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Old 11-16-2011, 05:35 AM   #1
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Post Getting approval from doctor for disability

Hello,

I have had infections for years and have recently been diagnosed with CVID.
Immune disorder. I am waiting for immunoglobulin treatment (CVIG).

I have been sick for over two months and it's affecting my ability to work or perform well on the job.

My doctor is trying to get approval with the insurance company to authorized my treatment, which is still ongoing after a month.
My insurance carrier is going to change on Jan 1st and have to start the process over again of getting approval. I need this treatment now, because I am sick, and don't have a date when I will be approved.

My issue is this; how do I approach my doctor with the question about possibly going on disability, and if he will support me?
I am afraid to ask because I have heard some doctors will "red flag" your records as someone who does not need to be on disability, and, I don't want this to happen. I explained I was very fatigued and cannot perform well on my job.
How can I ask the doctor is such a way, that I will get an answer of at least yes or no? and not be red flagged?

Also, if the doctor says no, and I go to another doctor who treats ppl with my condition, how do I approach the question if they will support me if I feel I need to go on disability?
I feel I have to move quick on this issue, as my job is on the line now and my employer my let me go. I do have STD and LTD through work.

How can i quickly move on this issue? if my doctor says "no", if I go to another doctor, should I approach the issue right away? the doctor I was thinking of seeing has had cases where ppl with AIDS have gone out on disability.

Please; any direction or help is appreciated. Thanks.

 
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Old 11-16-2011, 08:14 AM   #2
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Re: Getting approval from doctor for disability

I sympathize with your dilemma friend. You may have to take a huge risk and come outright and tell the doctor point blank like you did in this post and see what his reaction will be. I know the subject of disability is a delicate topic to broach with your primary care doc. I told my doctor I was simply unable to continue working due to my medical condition and ask him if he would be willing to fill out any disability paperwork for me if need be. I had another doctor so this guy was like a secondary. I also had to discuss this with the primary mental health doc. These things may be very uncomfortable to talk about but you must if you are sick and may not be able to continue working much longer.

If you lose your job do to attendance or poor performance, your STD and LTD go out the window. You then find yourself still sick with no income to support yourself or treat your medical condition.

Here is something you might consider. Call around in your local area some lawyers who represent SSDI claimants. Tell them you may be looking at filing a SSDI claim if your disability prevents you from working further and ask them if they have worked with any doctors in the local area that have helped past claimants of theirs. They may be able to recommend someone to you. STD and LTD are valuable benefits available to you if you become sick and can no longer continue working but these benefits are worthless IMO with unsupportive doctors. You are not doing anything wrong. You are simply sick. This is what I told myself over and over after working for the same company over 20 years. I saw possible STD/LTD in my case a year prior to it happening because of chronic mental health problems that I have struggled with for decades. If I did not have these valuable benefits available to me when I became too sick to continue working, it would have meant financial ruin for me. The beauty of LTD is that while you wait on the long SSDI approval process, you have incoming income to survive in the meantime. It is a valuable benefit that you don't want to lose even tho the DI carriers can sometimes be a PITA. Take care my friend. You must have this talk with your doctor. It is critical that you do so.

Last edited by BlueSkies14; 11-16-2011 at 09:56 AM.

 
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Old 11-16-2011, 01:21 PM   #3
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Re: Getting approval from doctor for disability

Instead of telling your Dr. that you want to file for disability benefits because it is getting too hard to work, ask the Dr. what he thinks about you filing for benefits . Maybe he will agree and support your claim. I hope he does. He has been treating you , he hopefully has your best interest in mind. I did not know Dr's would "red flag" someone records just because the person asks about disability , that is very unfortunate. I think having good communication with your Dr. is important. have you been going to the same Dr. for a while? Is so he should know what your medical conditions are and how it is affecting your overall daily functioning. Maybe approach the subject as asking for advice or his opinion about going on disability.

Last edited by mscat40; 11-16-2011 at 01:24 PM.

 
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Old 01-15-2012, 02:01 PM   #4
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Re: Getting approval from doctor for disability

I am really glad I spoke with my Dr. (Immunologist) about the issues I have had at work. He approved and signed the STD paperwork and FMLA forms. Thankfully I am on STD; the last day of FML/job protection will be March 22.
In the meantime, I have been taking much needed rest and going to my doctors regularly and my Immunologist with Kaiser is running extensive tests and lab work on my condition. I really hope they approve the gammaglobulin tx. The last insurance company would not because my levels were not low enough, however, my IgG subclasses 1 and 3 are very low.
Since I have been out of work, my infections never completely go away, even with antibiotics, my shortness of breath and tightness in my lower lungs is not improving either; had to call an ambulance last week because I felt like I was suffocating! I still feel like I have a constant low grade fever and this along with the bronchitis/asthma makes me very fatigued and tired.
Can anyone relate? I am not working and my house is still a frazzled mess. I just don't see to have the energy to do housework, don't want to leave the house because the cold weather aggitates my condition with breathing, and I avoid taking a shower and then going outside because the temp change will make me sick. Anyone relate to this? feeling "cold" all the time and sensitive to temp changes?

