BlueSkies and Spine - thank you for your previous posts and advise.
Well, I finally got my LTD approved with Hartford. I am very happy about that.
I met with my manager from work and returned my office equipment; he stated I had done a really good job and would want to rehire me if/when I become well enough to work again.
I am not having much luck with the IVIG; I have very bad joint/muscle pain, nausia, and lite headedness. My home nurse stated the IV drip will have to be done slower as a result. They are going to have to extend the IV drip 6 hours a day for 4 days for the Gammagard S/D. I cannot tolerate anything faster than this; the nurse did a baseline on me.
The insurance company sent me a letter that I needed to apply for SSDI now.
They asked if my condition will last 12 months or more and I said yes.
Spine, OWN OC is 24 months, then after that it becomes ANY OC. The SSNRA is age 67.
I asked them for an SSDI attorney who could help me and they referred me to an SSDI advocate who will handle the SSDI process and communicate directly with SSA. They said an attorney will not be involved at this point, unless I had to go see the ALJ, then a lawyer would be assigned to help me.
Does this sound reasonable, that an advocate would help me through the SSDI process and not a lawyer at this point? they were referred to me by the Hartford, so I'm sure it's in their best interest to get me approved for SSDI.
Also, what do you all do when you feel you are being investigated by the insurance company. Right after my approval, I had some guy on a Saturday walking up and down the sidewalk back and forth watching me in my backyard - I was just sitting.
The other day I was well enough to meet a friend for lunch at a restaurant.
There were two men diagonally across from me in a booth, and one of them was looking over at me a lot, playing with his "cell phone" picked it up and faced it toward me like he was recording me or trying to take a picture.
What can you do about this, anything?
There are some days when I feel well enough to leave the house - how do we go about handling the possibility of being investigated?
Yes, an SS advocacy firm is fine. There are many that contract with LTD insurance companies and the only way an LTD ins co is going to refer you to an advocate or attorney is if the firm is proven to be excellent at getting SS approved.
Surveillance can occur. However it's very expensive. You should call police if at any time someone is observing your home, parked in the street near your home without just cause (if it's the cable TV guy working on a junction box it would not be something to call about). In a restaurant, ask to be repeated elsewhere as you feel the patrons at the other table are making you uncomfortable.
In order for surveillance to work it has to show you substantially deviating from your restrictions and limitations repeatedly. I'll try to add more later to give some examples.
Surveillance can only be used if it can show you consistently do activities above and beyond what you and your doctors have stated.
This is why I say never say "never" on a questionnaire uniless it's truly never.
A few examples of when surveillance fails:
You don't walk much outdoors due to pain. But a neighbor in the hospital asks you to pick up her mail for a week and she lives 6 houses away. Watching you walk to her home and bring back her mail doesn't prove you can work.
If you say that you can occasionally sit and stand and the amount of time is dependent on pain, then lunch with a friend for an hour is reasonable. A three hour lunch observed by surveillance may raise red flags BUT it's once. Only if they can see you doing that regularly can it be used. Maybe your friend drove you and you are highly medicated and fidgeting in your seat due to pain.
People who say they "never" drive but are observed driving 2 miles to the pharmacy and grocery store 3x/week have caused a concern if under surveillance. Because they said "never". If they had said "as needed for pharmacy and basic household needs 2-3x/wk limited locally" then doing so doesn't go against the stated limits.
If you feel you are under surveillance and law enforcement does kick someone off your street (whether they are parked or walking) you can call the insurance company and voice your concern saying "I'm working with the local police as we're concerned about trespassers who may be on my property. Are you aware of any investigators that may be in my area on behalf of your company?"
Surveillance does happen, but it's rare because of the expense. Usually it's because they have reason to believe someone isn't disabled. Being newly approved I would be VERY surprised if you are being investigated. I think it's a little normal to be paranoid when out and about while being on disability. All private LTD companies have fraud units, and now even SSDI has a newly created fraud unit, so it's understandable to be a little paranoid. As long as you know you are unable to work and you aren't outdoing anything that would give the appearance of having any work skills, you should be fine!
