› Forums › General Melanoma Community › Private disability claim being delayed
- This topic has 10 replies, 4 voices, and was last updated 8 years, 5 months ago by
Brittany1999.
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- February 14, 2017 at 4:46 pm
On January 17th I filed a disability claim with my employer (major health technology company) based on my diagnosis of stage 3b melanoma.
I wasn't planning to take disability until my surgery for lymph node removals in my neck (and surrounding tissue where positive-testing nodes were embedded).
I completed all the paperwork and my oncologist completed their portion of the paperwork. Then I asked what else needed to be done to get an approval. The insurance company said that no approvals are given in advance because schedules change (2nd opinions, surgery scheduled, etc). However they said that as soon as I was admitted to the hospital they would be approving my claim automatically.
On Feb 9th (Thursday) I had my surgery and was in the hospital til Feb 13th (I put in sick days for Feb 9th and 10th just to be safe). On Feb 13th I called the insurance company (they hadn't called or emailed me, and my work accounts still listed me as active rather than on leave). I was told that on Feb 10th they had called the hospital (it's a major health system in Southern California) and were disconnected while in the phone tree. No other actions had been taken on their part (they didn't call the hospital back and didn't pursue any other avenues for verification, and didn't contact me or my wife).
I'm furious and want to hire a lawyer just because I can't believe how little they have done in nearly a month! It seems like I have no recourse except to accept the very little they are doing to move this claim forward. As of yesterday I am absent without leave from my employer because I didn't put in for sick time, yet I am out of the office without an approved disability claim. My boss knows all about the situation and tells me not to worry about it, but I don't understand how they can accept such poor follow through from their disability insurance company.
i also opened a claim for social security disability yesterday because I just don't know what else to do.
-No progress on my employer's disability claim
-My employer's disability claim has been worded by them to be specific to the surgery and not to my diagnosis of Melanoma. (So I'm worried they are going to say I'm approved for only 2 weeks of leave to recover from surgery and no coverage for my subsequent physical therapy of shoulder and speech, and immune therapy).
-Social Security Disability has a compassionate allowance for metastatic melanoma, so hopefully it gets approved easily and I can feel comfortable that I am on some disability plan (even though it will pay less than 25% of my previous salary vs. the 55% which my employer's disability insurance policy would pay).
I'll just finish this note off by saying that I hope this is all in my head and that everyone working on my claim has the best intentions but just limited resources to move things forward.
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- February 14, 2017 at 10:51 pm
Sorry you're dealing with the stress of this on top of everything else. Just want to say that Stage 3 is not metastatic, so I am not sure how that will effect getting Social Security. Also wanted to say that you may not need to take disability, not sure how many other stage 3ers have done it, but from what I've gathered, most of us haven't needed to quit working. I work less hours and am able to take a day off for infusions and a day off for scans. They can't fire me for having cancer, so they just have to deal with me taking days off more than I normally would. Not sure how your employer would feel about it, but I find having some sense of a normal life by working really helps mentally with all of this. Hope you're recovering well from surgery.
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- February 14, 2017 at 10:51 pm
Sorry you're dealing with the stress of this on top of everything else. Just want to say that Stage 3 is not metastatic, so I am not sure how that will effect getting Social Security. Also wanted to say that you may not need to take disability, not sure how many other stage 3ers have done it, but from what I've gathered, most of us haven't needed to quit working. I work less hours and am able to take a day off for infusions and a day off for scans. They can't fire me for having cancer, so they just have to deal with me taking days off more than I normally would. Not sure how your employer would feel about it, but I find having some sense of a normal life by working really helps mentally with all of this. Hope you're recovering well from surgery.
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- February 14, 2017 at 10:51 pm
Sorry you're dealing with the stress of this on top of everything else. Just want to say that Stage 3 is not metastatic, so I am not sure how that will effect getting Social Security. Also wanted to say that you may not need to take disability, not sure how many other stage 3ers have done it, but from what I've gathered, most of us haven't needed to quit working. I work less hours and am able to take a day off for infusions and a day off for scans. They can't fire me for having cancer, so they just have to deal with me taking days off more than I normally would. Not sure how your employer would feel about it, but I find having some sense of a normal life by working really helps mentally with all of this. Hope you're recovering well from surgery.
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- February 14, 2017 at 11:20 pm
As a HR Director, I would lean towards you are not going to qualify for disability, short term, long term or social security. I have stage 4 non surgical metastic melanoma and I still work every day except when I go for treatment and scans. Advice would to be work with your employer to be able to continue to work for several reasons. First, it provides a sense of normality in your life so you don't let melanoma take control of your life and mind. Second, as you stated the disability is not near your normal pay. So if you quit work and drew a small check you would sit around worrying about the melanoma and the bills that pile up which neither would be good in your fight. Not trying to sound negative just my experience dealing with disability insurance policies.
