Short Term Disability Problems

[mainemomof2]

I posted this in 2nd tri too...but I thought this might be a better place.

I have a STD plan though UnumProvident. I have been out of work since Sept 1st, and have been hospitalized twice since then for HG. Well they STILL have not approved (or denied) my claim. They keep calling with questions such as, when will you go back to work, what exactly about working can't you do? I work at a direct supervision jail where there is a 1:52 ratio of staff to inmates with 12.5 hour shifts. Seriously.

So today I called the supervisor of my plan. He said with a diagnosis of HG he doesn't have any idea why I would be out of work still. I was only in the hospital for 3 days one time and 4 days the next. HG isn't something that keeps you out of work for a long time, and I don't have any active plan to go back.

Is he serious? Just because I am not impatient doesn't mean that I am hydrated, it doesn't mean I am not everyday, all day. It doesn't mean I am not medicated to survive. It doesn't mean I am able to be back to 'normal' I lay in bed all day.

Blah. So they again requested my entire medical record to meet with the Unum clinician..

Do I need to keep going to the hospital everytime I feel sick to get paid for an insurance policy that I purchased?

Grrrrr.

[jen1473]

I replied in the other forum - but just wanted to add that I was approved for short term and then long term disability for HG. The LTD was in effect until 6 weeks after I delivered.

[aaronsmommy]

Your state should have a formal appeal process if you get rejected. In the meantime, you may be able to complain to your state's insurance comission regarding the delay.

Some insurers/reviewers are really difficult with this and some aren't. It also depends on how your disability policy reads. Some pay when you can't do your job, some when you can't do any job, and some when you can't do a certain # of "activities of daily living" meaning you would need help with feeding, bathing, dressing, toileting before you could collect disability. Check your policy to see what it says so that you are ready to defend your claim.

If they are making you see another physician for review, you may want to consider looking your worst on that day.