Thank you all for your support; appreciate it.

 
Old 01-15-2012, 03:16 PM   #5
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Re: Getting approval from doctor for disability

I am glad you were able to be on STD , have your filed for SSDI benefits yet? If your disability prevents you from working a SGA for a year or longer or is expected to last this long then I would file for SSDI, it can take a while for a approval. Remeber it is not a approval from your own DR, that counts, it will be that of social security's DDS worker and they use their own Dr.s Althouh it makes it a lot easier when you have your own Dr;s support.

 
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Old 01-15-2012, 03:51 PM   #6
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Re: Getting approval from doctor for disability

Think of your doctor or doctors as primary and the SSA CE's, medical/psychological consultants and DDS disability examiners as secondary. What your doctors say and your medical records are what is going to get you approved.

 
Old 01-15-2012, 06:22 PM   #7
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Re: Getting approval from doctor for disability

Quote:
Originally Posted by BlueSkies14 View Post
Think of your doctor or doctors as primary and the SSA CE's, medical/psychological consultants and DDS disability examiners as secondary. What your doctors say and your medical records are what is going to get you approved.
You are so right Blueskies, what I was tryimg to say was just because your DR. tells you you are disabled does not mean social security will agree. & you will be approved because of this.

 
Old 01-15-2012, 08:19 PM   #8
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Re: Getting approval from doctor for disability

Quote:
Originally Posted by mscat40 View Post
You are so right Blueskies, what I was tryimg to say was just because your DR. tells you you are disabled does not mean social security will agree. & you will be approved because of this.
Yeah, I knew what you meant Mscat. You are absolutely correct. Just having your doctor say my patient is disabled is not enough. You and your doctor(s) must prove it with your medical records.

 
Old 01-16-2012, 10:52 AM   #9
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Re: Getting approval from doctor for disability

BlueSkies14 and MsCat40,

Thank you for the reply. I have not applied for SSDI as I am not sure how my health will be at the end of the STD period. If my health is not good, I will speak with my doctors' regarding LTD.

I don't know if my Immunologist through Kaiser will put me on CVIG tx, as she is running more lab tests on me to get the overall results regarding my immune system. She said depending on the results, she might take other courses of treatment.
She said she wanted to put me on a low dose of antibiotics for a long time and see how this works. I mentioned if the course would interfere with lab results and she said no. This is hard to understand, as I have had antibiotics thrown at me for 20 years, and really want to get to the root of the problem.
She is hesitant to put me on CVIG tx too early because if it is not the best tx for me, retesting lab work later would not give accurate results, so she wants to be prudent.

I am hoping with my CVID, depression/anxiety, and neck/back issues that if I need LTD later, that my doctors will support me. It is unsettling to think what would I do if they did not. I don't want to return to work if my health is still in jeopardy, otherwise i could lose my job.
Also, an interesting thought is once someone is approved for CVIG tx with insurance companies, if they go back to work, what happens if they lose their job/insurance, or, what happens if they change jobs and the new insurance co. through the new job will not approve CVIG tx or there is a pre-existing condition clause. This is of major concern, because I could get sick without tx and wind up where I am now.
This would be a very good reason to apply for SSDI because in two years could get Medicare. Medicare will not reject this tx, correct?

Have you all experience the above concerns before? what good course of action did you take? Where your doctors supportive of LTD and SSDI?

Thanks!

 
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Old 01-21-2012, 09:03 PM   #10
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Re: Getting approval from doctor for disability

If you are diagnosed correctly for CVID (history of repeated infections, low IgG and IgA and/or IgM, and then do not respond (make antibodies) to vaccinations of pneumonia and/or TDAP), then when you switch insurances there would be no issues getting IVIG (Intravenous Immune Globulin). I have CVID (am also on Kaiser insurance), am a single mom with very limited support, work 10 hours a day and own my own home. If indeed you do have CVID, typically once people are on fully on treatment (6 months to a year) , we lead very normal lives.

Your doctor was correct in starting you too soon on IVIG. If you are not properly diagnosed, insurance will force you OFF treatments for 6 months and make you go through the diagnosis process again.

CVID is on the list of conditions that warrant disability, but it typically comes with years of documented, frequent infections, multiple hospitalizations, and more.

Should you test positive for CVID, please make sure to encourage your doctor to run a CT scan to check for lung damage (bronchecatasis and nodules). Take care.

