Private long-term disability interview

erock77

Member
I enrolled in my companies long term disability program about a year ago. After a certain period they send someone in person to evaluate my condition and whether I can work any job full time. I'm an engineer working part time now. I'm pretty nervous about this interview as I thought I'd be smooth sailing the rest of my life on this private LTD benefit.

The interview is in an hour, it's late notice. But has anyone gone through this? have tips?
 
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welshwitch

Guest
Oops, you already did your interview. How did it go?
 

erock77

Member
Thanks witch. I did get ahold of my social worker before the visit which helped me get a little perspective on what to expect. I was a little late in requesting advice, the thought of seeking advice didn't occur to me till the morning of the interview.
Thanks for the hotline info, I forgot we had one of those.
I think it went well. It's a tricky situation b/c obviously I "can" work full time, but the cumulative affect of going back to full time would make my health worse. Luckily the assessor seemed to really know his stuff w/ CF. That was my social worker's main concern, since I may look fine and they won't understand it's a progressive thing. He admitted late in interview he's been counting my coughs, severity, along with nailbeds, respiration, etc. Put me a little on edge, but glad I let the coughing fits fly in his presence, (and that I skipped my HTS & vest that morning for that purpose *shhh*). He had the impression the hardships of CF hit me late and I hadn't even fully seen it. I explained as a kid I was hospitalized 3-5x per year and had a lobectomy at 11 (1988), so I don't have a mild case.

I got the impression he understood the rational of me working part time, reducing stress, and that I'm using my time to be in better health. But who knows, freaks me out a little to think I could lose this benefit. I was ecstatic after I was accepted, not thinking they could kick me off. But I'm not really in a different situation than when they initially accepted me, so I should be good.
 

LouLou

New member
I'd still call the legal hotline. It's good to brush up on what your rights are so if they try some silly business to see how much they can get away with you can call them out. Good luck & keep us posted!
 

erock77

Member
Quick update. So now they want an "independent physical" done by some doctor nearby. No other details. Again, this scares me. Has anybody had to deal with one of these physicals? What did it include? What was the outcome? I asked them what it would entail and that I "assume" they're familiar with CF and it's progression. This sucks. Yeah I can work, but I'll feel worse and get sicker. I worked hard for years, it was tough to come to this point of backing off my career.
 
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welshwitch

Guest
Yikes, that's weird. Why can't your CF doctor do it? S/he is familiar with the progression of your disease. I can't see how a new doctor would be able to accurately explain/assess what's going on with your health.
 

Oboe

New member
Quick update. So now they want an "independent physical" done by some doctor nearby. No other details. Again, this scares me. Has anybody had to deal with one of these physicals? What did it include? What was the outcome? I asked them what it would entail and that I "assume" they're familiar with CF and it's progression. This sucks. Yeah I can work, but I'll feel worse and get sicker. I worked hard for years, it was tough to come to this point of backing off my career.

I had to do something like this for my SSI disability a number of years back. It was really basic, just a regular physical with a PFT. They asked about my therapy routines and medications and whatnot, if it were done today I wouldn't be surprised if they wanted a six minute walk. Might be a little different for a private insurance company, but more than likely won't be much more than that.
 

erock77

Member
Oboe, I'm assuming they let you keep the SSDI? I received a response from my case worker, which answered what to expect. I wish I knew what their criteria was. They've already gotten my medical history. They're a business and obviously would rather keep the money they're giving me. At least I can do some prep to dramatize my CF life a bit, I'm hoping I don't feel good that day. :)

"The purpose of an IME is to provide us with an objective and impartial view of your medical condition and how this may impact your ability to work. The examining physician does not provide treatment, but may offer recommendations on what they think is appropriate, etc. You will likely be asked to provide a history of your disabling condition, work history, activities of daily living, etc. The doctor will do a routine exam and will provide us with a report of his or her findings. They will also provide clear restrictions and limitations and advise, based on their exam, whether they feel you are working to your full capacity given your medical condition."
 
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David991

Guest
Please consider one very important fact. The IME is retained by the insurer and is frequently a hired gun/less than neutral. It might be a thought to have a witness present to confirm what was asked and done during the exam to preclude an inaccurate report. Perhaps the legal hotline can advise you further but caution is the word. None of these systems are a ideal as the quote defining an IME. Good luck.
 

Oboe

New member
Oboe, I'm assuming they let you keep the SSDI? I received a response from my case worker, which answered what to expect. I wish I knew what their criteria was. They've already gotten my medical history. They're a business and obviously would rather keep the money they're giving me. At least I can do some prep to dramatize my CF life a bit, I'm hoping I don't feel good that day. :)

That was actually to qualify in the first place, and yeah, I qualified. Then again at the time I was at around 50ish% FEV1, so numerically speaking I was disabled even if I was a lot more active than I am now. If you're actually having problems, it shouldn't be hard for a medical professional to see and shouldn't be a problem. Though, as David said, it probably couldn't hurt to have a friend or sibling or something as a witness.
 

cflawyer

New member
The number for the CF Legal Information Hotline is 1-800-622-0385. Or email
CFLegal@sufianpassamano.com
All contacts are free and confidential. Contacts and calls are answered by the Director, Beth Sufian who has been an attorney for 24 years, is 48 and has CF.
 

robbiekay

New member
My son had to do a test like that for ssd just remember you are sooooo sick make sure to rember you can not run you get winded easily, cough allot don't sleep, and bring all your meds In a bag :) good luck
 

erock77

Member
Thanks David, I googled a bit and now I'm more nervous. I was only mildly so before. I saw my CF doc a few days ago too and mentioned it to him. He suggested preparing a list of all my symptoms over time and treatments that were done. He also prescribed a couple antibiotics since I've been a little exacerbated lately, but now I'm nervous to take them so I don't feel Too awesome whenever this IME takes place. I found some helpful tips online. I'm thinking of bringing my handheld recorder to document the visit, in case I have to argue anything later.
http://www.nolo.com/legal-encyclopedia/tips-the-independent-medical-examination-ime-injury-case.html
http://www.badfaithinsurance.org/reference/HL/0090a.pdf
 

2005CFmom

Super Moderator
I don't have any personal experience with this but remember something from a different thread regarding this. Make a daily log of everything you have to do to maintain your health. Include treatment times, how long it takes for cleaning and sterilizing equipment, how often you have dr visits, time dealing with insurance and prescription issues, time needed to get ready in the AM (if it takes longer than "normal" due to having to rest between steps) etc.
I think the idea is that if you are on the cusp health wise, this helps to show that although you do have energy to do stuff that gets eaten up by just the day to day care you need to take for your self.
 
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