be eligible to be considered for their own job or another job.

Whenever a disability claim is approved, extended, terminated or denied the employer is made aware of this (sometimes by letter but more commonly these days by electronic reporting). Each employer is different in terms of who receives the notices from the insurance company and who is most involved. So the Benefits Department could have received notification that LTD has been approved but Human Resources may not know yet (or their system is automated to spit out the letter and request you received). This happened in my case. I had an HR representative call me on my cell phone to ask when the accommodation paperwork would be completed by my physicians and sent to HR for review. I advised her that I was on disability. So she agreed that the form was not needed at that time.

Unfortunately in large companies there is a "silo" mentality where each person only does his/her job and each department only does their specific function. I was stunned that the HR person would be taking the time and effort to get paperwork from me that was no longer needed. But it "wasn't her job" to know if I was on disability or not.

The "Silo Effect" hit again a few months later. Based on the structure of the STD/LTD at my employer I had a 4 week gap between the time STD ended and LTD began. As I had already received a letter from my employer that my position had been eliminated, I decided to request to have my remaining 3 weeks of PTO paid out to me. Once again I called the same person in HR and she said "I now have to seek verification that you are on disability". She did and I was ready for a fight but she got back to me a week later and said it was all done and I'd be paid out my PTO, a week later I got the check. The scary thing is I bet some people wouldn't have known to ask and they may never get the PTO. Since I remain an "Employee Not Otherwise Specified" for as long as I'm on LTD they wouldn't have acted on their own to pay out my PTO.
__________________
Rt&Lt thumb arthroplasty 2012 ; RT TKR & Bilat CTS 2011
Fusions: L5-S1 (87), L4-S1 (93), C5-C7 ('06), L3-S1 ('10)
C5-C7 foraminotomy 08

 
Old 02-13-2010, 04:00 PM   #6
Junior Member
(female)
 
Join Date: Oct 2009
Posts: 15
rkmgkm HB User
Re: Long term disability approved by Metlife- Employer asking job accomodation Q-nair

One small clarification, I need to understand the transition process from STD to LTD. My doctor's note given dec 09 mentions that I can return to work with no restrictions end of March 10. My LTD was approved Feb 9th from Dec 09 onwards. My LTD mentions it covers upto 2 years if unable to work in my own occupation and after 2 years any similar occupation. So, should i go to doctor to get the dates extended beyond march 2010 ? How does things work in LTD ? should dr keep extending dates like in STD ? I am so confused. Please help me understand

 
Old 02-13-2010, 05:21 PM   #7
Facilitator
(female)
 
SpineAZ's Avatar
 
Join Date: Oct 2005
Location: Wisconsin
Posts: 5,097
SpineAZ HB UserSpineAZ HB UserSpineAZ HB UserSpineAZ HB UserSpineAZ HB UserSpineAZ HB UserSpineAZ HB UserSpineAZ HB UserSpineAZ HB UserSpineAZ HB UserSpineAZ HB User
Re: Long term disability approved by Metlife- Employer asking job accomodation Q-nair

In STD it is common for "benefit approve through" dates to be continually moving. (To me STD is like "extended monitored sick pay"). Thus in STD it's common for the insurance carrier to be in occasional contact to get more information, extend the approve through date, re-review facts etc.

STD and LTD claim staff evaluate many factors on each claim and among them are:
(1) standard disability duration guidelines
(2) nature and type of job
(3) effect of any and all other medical/psychological conditions
(4) employers ability or willingness to accommodate return to work if possible
(5) employer input as to anything else relevant to the claim

At first, in some STD claim, a note from the doctor simply stating "disabled through _____" can be part of the equation IF that date makes sense. More often there is a need for objective medical information to determine claim progress and adjust approve through date. It's likely you signed a release of information form that allow the insurance company to communicate with your physicians and to request information as needed (verbally or in writing, depending on how the doctor's office operates).