 
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Old 01-22-2012, 02:21 AM   #11
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Re: Getting approval from doctor for disability

Quote:
Originally Posted by GregBear4you View Post
Have you all experience the above concerns before? what good course of action did you take? Where your doctors supportive of LTD and SSDI?
I was close to losing my job due to absenteeism from being sick. Both of my doctors were supportive of SSDI and LTD.

Quote:
Originally Posted by GregBear4you View Post
I have not applied for SSDI as I am not sure how my health will be at the end of the STD period. If my health is not good, I will speak with my doctors' regarding LTD.
How long have you been on STD? Is LTD provided by the same insurance company who approved the STD? My STD was administered in-house by the company I worked for. You are on STD so your doctor must have filled out the necessary paperwork for that. Why not ask him/her if your STD runs out and you are still sick, would they support your claim for LTD?
Quote:
Originally Posted by GregBear4you View Post
I am hoping with my CVID, depression/anxiety, and neck/back issues that if I need LTD later, that my doctors will support me. It is unsettling to think what would I do if they did not. I don't want to return to work if my health is still in jeopardy, otherwise i could lose my job.
If you lose your job due to being sick, you still have a very narrow window where you can submit a claim for LTD. I was actually told by HR that LTD would probably be the best option in my case given my medical history and they were right. Most employers don't want to fire good, longterm employees for being sick too much. I could have still filed a LTD claim had I been fired, but I would have lost my eligibility for retiree benefits. I am glad I made the decision to go for LTD/SSDI. I had a very good outcome.

Most STD will pay for 6 months. Most LTD group policies have a 6 month elimination period, so after you have exhausted your STD, LTD can pick right up so there is no lapse in income. My 50% tax free LTD was a lot more than my 60% taxed STD, although I did get 6 months of STD @ 100% pay and 6 months @ 60% pay due to my years of service.

If you are able to go back to work, all the better but you must prepare yourself and your doctors for the worst case scenario also.

Last edited by BlueSkies14; 01-22-2012 at 02:27 AM.

 
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Old 01-23-2012, 04:47 PM   #12
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Re: Getting approval from doctor for disability

Quote:
Originally Posted by GregBear4you View Post
Can anyone relate? I am not working and my house is still a frazzled mess. I just don't see to have the energy to do housework, don't want to leave the house because the cold weather aggitates my condition with breathing, and I avoid taking a shower and then going outside because the temp change will make me sick. Anyone relate to this? feeling "cold" all the time and sensitive to temp changes?
YES i can relate...i feel cold all the time and have sinus issues....people are always asking if i have a cold. It makes me tired and hungry all the time....i have no energy to do anything.....i constantly have to dress in layers, and even then my hands and feet are like icicles.

 
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Old 01-23-2012, 04:57 PM   #13
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Re: Getting approval from doctor for disability

I have a thyroid condition that makes me constantly cold all the time. plus arthitis aggravates my symtoms in cold weather , and the cliinical depression ,makes me just want to curl up and sleep all day. I remeber one poster telling us that she was required to file for disability when she was on LTD though her job , but I do not know if everyone has to do that.

 
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Old 01-24-2012, 03:39 AM   #14
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Re: Getting approval from doctor for disability

I am cold all the time to . I had my thyroid checked and it came back normal. The cold weather effects me so bad both me and my husband. We were told by the DR. warmer weather would be better for both of us. I all so want to sleep all day and then when I do lay down my heart races. I think they have a thing called seasonal depression but lately it seems like I have all seasonal depression. Gregbear4you, I hope you get approved hang in there .

 
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Old 02-04-2012, 01:52 PM   #15
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Re: Getting approval from doctor for disability

Hello BlueSkies,

You asked me: "How long have you been on STD? Is LTD provided by the same insurance company who approved the STD? My STD was administered in-house by the company I worked for. You are on STD so your doctor must have filled out the necessary paperwork for that. Why not ask him/her if your STD runs out and you are still sick, would they support your claim for LTD?"

STD - a little over a month now have been on STD - my company I work for pays for it. Will last no more than 12 weeks, unless apply for an extension.
LTD - is through an insurance company, by premiums I pay into at work.
Yes, my doctor signed the STD forms with no reservations. I was really shocked, but, so glad he did. My insurance is not going to give me the gammagard drug; the immunologist there said "you really don't have an immune deficiency disorder unless you IGg level is below 400. What a line of bull! I am very angry!

I am deficient in IG 650, sublcasses 1 and 3, which have to do with recurring infections and lung infections.

We now are applying for the CVIG drug, but there is a 6 month pre-existing condition clause., so therefore, I will have to go on LTD until I can get this drug, then be re-evaluated. I am certain the Kaiser doctors will not support me for LTD, but they might, so I have to have this talk again with my Immunologist. I am praying he does support this. Again, I feel nervous about asking, because if I get turned down, there is really no one else who could help me.

Thanks for your help, BlueSkies!

GregBear4you

 
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