Disability?

[ilgal]

Social Security Disability is automatic with ALS diagnosis. Individual and employer-sponsored disability insurance are not. If ALS affected only someone's legs but his job involved only sitting he might not be considered disabled under the insurance. Mine not only required that I not be able to perform my job duties, but that I also 1) have a terminal diagnosis with a life expectancy of 12 mo. or less or 2) be hospitalized for 72 hrs.

 

[tmasters]

My employer-sponsored LTD disability policy, from UNUM, is vague. It states:

Definition of Disability
You would be considered disabled and may be eligible for benefits of because of sickness or injury:
- you are limited from performing the material and substantial duties of your regular occupation: and
- have a 20% or more loss of earnings due to the same sickness or injury:

-Tom

 

[brooksea]

Tom,

Nothing like making things difficult! Sounds as if you would have to be penalized for being disabled before you could collect disability! Can you collect Short Term Disability first? That would account for loss in earnings.

I also wanted to mention on this thread that you can work with SS Disability (very limited monthly earnings), but most private disability insurance will not allow you to be employed at all.

 

[brendapals]

Here's the latest from my journey into disability-SSD,

I talked to an ALS rep from KY who said that yes, ALS was one of the diagnosed that SSD would "kick in" right away. I explained to her that I had been denied. She said she would find out more.

So today I get an email from her that says I have to be "completely unemployed" for "a period of time" before I am eligible. Now, I realize I'm not the smartest cookie the jar, but damn,

I have ALS, I'm not a millionaire, I have a family, I have the usual too many bills, and I am not supposed to work in order to qualify myself for SSD?

Thanks for letting me vent,
I don't get to do that very often!
-b

 

[tmasters]

CJ,

Yup, our company also has a Short Term Disability policy which covers the first 6 months, whereas LTD covers me from 6 months onward. Two separate policies with different insurance companies, but supposedly continuous coverage.

Would be bad news to be out of work for 6 months and then be denied LTD coverage for the 7th month onward. I tend to overthink these things I suppose.

Thanks again for your help,
-Tom

 

[brooksea]

Brenda,

This is a federal program that is supposed to be the same across the board!

My husband applied for SSD some 10 days or so after his last day at work. The rep told him he would be approved within 30 days and it would be effective from his last day on the job!

Everything happened like clockwork with SSD. I really think you need to elevate this, or you could be running into a nightmare! You don't need the stress!

I can't remember if you've said that you actually went to your local office. If you haven't, perhaps you should. It's a pain in the butt, but you may get what you're due!

 

[kelly]

After completing the whole process...short term disability....to long term disability....to disability insurance...amazing all the paperwork. We were fortunate that my husband's company handled all this. The only bump in the road was when we applies for SS they backdated his social security to the date of diagnosis..so we had to back pay the disability insurance. Of course we did not plan on this..it was an ouch for sure. Now he is receiving a reduced rate of company disability insurance and SS. I was surprised that the company's disability insurance could take all family members social security. Man..what a learning process. Now we are dealing with health insurance....all scarey stuff. However, we are soooo fortunate for the disability insurance. Hope everyone is staying warm tonight. Fondly, KR

 

[grantst44]

What about getting VA benefits? My husband is going in next week (we both are) to get a letter of diagnosed (ALS). It's getting to the point where he may have to go out on disability. His employer does have a long term disability benefit, including paying his life insurance and 60% of salary. Does he have to retire in order to get this, why not just go on the short term disability and then to the long term with his company? I know these are a lot of questions but I don't want to get stuck with no income for 6 months. (He is a veteran and we spoke with VA med center and they said he could get treated based on presumption and that he should also file a claim with Vet Admin. His sister may have had ALS so I'm worried that he may not qualify because it may be familial. Anyone got any answers? THANKS!

 

[georgia]

As far as VA on the two boards I am on only 2-3 people that filed said they had gotten benefits very soon (meaning since the Sept change). The two other times we have filed claims it took a year to get an answer. They did back pay but that doesn't help till then. They MAY pick up the medical treatment sooner but I wouldn't count on anything soon and be blessed if it does. Get the ball rolling and explore other means. You also might check if they do pay do you have to back pay LTD for the difference so at least you would not spend it all when you got it lump sum.

 

[JAKE]

I was diagnosed in Nov. 2005 with "probable" ALS and given a paper for SS disability from the Dr. If I retired from the state and only paid in retirement for 30 yrs, would I still be eligible for any type disability? I never paid in SS during my working career. Just curious if anyone has any insight into this.

 

[georgia]

If you didn't pay into SS (unless you make under $620 I think family income to quality for SSI) you would not get SSD.