So someone who submits an STD claim for a lower leg fracture will likely be approved but the duration of approval will depend on :
(1) Type of surgery/treatment: Open with incision? Pins under sedation? Cast? Weight bearing? etc
(2) Job type and requirements: Physical requirements, envisonment, job essential duties

So this claim will be handled differently for a person who does back-room production staff at a TV station vs a pilot. One may be approved for 4 weeks and one for 4 months. But follow up along the way can change the date the claim is approved through in either claim depending on progress, infection, healing, etc.

LTD is different. Unless they have a defined date on which they think you'll be able to return to work then the LTD letter does not give an "approved through date".

It appears you have the most common type of policy in which the first 2 years are based on you meeting the "own occ" definition of disability and being unable to work at your job/occupation. After 2 years they look at the "any occ" definition of disability and your ability to do any occupation for which you are reasonably suited by education, experience, background, etc. [Keep in mind LTD decisions are not based on whether your employer exists or if a job exists. My position at my employer has been eliminated but if my disability insurance company determines I can return to work it doesn't matter if a job exists for me, my claim simply ends. ]

The disability insurance company will continually evaluate your LTD claim over time. If they ever see that medical evidence supports you may be able to go back to work they'll be in communication with you specifically about this. They have Vocational Counseling staff to help you consider other jobs you may be able to do should your claim move toward a possible end ( whether that's 6 weeks from now, 6 months from now or 6 years from now. At this point you want to wait and see what the insurance company requests from you. Commonly you may have to complete an Activities of Daily Living form. If this happens let me know and I'll guide you through that.

From this point forward, unless the disability insurance company asks you to, don't get extension notes from the doctor that say "out through (date)". In LTD the insurance company is looking for is medical information to evaluate your claim. The next time you see your doctors be sure they are aware you are now on approved LTD and that you need their help in that you ask they help you by having them respond to any requests from the disability insurance company to provide medical documentation.

If you don't already have it get a copy from your employer of the exact LTD policy uncer which you are covered. Especially so you can see what the definition of disablity is for the first two years (own occ) and beyond that (any occ).

Make a file and keep ALL letters you receive from Met and keep copies of everything you send to them. I created a file for this that I keep on my desk next to my computer.

LTD is never "permanent". Some people relax too much at LTD approval thinking they won't have to interact with the insurance company as often, etc. Instead the LTD insurance company may be in contact with you to let you know when they expect to contact you again, what information they may need, etc. At the same time, be sure to be proactive and contact the LTD insurance company if anything changes in your condition OR if new problems develop. I recall doing a claim for someone with a diagnosis of depression who was improving on medication and therapy. When I called her to let her know the claim may end as we didn't have anything to show she remained disabled she said "How can you do that? I just had my kidney removed due to cancer". We had never been told. Once she told us we gathered the names of her new physicians, got medical information, and even reached out to her psychologist and even he didn't know but wanted to help her through the process so she would not regress in terms of her psychological condition.


I hope this helps, let me know if I can help further. I am recently out of the hospital following surgery so if any of my responses seem disjointed it's medications and or fatigue. But I'm eager to help people navigate disability process

Oh, almost forgot, don't be surprised if Met requests that you apply for Social Security Disability Insurance. This is common and most LTD policies outline this requirement. But we can cross that bridge if/when it comes up.
__________________
Rt&Lt thumb arthroplasty 2012 ; RT TKR & Bilat CTS 2011
Fusions: L5-S1 (87), L4-S1 (93), C5-C7 ('06), L3-S1 ('10)
C5-C7 foraminotomy 08

 
Old 02-13-2010, 06:50 PM   #8
Inactive
(male)
 
Join Date: Jan 2008
Posts: 4,017
Executor HB UserExecutor HB UserExecutor HB UserExecutor HB UserExecutor HB UserExecutor HB User
Re: Long term disability approved by Metlife- Employer asking job accomodation Q-nair

Quote:
Originally Posted by rkmgkm View Post
One small clarification, I need to understand the transition process from STD to LTD.
I'll try to explain this as best I can....

