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Short term disability denied because physician sent paperwork late

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Old 10-05-2011, 03:48 AM   #1
Join Date: Oct 2011
Location: Alpharetta
Posts: 1
tiffaneys HB User
Angry Short term disability denied because physician sent paperwork late

On August 22,2011 I had surgery to remove 3 large tumor from my uterus. I had spoke with my physicians nurse at least 4-5 times regarding the completion of my short term disability paperwork to ensure I would be paid and my job would be protected. Each time she told me she was faxing it to the insurance company.

I received a email from my insurance company that stated the deadline for them to receive the paperwork was Sept 3 (which was a Sunday). I called the nurse on Sept. 1 to make sure the paperwork had been sent and she said she was completing it and faxing it over again.

Two weeks later I received a email from Prudential stating they never received my paperwork and my Short Term disability and FMLA had been denied due to them not receiving any medical paperwork from the physician. I called and spoke with the physicians office and the nurse said she was sending it that day! Two weeks late!!!!! Once she faxed it over, I called and spoke with the insurance company and they stated since she was not in compliance with the date the information was requested, the first two weeks of my leave would be denied and my job was not unprotected which would leave me with 10 days unexcused absences on my job. Also the first two weeks of my leave would be unpaid.

They stated the policy of the company I am employed with states if the paperwork from a physician is not received by the due date, they will not retro and that time will be denied. When I called the office to tell them this, the nurse said, I already faxed it and if you want to come pick up a copy, feel free to. She wouldn't even get on the telephone. What can I do?

I spoke with my boss and Human Resources to ask her if I could be fired or written up and she said yes because it was unexcused. She said it was my responsibility to get that information in to the insurance company. She said I should have done it before my surgery. I have had 4 surgerys while being employed with this company and I have never faxed in disability paperwork before the surgery. Then she said you should have gone to pick up the paperwork and faxed it yourself after the surgery. I told her, how can I do this and I just got out of the hospital from having surgery?????

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insurance, physician, short term disability, surgery

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