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- February 14, 2017 at 11:20 pm
As a HR Director, I would lean towards you are not going to qualify for disability, short term, long term or social security. I have stage 4 non surgical metastic melanoma and I still work every day except when I go for treatment and scans. Advice would to be work with your employer to be able to continue to work for several reasons. First, it provides a sense of normality in your life so you don't let melanoma take control of your life and mind. Second, as you stated the disability is not near your normal pay. So if you quit work and drew a small check you would sit around worrying about the melanoma and the bills that pile up which neither would be good in your fight. Not trying to sound negative just my experience dealing with disability insurance policies.
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- February 14, 2017 at 11:20 pm
As a HR Director, I would lean towards you are not going to qualify for disability, short term, long term or social security. I have stage 4 non surgical metastic melanoma and I still work every day except when I go for treatment and scans. Advice would to be work with your employer to be able to continue to work for several reasons. First, it provides a sense of normality in your life so you don't let melanoma take control of your life and mind. Second, as you stated the disability is not near your normal pay. So if you quit work and drew a small check you would sit around worrying about the melanoma and the bills that pile up which neither would be good in your fight. Not trying to sound negative just my experience dealing with disability insurance policies.
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- February 15, 2017 at 3:26 pm
After having brain surgery for a stage IV diagnosis, I did go on California EDD state disability. Nobody is going to follow through on approvals unless you are "in their face" with it. If you are "out of sight" you are "out of mind"… even when it is their JOB to handle your case. Your insurance company SHOULD have a nurse case manager assigned to you, to assist with navigation and getting things processed for you. I found the state program to be reasonably "easy" to deal with, although they do make you jump through a lot of paperwork… which repeats at very regular intervals. I had more difficulty getting the state to STOP paying me when I did return to work! The left hand isn't always keeping tabs on the right. The state will not process a claim until after treatment is initiated, but will compensate for "back pay". They will make you use every last vacation and sick day, prior to beginning any assistance, and you will only be eligible for "up to" 50% of your average monthly employment income. Put in for use of your sick time and vacation time accrued with your employer, so you can protect yourself from being terminated due to "absence without leave". That will buy you the time needed to hound people with phone calls enough to get paperwork pushed through. http://www.edd.ca.gov/Disability/Am_I_Eligible_for_DI_Benefits.htm
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- February 15, 2017 at 3:26 pm
After having brain surgery for a stage IV diagnosis, I did go on California EDD state disability. Nobody is going to follow through on approvals unless you are "in their face" with it. If you are "out of sight" you are "out of mind"… even when it is their JOB to handle your case. Your insurance company SHOULD have a nurse case manager assigned to you, to assist with navigation and getting things processed for you. I found the state program to be reasonably "easy" to deal with, although they do make you jump through a lot of paperwork… which repeats at very regular intervals. I had more difficulty getting the state to STOP paying me when I did return to work! The left hand isn't always keeping tabs on the right. The state will not process a claim until after treatment is initiated, but will compensate for "back pay". They will make you use every last vacation and sick day, prior to beginning any assistance, and you will only be eligible for "up to" 50% of your average monthly employment income. Put in for use of your sick time and vacation time accrued with your employer, so you can protect yourself from being terminated due to "absence without leave". That will buy you the time needed to hound people with phone calls enough to get paperwork pushed through. http://www.edd.ca.gov/Disability/Am_I_Eligible_for_DI_Benefits.htm
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- August 9, 2017 at 3:58 am
It all worked out. Approved as temporarily disabled both at work (HR plan) and state. Completed it all now and off to seek my new dreams within healthcare tech.
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- February 15, 2017 at 3:26 pm
After having brain surgery for a stage IV diagnosis, I did go on California EDD state disability. Nobody is going to follow through on approvals unless you are "in their face" with it. If you are "out of sight" you are "out of mind"… even when it is their JOB to handle your case. Your insurance company SHOULD have a nurse case manager assigned to you, to assist with navigation and getting things processed for you. I found the state program to be reasonably "easy" to deal with, although they do make you jump through a lot of paperwork… which repeats at very regular intervals. I had more difficulty getting the state to STOP paying me when I did return to work! The left hand isn't always keeping tabs on the right. The state will not process a claim until after treatment is initiated, but will compensate for "back pay". They will make you use every last vacation and sick day, prior to beginning any assistance, and you will only be eligible for "up to" 50% of your average monthly employment income. Put in for use of your sick time and vacation time accrued with your employer, so you can protect yourself from being terminated due to "absence without leave". That will buy you the time needed to hound people with phone calls enough to get paperwork pushed through. http://www.edd.ca.gov/Disability/Am_I_Eligible_for_DI_Benefits.htm
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