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I'm so sorry for your situation but, if you want advice (instead of just ranting), you should probably have this moved to the HEALTH INSURANCE forum:
Apparently, it's not the OP who has the problem, it's a relative.
And speaking of ranting....
Quote:
Originally Posted by NHartphotog
SSDI is given freely and permanently if you are a cheater or scam artist, but if you REALLY deserve it--and have MORE than paid for it with over 40 years of SS taxes, then TOO BAD!!!! The "Safety Net" only applies to those who are irresponsible--if you are hard-working, our uber-corrupt Big Gov't will find a reason to make sure you get as little as possible.
A close relative of mine is 60 years old, and has paid over $400,000 into the Social Security tax system (not including Medicare), while working 50-70 hours a week and NEVER having even a week of unemployment. Thanks to the post-college recession that gave him no option other than 3 years as a nuclear submarine officer (exposed to ionizing radiation 8 months per year, 7 days a week), he is now paying the price, and was recently diagnosed with an incurable blood cancer called Multiple Myeloma. It destroys (creates holes in) your bones, among other things (your bones break simply because the muscles attach to them). Half the people who get it die in 5 years; almost none make it to 10 years.
MM is incurable, and the bone damage is permanent. They can do a stem cell transplant and daily + monthly infusion chemo to stop further damage, but the medical community calls it "remission" even though it is not the same remission as most other cancers, that returns you to relatively normal function. Try explaining all this to SS staff, who couldn't pass a kindergarden entrance exam. They are very good at picking out the responsible people, though, so as to deny them benefits. Too bad my relative didn't claim to be a drug addict or alcoholic.
So he got 7 months of SSDI checks (a whopping $2,700 per month)--before being automatically thrown off SSDI because he was in "remission" (MM remission, not the kind they think). He'll appeal, but the success of appeals is under 10%, unless you hire a lawyer and cut your minimal benefits by 1/3).
SS staff is too stupid to understand anything, let alone that with Multiple Myeloma, the disability is still the same as before; it just hasn't gotten worse than it was when he was initially declared "disabled." MM always comes back (becomes resistant to the chemo drugs), and the side effects of the chemo become worse each month. There's no way he could do any type of work; the pain, disability, and "chemo brain" effects are more than obvious.
Why ANYONE would support a government that manages to waste so much money on a "safety net" that virtually NEVER helps the people who deserve it, is beyond me.
Apparently, it's not the OP who has the problem, it's a relative.
And speaking of ranting....
Why am I not surprised?
Since OPs relative would have been entitled to a Trial Work Period, we would have to assume that his benefits were terminated because he cheated. Oh, my!
Well I don't know about those who were approved for SSDI and then somehow thrown off, but I got my mom's SSDI denial (initial application) overturned on appeal, and I didn't need a lawyer to do it. I simply wrote er appeal within the prescribed period, included doctor statements and a capsule description of her medical history (extensive) and it was granted upon reconsideration.
With the two posts re: the same situation, I'm not sure this is any help, but if OP's relative feels his denial is unfair, he needs to appeal and, if they don't feel they are able to do it on their own, get a one of the many lawyers who do this sort of thing to help. There are processes in place to appeal SSDI decisions. As for Cygna, check the policy. Most employer policies have a limited term. As others have said, the employer probably did not have a permanent disability policy. If the illness is work related, as the other post about submarine work suggests, maybe a lawsuit is in order if the employer knew the work conditions were unsafe and subjected employees to that danger without adequate protection. If the employer was the US military, perhaps he should check with the VA for help.
Apparently, it's not the OP who has the problem, it's a relative.
And speaking of ranting....
That's great, claims over $400k in FICA payments for a 60 year old. If they worked from 1976 to now, they would have paid less than $180k as an employee, twice that as self employed.
I just want to encourage the OP to continue to fight to help his sick relative get all benefits s/he deserves.
File all appeals (with help if need be), read all fine print.