As Spine says STD is the initial disability stage. In many cases a simple Dr's note is all it takes to get things started...Whatever your condition may be. At my company, anything under 10 days of absence required vacation or sick leave. Anything greater than 10 days required STD. So, if one had surgery of some type and was going to be out of work for a couple of weeks, then STD would be appropriate.

Each company is different, depending on the plan they have. Most companies pay STD at 100%, meaning you get 100% of your salary. The longer you stay on STD, the more information the plan wants....To ensure that you qualify & that the proper documentation is obtained & etc.

At some point, STD transitions to LTD....Usually at the 6th month mark. The standard for LTD is much greater than STD. Once on LTD, then the compensation is usually a % of your income.....Either 50, 60, or 70%. Again, it depends on the plan. If the premiums were paid with pre-tax dollars from your check, then the money is taxable. However, if the premiums were paid with post tax dollars...Either subtracted from your check after taxes or paid some other way....Then, the money is non-taxable. For example, in my case, I paid with post tax dollars, so my LTD is non-taxable. 70% untaxed is about the same as 100% taxed.

Also, the higher the % of pay, the higher the premiums, or cost. Some companies pay the premiums for the employee as a perk, and it's a fixed amt...Normally 50%....For everyone. However, if the company gives the employee the option of LTD or not, then the employee picks what level they want and the corresponding premium. For example, in my case, I signed up for 70% when I was hired and paid the premiums with post tax dollars out of my pay check every two weeks. I was very fortunate that someone I trusted recommended that I sign up for LTD. I was young and didn't know any better. I paid the premiums for over 20 years, so I definitely earned it.

The definitions for LTD vary, again depending on your plan. As Spine stated, LTD usually starts out with a definition of "if you are disabled and unable to perform your job." Then after you've been disabled for 12 full months (including STD), then the definition changes to "if you are disabled and unable to perform any job that you are adequately trained for." Once you meet this definition, LTD normally carries on indefinitely, assuming your plan doesn't have any other contingencies.

Once on LTD, the carrier will want regular updates from your Dr to ensure you meet the definition and that your condition hasn't changed. Many people incorrectly assume that once you get LTD, it just continues on forever or is permanent. Just because one is disabled today, doesn't mean they will be tomorrow. For example, people who get cancer, can eventually recover enough to go back to work.

LTD can continue on forever, assuming you meet the definition and your condition doesn't improve. In my case, for example, I am sent an update packet once a year for my Dr to fill out. It asks for an official diagnosis, some questions about my condition, meds I'm taking, and then at the end, it point blank asks if I'm disabled and can go to work....And if the Doc ever expects me to be able to go back to work. I've been on LTD for 7 years now, and I've received this packet once a year ever since going on LTD. Even though my Dr states "never" in terms of going back to work, I still get the packet once a year.



Quote:
Originally Posted by rkmgkm View Post
My doctor's note given dec 09 mentions that I can return to work with no restrictions end of March 10. My LTD was approved Feb 9th from Dec 09 onwards.
My guess is that what may throwing a monkey wrench into the situation is that your Doc keeps listing a possible return to work date and the carrier sees that and is staying all over you, as you expect. Your Doc probably is thinking that he'll list periodic dates for evaluation and then move it out again, re-evaluate at that time and so on. Many Docs will do this vs just come right out and say that you're disabled forever.

At some point, you'll probably want your Doc to say that at this time, it doesn't look like you'll ever be able to return to work, but that you'll keep them posted if anything changes. This would make things look more permanent in the carrier's eyes. Conversely, at this point, they may think that you're coming back to work in March.


Quote:
Originally Posted by rkmgkm View Post
My LTD mentions it covers upto 2 years if unable to work in my own occupation and after 2 years any similar occupation. So, should i go to doctor to get the dates extended beyond march 2010 ? How does things work in LTD ? should dr keep extending dates like in STD ? I am so confused. Please help me understand
I covered this in my last section. So, it looks like the first two years are covered for your job and then the next two years for any job....Most plans are one year for your job and the any job from there on out.

In your plan, what happens after 4 years? Does it end, or continue on indefinitely? Mine continues until I'm 65 and then I move to Social Security.

