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Old 07-23-2010, 04:56 PM   #1
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denied long term disability waiting for ssd hearing decision,

Hi, I live in new york state, was denied in 08 for ssd and ssi, got lawyer had my hearing on may 4th 2010 no decision yet lawyer 99.9% sure won due to judge saying on record, claiment unable to perform sedentary work. I have been recieving long term disability through last employer and its been 24 months so had to review they knw appeald and wnt to hearing and waiting, can't believe they denied me. I need the money so bad my husband and I have 3 kids to support. I was born with cong kyphosis, had surgery T12-L2, with fusion and instrumentation, now have post laminectomy syndrome-lumbar, ddd, sacro joint pain, right leg/hip pain, severe pain, I also have major depression, sleep apnea, ibs, gerd, I really need some advice, they said I could appeal and could reverse or prob take 30 days, any help would be appreciated. thanks to all

 
Old 07-24-2010, 10:24 AM   #2
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Re: denied long term disability waiting for ssd hearing decision,

Read the termination letter carefully for how you are to appeal. Also make sure to appeal in whatever time-line they mandate. You'll want to provide the LTD carrier as much medical information as you can to substantiate that you are disabled from any occupation. After 24 months they no longer evaluate your LTD based on if you can do your own occupation, but if you can do any occupation.

Are you currently in active Pain Management? If so, and if the medications are significant you'll have to make sure your Pain Management doctor provides the LTD carrier information that shows you can not work on the medications you currently take.

In most cases your LTD decision is based on ERISA guidelines and it will say this in the termination letter. ERISA just lays out what must be in the denial letter, how long you have to appeal, how many levels of appeal you have, etc.

The LTD termination letter should denote exactly what it was that led to the termination of benefits (what the medical informatino indicated, what they reviewed and how the decision was made) and it the letter will also denote exactly what to do to appeal the termination. So get all the medical ammunition you can together and write an objective and clear letter that states exactly why you can not work at any occupation. Leave out anything about needing the money, you have kids to support, etc as that has no bearing on LTD. The more brief and to the point (and un-emotional) you can make the letter the better. You often have a limited time to appeal so make sure you don't miss that guideline. If you want to use a lawyer in the appeal you certainly can and should move quickly. Once you appoint a lawyer to represent you the communication now becomes directly between the LTD carrier and your lawyer.

Some SS attorneys do LTD appeals, and some do not. But often if they do not they know someone who does that can help you. So seek assistance from your SS attorney if needed.

I fear this will happen to me when I hit 24 months so I've already located a local LTD attorney just in case.
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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

Last edited by SpineAZ; 07-24-2010 at 10:25 AM.

 
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