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Advice for depression and Short Term Disability

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Posted 11/14/2011 11:20 PM (GMT 0)
I need some advice regarding my Short Term Disability and FMLA leave. I was admitted to an inpatient facility the end of the summer for attempted suicide. At that point, I was obviously VERY depressed and my FMLA and Disability were both approved with no problem. My therapist and my psychiatrist both agree I am not able to go back to work yet, especially since my job was a major factor to my depression in the first place. However, my case manager has stated that my records don't show that I am incaapacitated from working and my disability claim most likely won't be extended, meaning I either go back to work before I'm ready, or I go jobless. I don't understand how an insurance company can say I can work but my doc and therapist say I can't. My gaf is 42 and after doing some research I've seen that you can be approved for social security disability with a gaf of 50-60, and social security is usually very hard to get!

My question is, should I contact an attorney, or should I wait until my claim is officially denied? I'm afraid getting an attorney involved now would only delay the process, and I live paycheck to paycheck so I can't afford to have anything held up. I'm afraid of not having a job and being able to support my family, but I'm more afraid of having to go back to work and relapsing into that very bad state of mind.
Posted 11/14/2011 11:54 PM (GMT 0)
I think it would be a good idea to get an attorney. Get the kind that only charges if you win the case. I had a low gaf too, but still didn't get it. But eventually I was able to go back to work for awhile. I am thinking about reapplying. It is a long process anyway. But I think you would be further ahead if you talk to an attorney.

Best wishes to you, and welcome to the depression forum. I think you will find that there is a really great group of members here. Very supportive.

Keep posting,

Hugs, Karen
Posted 11/15/2011 12:24 AM (GMT 0)
Karen has adviced you well - get the attorney involved now.  Perhaps a letter from your family Doctor would also help. 

Don't do like I did and forgot all about my short term and long term disability so I took early retirement and used my pension fund................I am still beating myself up for that snafu.

I wish you the best of luck and let us hear how things are going for you.

Kindly,

Kitt

 

Posted 11/15/2011 1:03 AM (GMT 0)
Thank you for the advice. I really am leaning towards an attorney, but I actually work in the insurance industry so I am afraid if I hire a lawyer they might think I'm using my knowledge of how everything goes to "work the system". Which I am not, I have a real problem, and am amazed that with a suicide attempt, severe depressive disorder and anxiety wouldn't be approved. Not to mention that my medication is still being adjusted, my lexapro dosage was upped last visit and wellbutrin was just added also. I find it unbelievable that because I am no longer suicidal that that quilifies me to go back to work in their eyes. Its just unreal, and is only stressing me out further!

Thank you for the support, I'm glad I found this forum.
Posted 11/15/2011 2:57 AM (GMT 0)
We aren't allowed to discuss suicide on the forum so I cant help you with that issue. I just hope that it all works out for you. I honestly would get an attorney. At least talking to one would give you an idea of what your chances are. There is no sense in letting yourself get stressed out. That just makes depression and anxiety worse. It could be a long process, so try to be patient. Try to live in the moment and take life one day at a time.

I don't think having an attorney would make it look like you were "working the system". It would take a lot of stress off of you, I would think. But it is your call. Do what feels the most comfortable for you. Trust your instincts.

Hugs, Karen
Posted 11/15/2011 3:06 AM (GMT 0)
My job won't allow short-term disability or FMLA for any psychological problems, so I am a bit shocked to hear you got both, to be honest. If your insurance is more flexible with that (which is obviously is), then I would certainly fight for it if you're not ready to go back. I think it'd be easier fighting for it before the official rejection comes through. I wish you the best of luck with it.
Posted 11/15/2011 6:04 AM (GMT 0)
Anyone dealing with insurance issues or FMLA should not rely on what their employer says. You should investigate the matter yourself. FLMA regs are easily found online and what your insurance will and will not cover should be available in the handbook your employer provides, through the insurance company's web site, or by calling the insurance company directly.

While some companies, in particular when it comes to FLMA, are more generous than what is required there are others who will try to con their employees to prevent them from using the benefit as allowed under the law.
Posted 11/15/2011 6:14 AM (GMT 0)
JellyG have you asked your case manager exactly what they need from your doctor(s) in order to show that you are not able to return to work yet?

I have been down this road with insurance before on a couple of occasions and after doing some digging and asking some very direct questions learned that my doctor was providing some very general information to the insurance company which left questions as to what my condition at that time really was and all it took was my doctor to get more specific and actually write a letter or fill out some form or another stating directly that I was not able to work and would be re-evaluated at such and such date, etc.

You say you work in the insurance industry so I assume you know all too well how they are. If every "i" is not dotted and every "t" crossed in the way they want it they will deny or shorten a claim. Of course, sadly, there are times when everything the insurance company wants done is done and it still is not good enough and the lawyers have to be brought in.

If I were you I think I would do 2 things. First talk to the case manager and find out EXACTLY what the problem is and EXACTLY what needs to be done, and then I would also go and do an initial consultation with an attorney. Most will not charge you for that first visit and that way an attorney will have an idea what is going on in case you are unable to resolve this quickly on your own.
Posted 11/15/2011 7:11 AM (GMT 0)
all the best. we have a different system.........sorry i can't be of much help. jamie
Posted 11/16/2011 1:17 AM (GMT 0)
Thank you all, I did leave a message for a lawyer today. I will let you know what they say.

Alaskah- I've worked in the insurance industry for 13 years, and I've never come across a short term disability plan offered through an employer that doesn't cover disability. Of course, your doctor has to show proof that you can't perform the regular duties of your job, but that should be up to the insurance company to decide and not your employer. It never hurts to file a claim, the worst that can happen is its denied and you're no worse off then you were. As far as FMLA, its a federal law and absolutely not open to employer interpretation. If they denied your FMLA leave for a meantal health issue they could be in serious hot water. Keep in mind, FMLA is an approved leave of absence that secures your job for up to 12 weeks, but doesn't provide any payment, that's where the short term benefits come in, and you can be approved for FMLA but denied disability benefits since the burden of proof of disability is much moe cumbersome with disability. I hope your employer hasn't mislead you regarding your rights!
Posted 11/16/2011 1:54 PM (GMT 0)
Just got a call from my case manager that my benefits were extended another month! Guess I was freaking out for no reason!
Posted 11/16/2011 3:26 PM (GMT 0)
That is so good to hear jellyg! I had severe PPD with my first baby, and I didn't get diagonosed until my 6 week post partum check up, so I was able to extend my short term disability for another 12 weeks after that. At the 18 week mark, my doc (OB) agreed that the meds I was on were working and I could function at work.

My boss was NOT happy about me not coming back for so long, however, this is why we have short term disability and an HR department to handle these issues.

Good Luck!
Posted 11/16/2011 4:21 PM (GMT 0)
Jelly - it might be different for FMLA, but I wouldn't get paid for anything for that, it would just hold my position with the company. Short-term disability will not be paid by the employer if it is psychologically related unless you are confined to a hospital. They also do not pay STD for self-inflicted injury, which I'm interpreting as a suicide attempt or perhaps cutting due to depression, so they have some tricky wording for the STD. But my company's policies and benefits are terrible, so this doesn't surprise me.
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