Somedude said...
LOL 12 weeks....
I work for the federal Gov in Canada. If I feel like sitting home for the next 3 years I can and then I can come back to my position. Granted it's going to be unpaid leave. But whatever.
Stupid laws in U.S Geez, w.t.f. who wants to catch a chronic disease. 12 weeks....yeah ...U.C. and Crohn is going to cooperate after 3 months...
It's not the worst law when it comes to being ill, disabled and out of work. A person, including myself thought I had some protection, something to fall back on with Short Term Disability and Long Term Disability. We have this thing called, insurance or so we think. I received 60% of my pay while out of work on STD, then extended to LTD from the insurance carrier. When a person gets their insurance through their employer, then become disabled, all this falls under a law called ERISA. A law first meant to protect employees that has back fired and works against employees and benefits the insurance companies.
Take a read here-
www.erisa-claims.com/blog/erisa-encourages-bad-insurer-behavior.cfmThe insurance company I dealt with terminated me because I can lift 20 pounds, which means I can do sedentary work. Now one needs to ask themselves, what does that have to do with Crohn's and everything that comes with having Crohn's? The conclusion I come to is, nothing. It doesn't matter in the end, the only thing that matters when it comes to the insurance company is profit. The insurance company I had been dealing with made a profit of 3 billion dollars last year. Operates on the markets at 26 billion dollars and is asking for over $200 million in tax credits for a new building. All insurance companies operate this way, accept premiums, deny claims.
Under ERISA, I can only sue for what they were going to pay me. Meaning, no punitive damages, nothing beyond what they were initially going to pay me while being disabled.
I have to get an attorney well versed in the disability laws, pay them a fee as well only to recover what the insurance company was going to pay me. I cannot receive help from the state I live in as ERISA makes the whole matter a Federal issue. The appeal time is 180 days, that is 180 days with no income.
Also during the time of being disabled, applying for SSDI & SSI, the insurance company will take part of my SSDI payment from when I first applied for it. That is paying back what is considered a loan to me. Being disabled, my situation for example, I am owed 60% of my base pay. Let's say I receive SSDI for a certain amount per month, the insurance company must pay the rest to equal the amount of the 60% of my pay. Which is supposed to occur for as long as I'm disabled or until the age of 65.
The insurance companies intentionally terminate claims to save money. People are ill, disabled, already lacking funds and 9 out of 10 people do not appeal their denial of benefits.
The insurance company had a representative call me often for "retraining" and to call my employer to see if I have a job to return to. I denied both requests, didn't stop the representative from calling my manager. I'm sure it came across as badgering and he told them no, I do not have a position to return to.
Soon after my claim was terminated, the very next month. Talk about
being infuriated, stymied and at a complete loss, that is an understatement. You are left high and dry with zero, yes zero income and no aid.
This has been happening to people for years and years, it is an ugly practice that leaves people who are ill, disabled in a very bad place. Unable to pay any of their bills.
Read this article to see how blatant the practice is-
www.bloomberg.com/news/2011-03-01/accidental-death-becomes-suicide-when-insurers-dodge-paying-life-benefits.htmlIt does not matter that I have previously worked 30 years, been productive while having Crohn's for 39 years, the bottom line is what is always is, money.
Edit: I should add, I never met with a physician of and or by the insurance company. The person who decided I could do sedentary work had been a nurse. A nurse deemed that I could lift 20 pounds, can do sedentary work and that has a lot to do with Crohn's, right? Previously I received my benefits with some issues, the insurance company saying they didn't receive faxes, little things like that, so there were issues. Ultimately, the biggest issue came when I had no longer been employed, that led to an immediate termination of my claim.
Post Edited (Datawraith) : 8/21/2012 12:57:57 PM (GMT-6)