 

[brendapals]

hey jimercat and everyone,
Well, it's late and I'm too tired to go dig the denial letter back out, but it did come today:sad:

It had a sentence in there that made no sense at all-something about they looked at my work history, but not my health? And yes, jimercat, I went to the local SS office on 12/16/08, and then applied online that night, and did the phone application on 12/17/08.

You are so right about the stress=do not need it!

Anyway, it's back to the drawing board tomorrow. They KY ALS rep said she would forward my info to her clinic social worker. In the meantime, I'll call again my friend the lawyer and see if she's up to helping out.
Keep your fingers, and toes crossed!
-b

 

[georgia]

This is from the SSA.gov site.


How do I meet the earnings requirement for disability benefits?

In general, to get disability benefits, you must meet two different earnings tests:

1. A “recent work” test based on your age at the time you became disabled; and
2. A “duration of work” test to show that you worked long enough under Social Security.

Certain blind workers have to meet only the “duration of work” test.

The table below, shows the rules for how much work you need for the “recent work” test based on your age when your disability began. The rules in this table are based on the calendar quarter in which you turned or will turn a certain age.

The calendar quarters are:

First Quarter: January 1 through March 31
Second Quarter: April 1 through June 30
Third Quarter: July 1 through September 30
Fourth Quarter: October 1 through December 31

Rules for work needed for the “recent work test”
If you become disabled... Then you generally need:
In or before the quarter you turn age 24 1.5 years of work during the three-year period ending with the quarter your disability began.
In the quarter after you turn age 24 but before the quarter you turn age 31 Work during half the time for the period beginning with the quarter after you turned 21 and ending with the quarter you became disabled.
Example: If you become disabled in the quarter you turned age 27, then you would need three years of work out of the six-year period ending with the quarter you became disabled.
In the quarter you turn age 31 or later Work during five years out of the 10-year period ending with the quarter your disability began.

The following table shows examples of how much work you need to meet the “duration of work test” if you become disabled at various selected ages. For the “duration of work” test, your work does not have to fall within a certain period of time.

NOTE: This table does not cover all situations.
Examples of work needed for the “duration of work" test
If you become disabled... Then you generally need:
Before age 28 1.5 years of work
Age 30 2 years
Age 34 3 years
Age 38 4 years
Age 42 5 years
Age 44 5.5 years
Age 46 6 years
Age 48 6.5 years
Age 50 7 years
Age 52 7.5 years
Age 54 8 years
Age 56 8.5 years
Age 58 9 years
Age 60 9.5 years
[Back to top]

 

[rose]

some of what I've learned recently....

In regards to social security disability; If all the medical information showing your diagnosis was present then there’s no need for the Disability Determinations office to establish severity of disability. It is my understanding that with a diagnosis of ALS there is an approval of benefits. Your condition is a TERI claim, as well as ALS qualifying under the compassionate allowances program. Since the compassionate allowances program was just implemented nationally this past October/November there may be a delay for some sites in processing qualifying claims as such. It might help if you put the medical code for your diagnosis on your claim, and to spell out amyotrophic lateral sclerosis. The code is 335.20.

As far as any other types of disability claims, I just submitted my claim for LTD through my employer (and do not have its status yet) but read what my neuro wrote, and she just wrote "progressive bulbar dysfunction and limb weakness. For the spot where they are to esimate recovery, she wrote "no recovery anticipated" I did not see a copy of what was written for my SSD claim.

Bottom line is there's no need for the disability determinations office to establish the severity of your disability with a diagnosis of ALS.

BUT, about meeting earnings requirements to receive SSD, I do not think there is anything that a person can do about it if they've not paid in, or paid in enough, (or for a long enough time) to social security during the time that they were employed. The benefit which we may think of as a tax on our paycheck is kind of like making an insurance payment each pay, because if we haven't paid enough of its "premium" we don't qualify to receive it. Georgia, if your husband's work history meets the requirements you listed, you qualify as his spouse/dependent I think, to share his benefits.

They told me at the SS office, that my benefit I will receive from SSD will disqualify me from receiving the SSI due to the amount. There is a "sticky" at the top of one of these forum pages titled "need SSI help" (or something similar to this. It has helpful info in it.

 

[georgia]

This topic we know first hand. We were both self-employed and we filed under my # as one job rather than two. He had worked other wise and I had been home when he couldn't do his job he was helping me. We didn't realize that because of the time the credits were decreasing for him while they increased for me. He had worked part-time the yr before diagnosed so when I filed taxes for that yr we had enough. He was diagnosed in Feb we didn't have but when I filed in April it put enough. It was a scarcey few months Feb to Aug when we knew.