As Spine says, most LTD plans require one to apply for SSDI, but that's a whole different animal. My company even acquired and paid for the atty to handle it because they wanted me to win. Any amt you win, is subtracted from their amt, so it's in the company's best interests for the employee to win. So, for the sake of argument, if one gets $4000 month in LTD and you win $2000 a month from SS, then SS sends you $2K and your LTD pays the other $2K

I hope this helps clarify things.

Regards,

Ex

 
Old 02-13-2010, 07:13 PM   #9
Inactive
(male)
 
Join Date: Jan 2008
Posts: 4,017
Executor HB UserExecutor HB UserExecutor HB UserExecutor HB UserExecutor HB UserExecutor HB User
Re: Long term disability approved by Metlife- Employer asking job accomodation Q-nair

Quote:
Originally Posted by rkmgkm View Post
I was going through PIP when I went out first time on STD. I had finished 60 days and I had 30 more days to complete my PIP. My manager was giving me tasks that I am not familiar with in the PIP period and asked to complete in unreasonable time.
The PIPs are almost impossible to follow through on. The company has already decided they want the employee out and the PIP is just a formality. They write it up to make it look like there are attainable goals (in case the employee sues or something), but in reality, they aren't....They bank on the fact that outsiders don't understand the internal workings of the business.



Quote:
Originally Posted by rkmgkm View Post
I knew that I could no longer work for that dept as things had got worst. I took my doc advice and went on disability.
It's good that you did. And, as I'm sure you know, there is no way you could go back....It would be like walking into gunfire....No way you would survive. If you haven't told your Doc this, I would. He probably knows and that's why he recommended you go on disability. However, reminding him from time to time reinforces how important your documentation is. The bottom line is that as long as your Doc is firm in his assessment, they can't touch you. They'd have to get another Doc to directly disagree with your Doc, and even that doesn't work very often. Even if one did, it doesn't necessarily mean one is right over the other. As a general rule, Docs don't like to disagree with other Docs as it creates all sorts of problems and potential liability for them, especially when specialists are involved. Additionally, the chances are very small that an outside Doc would disagree with a specialist who has been treating you for a long time. You are positioned well thus far.


Quote:
Originally Posted by rkmgkm View Post
My manager and the dept suspects that I took an easy escape out from being terminated. The HR did not contact me all along and refused to accomodate me during last 8 months. I informed the manager everytime I got an extension from doctor and even communicated about the long term disability approval.
Yes, I'm sure they did. That's probably why they are treating you the way they are. This is also why you have to be very careful in everything you do. The less said the better. Loose lips sink ships.


Quote:
Originally Posted by rkmgkm View Post
this Questionaire totally surpirsed me.

Questions:

Last Visit:
Date of onset on the illness:
( I was dx lupus and fibro on the day I went on disability, till then I was taking nortriptylene for my pain)
physical/mental restrictions:
Expected duration of these limitations:
-Release with no limitation on --------
-Restrictions are of permanent nature

Impact of medications which may affect the employees ability to perform job(I had discussed with my manager that my medications interrupt my analytic ability and I cannot work fast- so clarifying with doctor!)

Since the HR is aware, I am little reluctant to talk to them about the long term disability approval and have such conversaion. They have sent this letter just after my LTD approval in the certified mail.
Ok, this makes more sense now. Knowing what I know now, I think I'd have the Doc simply fill out the form....Very succinctly and to the point. It will be put in your file with the rest of your information. He just needs to fill it out so that it's very clear that you can't work.

As far as the meds go, that's a big issue....I've got the same issue. When taking the meds, one gets foggy, tired / sedated, has to lay down at times, is disqualified from driving, and many other issues.


Quote:
Originally Posted by rkmgkm View Post
I know their intentions, they want me to remove from the job, with no benefits. HR wants the paperwork by next 2 weeks as my doc letter stated - return to work by end of march. I do not know how to explain this to my doctor. How to put this accross.
As I said in my other post, they are probably going by the assumption that you may be returning to work in March and they want this form filled out to know what limitations you may have when you return....That's the issue. However, your Doc is probably more than likely going to change the date again and of course, they don't know that (yet).

