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Old 03-06-2013, 08:58 PM   #1
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Join Date: Dec 2010
Location: Wisconsin
Posts: 49
rydr301 HB Userrydr301 HB User
LTD issues

Ok so I have been on LTD benefits since 1/28/11 all has been fine. My 24 months was up in Jan so I went under review starting in Aug. I have sero neg RA, OA, Sjogrens and now Fibro. I saw a new RA dr in Oct he gave me the Fibro dx. I emailed the LTD claim person he noted it I told him make sure you get his records as I know I'm under review.. in Dec I talked to them again and asked if they had requested the records and they told me that if they need them they will request them. beg of Jan they told me that my records don't match what my symptoms are so I had to go see one of their independent medical review dr, but they did finally start the process of getting my records... did that 1/29/13 very quick visit I felt it was quite the joke.. beg of Feb they requested the records again... 2/23/13 I got the form I had to sign to release them faxed it 2/25. I talked to the benefits lady on 2/26 and she said she got the report back from the eval I went to and they are sending the check for my records and will be in touch. she called me 2/27/13 and she said that they made a decision!! They are denying continuation of my benefits as based on the eval I could perform a sedentary information clerk!! I asked did you get my records from my new Rheumatologist? and she said no..I said well how can you make a decision when you don't have all the records?? She told me that they didnt have to wait for those records and that she could go by the med review and my previous records... I said well my new dr is the one that gave me the additional dx that is important info... She then told me that she highly recommends that I appeal and that will be a separate "eyes" and I should ask for them to continue my benefits while in appeal... As I will only be getting 1 last check..
How can they do this??? I have a call in to an attorney as I need the help I think it would be better they do the appeal than me.. Any advice any of you can give is very much appreciated!!

 
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Old 03-07-2013, 09:24 AM   #2
Junior Member
(female)
 
Join Date: Dec 2010
Location: Wisconsin
Posts: 49
rydr301 HB Userrydr301 HB User
Re: LTD issues

Thank you for your response!!

Good information. I keep really good records and I understand the email/mail communication vs phone. She did mention that I should ask the appeal department in my letter for them to consider a "reservation of rights" she thought it was called (to continue my payments as they are my sole income until a decision was made) Have you heard of that?
I am waiting for their official letter to come in the mail. I received my last check it usually gets posted on the 3rd but it was posted on the 27th so I'm sure the paperwork is coming.. As soon as the official letter comes I will request any and all information records/reports on my claim be mailed to me so my attorney can review them.
Hoping to hear back from the Attorney today that I hope will be helping me with my appeal.
Again thank you.. it is difficult to tend to all of this and my health at the same time it is all very overwhelming.

 
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