Educate yourself about the different appeal processes. The process for SSDI may different from the process for private policies (IF one has grounds to appeal).
People who are fighting for their life need an advocate (sometimes MORE than one). It takes a team effort sometimes.
I hope others have more tips and encouraging news about the appeals process to the OP can help his relative.
It really isn't about government regulations when you're discussing a private policy. It's up to the employer as to whether or not they want to offer LTD to their employees. It would be great if they all did but unfortunately most don't. When an LTD plan is offered, the maximum is usually 24 months. It's not intended as a permanent disability plan so there is really nothing that can be appealed as long as the 24 months have been paid according to the terms of the policy.
We have the contract: the CIGNA insurance we PAID for is short term disability for about 6 months, then long term disability after that -- until retirement age.
An attorney is now handling the case--3 years of Cigna foot-dragging so far--and he reports that although all insurance companies are horrendous, CIGNA is BY FAR the absolute worst. On the very last day when they are required by law to make a decision, they ASK FOR MORE INFORMATION -- all in an effort to get the disabled person to DIE in the interim (since many disabilities happen when you're dying of something).
As to the liberals here who scoff at what they think is my request for "regulation" of such abuses, given my conservative views, here's your answer: we ALREADY HAVE INFINITE LAWS ON THE BOOKS, supposedly to "protect the public" and ensure that the citizens are not ripped off. CIGNA simply ignores them, and/or uses the loopholes that our elected officials so kindly provided them with (in return for "campaign contributions" and under the table cash). No matter how bad the abuse, your wonderful Big Government does nothing but token gestures that enrich the already-wealthy. In 40 years, I have yet to see Big Government do anything other than harass and rob the common citizen.
BTW, this incurable, bone-destroying cancer that CAUSED the disability is a direct result of exposure to ionizing radiation while serving on a nuclear submarine -- and there's supposed to be a Government support program for that, except it conveniently excludes anyone who served in a job that the U.S. military still has. So killing a group of the brightest & most honorable men in the nation in their mid-50s, after taking 3 entire years of their lives serving underwater with zero contact with the outside world, isn't enough. Washington not only won't provide a penny to support the people they've doomed to die as they become too weak to work--it won't even enforce the laws on the books for the insurance we BOUGHT and paid for every 2 weeks for decades! There are no limits to the evil incarnate of Big Government and the Military Industrial Complex.
IF BIG GOVERNMENT WANTED CIGNA TO STOP RIPPING OFF DISABLED PEOPLE WHO HAVE PAID A LIFETIME OF CLAIMS, all they would have to do is (1) allow pain & suffering to be added to the judgements of those who survive long enough to get through Cigna's ridiculous delays, or (2) impose a BILLION DOLLAR fine just one of the countless times Cigna has been found guilty of fraud, since countless states have already taken Cigna to court for ALWAYS denying legitimate claims. Do either one of those things, and suddenly it would be more economical for CIGNA to do what they are grossly overpaid to do.
The point is, BIG GOVERNMENT is in league with BIG BUSINESS. to rob the American citizen of everything he or she earns, or has.
Permanent long term disability is a myth, regardless of who you worked for or who the insurance carrier is. The chances of winning those benefits on appeal are nil. Sorry to be blunt but insurance companies are not in business to provide permanent disability.
I realize this post is six months old, but I don't know what you're talking about. It's typical for employers to offer short-term disability for six months, then long-term afterward, through Cigna, MetLife, etc. The employee still has to apply for SSDI, and the insurance company deducts what SSDI is paying from their monthly payment. And then it's typical for insurance companies to have their paid "outside physicians" review the case in a year or two to find some bogus reason to terminate the LTD (their portion, not SSDI).
The employee then has to get a lawyer to appeal the termination and the chances of winning are certainly not nil. It sounds to me like this is what happened to the OP or whoever is involved in this case. And winning the case doesn't mean the insurance company won't try it again in a year or two.
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