I'd have a very nice heart to heart with him and explain that you can't go back and things haven't improved, as you've stated. I'd fill the form out saying that you can't return and won't be in March. If your Doc plans on extending the date, he needs to go ahead and do it now. Otherwise, you'll need to put a plan together for attempting to go back to work, or look for another job.

Let me know if I can help further.

Regards,

Ex

 
Old 04-07-2010, 05:43 AM   #10
Junior Member
(female)
 
Join Date: Oct 2009
Posts: 15
rkmgkm HB User
Re: Long term disability approved by Metlife- Employer asking job accomodation Q-nair

Hi

It was a long process to get things done. The form was so confusing to my doctor, he asked me to go to PCP to get that form filled. I could not go to PCP as he was not my treating physician and he is not aware of my symptoms-disease pattern. The form was there with my rhemy for nearly a month. My doc told me the letter was not reqd as my LTD was approved and only if i return to work, that form needs to be filled. Upon repeatedly telling this to my HR, they later said that it was optional to fill that form. The HR pushed me to max extent possible. In the meantime my doc had also prepared a letter saying that she has a permanent disabling illness and cannot go back to work on ...date as mentioned earlier. This helped me solve the problem.

Thanks for all your help !

 
Old 04-13-2010, 02:59 AM   #11
Newbie
(female)
 
Join Date: Mar 2010
Posts: 1
Nugget01 HB User
Re: Long term disability approved by Metlife- Employer asking job accomodation Q-nair

Hi, this isn't in reference to your questions, but maybe you can help me out.
I have MS. I have been on S/T since Oct.09 I was just fixing to transition over to L/T but Metlife wanted more information from the doctors, now they say I have been denied. Can you give me some pointers.

Jacki

 
Old 04-13-2010, 03:47 PM   #12
Facilitator
(female)
 
SpineAZ's Avatar
 
Join Date: Oct 2005
Location: Wisconsin
Posts: 5,097
SpineAZ HB UserSpineAZ HB UserSpineAZ HB UserSpineAZ HB UserSpineAZ HB UserSpineAZ HB UserSpineAZ HB UserSpineAZ HB UserSpineAZ HB UserSpineAZ HB UserSpineAZ HB User
Re: Long term disability approved by Metlife- Employer asking job accomodation Q-nair

First, you have to determine why your LTD is being denied. If you did not enroll and/or do not meet the requirements to receive the coverage, that is a difficult barrier to overcome.

However, if they are stating that they find you are not disabled from doing your job they are required to send you a detailed letter as to how they reached this decision. So call them ASAP and ask for the specific reason and when you can expect to receive the denial letter so you can begin the appeal process.

LTD benefits are not payable purely on a diagnosis. The LTD insurance company is looking for objective medical information to substantiate that you are unable to perform the requirements of your job. Many people with MS are able to continue working so the insurance company is looking to see what prevents you specifically from doing your job. If you have restrictions and limitations which would prohibit you from going back to your job you need to discuss this ASAP with your physicians. Write out specifically, and objectively, what limits you from doing your job.

Many doctors don't understand the intricacies of various jobs. Thus the way they complete forms may make it seem you are able to work. So you'll need to write out for the doctor exactly what your job requires and why you can not perform that function. You can also provide that same information to the insurance company.

For example:

My job requires standing 4 hours per day, due to my persistent symptoms of xyz I am unable to do this aspect of my job.

In addition, my job requires lifting X amount of pounds frequently and I am unable to do this due to my persistent symptoms of xyz.

Etc.

I took the Attending Physician Statement that my surgeon was required to complete and I looked at each question and provided my own answer and perspective. For example, my title was Account Manager and my doctor had no way of knowing that mean air and car travel 1-3x per week. Since I could not lift over 10 lbs the disability insurance company agreed that travel was not an option. My employer agreed this was a key component of my job. Also, I was in a small office where I had to do all the filing as it was just the Sales person and myself. In some offices there may be clerical staff but we did not have that. So my employer agreed this was a crucial job function and the disability insurance company agreed I could not do bending, twisting, pulling and pushing more than infrequently based on the medical information from the doctor.

I hope this helps!
__________________
Rt&Lt thumb arthroplasty 2012 ; RT TKR & Bilat CTS 2011
Fusions: L5-S1 (87), L4-S1 (93), C5-C7 ('06), L3-S1 ('10)
C5-C7 foraminotomy 08

 
Old 04-13-2010, 11:31 PM   #13
Junior Member
(female)
 
Join Date: Oct 2009
Posts: 15
rkmgkm HB User
Re: Long term disability approved by Metlife- Employer asking job accomodation Q-nair

Quote:
Originally Posted by Executor View Post

I'd have a very nice heart to heart with him and explain that you can't go back and things haven't improved, as you've stated. I'd fill the form out saying that you can't return and won't be in March. If your Doc plans on extending the date, he needs to go ahead and do it now. Otherwise, you'll need to put a plan together for attempting to go back to work, or look for another job.

Let me know if I can help further.

Regards,

Ex
State has sent me a form to be filled by doc for paying my STD. Medical registrar told me that the state will not accept letters with permanent disability. The state needs a date to process the STD. Until now my pay was integrated. State was paying me the regular STD amount eligible and the difference was paid by LTD. What should I do now ? I personally requested doc not to put any date as my employer was thinking that I would return to work and I was not in a condition to go back and work. So according to my request the doc wrote a letter to show to my HR. Now state needs extension letter. If I do not provide the extension letter, who will pay me the eligible amount ? Will metlife pay me ?

Met life also has called me 2 times now. And they asked me when I am returning to work, also when will I visit my doc ?

I do not understand how frequently will they enquire in LTD. It has just been 3 months that I am on LTD with pay integrated by STD.

Please advice.

Thanks

 
Old 04-14-2010, 07:36 AM   #14
Facilitator
(female)
 
SpineAZ's Avatar
 
Join Date: Oct 2005
Location: Wisconsin
Posts: 5,097
SpineAZ HB UserSpineAZ HB UserSpineAZ HB UserSpineAZ HB UserSpineAZ HB UserSpineAZ HB UserSpineAZ HB UserSpineAZ HB UserSpineAZ HB UserSpineAZ HB UserSpineAZ HB User
Re: Long term disability approved by Metlife- Employer asking job accomodation Q-nair

State disability is much different from STD/LTD run via an insurance company (or 3rd party administrator).

Insurance companies provide employers with "managed disability" for STD/LTD, at the employers request, where medical documentation is required to substantiate any period of STD/LTD. So a doctor's note stating "she may be able to return to work on 6-1-10" does nothing for the claim. There must be objective medical evidence which is evaluated along with the job requirements to determine the STD/LTD benefit duration.

State Disability (CA, NY, NJ, HI, RI, and PR provide state short term disability) usually only requires diagnosis and estimated return to work date. Often the state can provide you a form for the physician to complete. (If you are in CA I can get you the state's website for CASDI).

Social Security Disability, which is federal, requires a ton of medical evidence initially for approval. Any review thereafter is less stringent unless SS has reason to believe something has changed.
__________________
Rt&Lt thumb arthroplasty 2012 ; RT TKR & Bilat CTS 2011
Fusions: L5-S1 (87), L4-S1 (93), C5-C7 ('06), L3-S1 ('10)
C5-C7 foraminotomy 08

 
Closed Thread




Thread Tools

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is Off
HTML code is Off
Trackbacks are Off
Pingbacks are Off
Refbacks are Off




Sign Up Today!

Ask our community of thousands of members your health questions, and learn from others experiences. Join the conversation!

I want my free account

All times are GMT -7. The time now is 01:33 AM.



Site owned and operated by HealthBoards.comô
Terms of Use © 1998-2014 HealthBoards.comô All rights reserved.
Do not copy or redistribute in any form!