Short term disability denied

brown

New member
Joined
May 5, 2019
Messages
4
Reason
CALS
Diagnosis
03/2019
Country
US
State
GA
Spouse diagnosed with motor neuron disease and referred to ALS clinic which next available appointment is still 4 months away. Today we were notified by his short term disability that he has been denied. He hasn’t been paid in 2 months. Anyone have any suggestions on how to get the appeal approved? Already applied for Social Security Disability upon doctors advice.
 

Nikki J

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Joined
Mar 22, 2012
Messages
7,636
Reason
PALS
Diagnosis
04/2014
Country
US
State
MA
This is a private policy? Bought through work? Find out the grounds for refusal it may be a matter of documentation in which case you need to get the neurologist to write something more. Until you know why all I can say is find out the process
 

brown

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Joined
May 5, 2019
Messages
4
Reason
CALS
Diagnosis
03/2019
Country
US
State
GA
Yes bought through work. They paid the first 4 months and haven’t the last 2 months. Today they called and said claim is now being denied. Doctor sent all additional info Hartford requested and even said he’d welcome one of the insurance companies doctors for a second opinion. We were just told Hartford does this kind of thing a lot and most people don’t win the appeal without an attorney. Just wondered if anyone else has experienced this?
 

KevinM

Active member
Joined
Mar 30, 2019
Messages
64
Reason
PALS
Diagnosis
06/2019
Country
US
State
FL
Hello. I was recently diagnosed with ALS, and my neurologist provide a letter stating unequivocally that I have ALS and am permanently disabled. I too have Hartford through my work group life insurance plan, and shared the letter with them last week. They didn’t indicate any issue and will complete short term disability filing this week.

Hartford will pay 60% of my regular paycheck, with the other 40% paid by me from accrued sick/vacation time. I have about 3-4 months accrued, but once I use that up then the Hartford payments stop, unless I wanted to continue paying the 40% out of my pocket. During this time, I will also apply for SSDI since I am no longer able to work.

I don’t know if the 40% payment from you ended, or just what triggered their refusal. Check into that part of it, though. Good luck Kevin
 

KimT

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Extremely helpful member
Joined
Nov 18, 2014
Messages
3,397
Reason
PALS
Diagnosis
08/2015
Country
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State
South
My short-term disability was my accrued sick leave from the college. I did have to fight for my long-term disability through UNUM. The premiums had been paid in full by the college and, even after I was approved for SSDI (which took only two weeks with an excellent letter from my doctor), UNUM kept saying they needed more information and needed a second opinion. So I got another doctor to write the second opinion. Next, they asked for my medical records and I refused based on the wording of the policy and my total compliance. They started paying immediately.

If there are any "I"s undotted or "T"s not crossed, they will deny. I had to get very aggressive with them to the point where I was calling every day.
 

KarenNWendyn

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Messages
2,452
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PALS
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07/2017
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State
OR
Mod note: thread moved to general forum because it looks like there is a confirmed diagnosis of MND
 

Jrzygrl

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Joined
Feb 14, 2017
Messages
552
Reason
Lost a loved one
Diagnosis
08/2014
Country
US
State
NJ
My PALS got short term, and now long term disability with Hartford. Call and get a case manager at Hartford. Also call his work's benefits dept or HR and get them to help. Lots of paperwork was required. And they still request occasional re-confirmation of info. Yes, for a terminal disease.
 

ChristineRK

Active member
Joined
Jun 6, 2019
Messages
48
Reason
PALS
Diagnosis
08/2015
Country
US
State
OH
I know this isn't very helpful as it was stated previously - find out if there are any forms that were overlooked that needed to be filled out. My STD and then my LTD were approved, BUT my neuro needed to fill out a bunch of of forms stating that I have ALD/MND and I will 'continue to decline'. Maybe have them word it specifically as though this isn't a transient disease - you aren't going to get better! Usually Neuros offices are used to filling out these forms and know how to word these things (they are not lying or deceiving AT ALL - because they know they would be in serious trouble). I'm shocked that it didn't get approved. Can you ask for another copy of the forms and make an appointment to SIT in your doctors office and let him know what has happened. It will probably infuriate your doctor as he knows the struggles you are going through - and then this?? I am surprised. Call Hartford and as what they are looking for SPECIFICALLY. Maybe your doctor misworded something?
Try this before hiring an attorney. I have Guardian and I don't really know anything about Hartford.
I am so sorry about this - like you need it at a time like this.
 

CTMary

New member
Joined
May 17, 2019
Messages
6
Reason
PALS
Diagnosis
09/2016
Country
US
State
CT
So sorry for the short term problem. My employer short and long term disability payments {not Hartford} took work too but I got there. My word of cation is this. SSDI and short-long term both told me they communicate and that my long term pay was ok. but after 2 years long term said I had been over paid! Fortunately I did not get a bill but a much reduced long term payment to pay back overage. So when getting both you must make sure long term gets any and all SSDI pay and changes like cost of living increase etc. Good luck all.
 

ChristineRK

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Joined
Jun 6, 2019
Messages
48
Reason
PALS
Diagnosis
08/2015
Country
US
State
OH
( as if there weren’t enough struggles…… )
 

brown

New member
Joined
May 5, 2019
Messages
4
Reason
CALS
Diagnosis
03/2019
Country
US
State
GA
Thanks so much for your replies! After I posted this we received a call from Social Security saying approved for disability! Very thankful! Just don’t see how insurance we paid for through work can deny you! Unacceptable
 

Jrzygrl

Senior member
Joined
Feb 14, 2017
Messages
552
Reason
Lost a loved one
Diagnosis
08/2014
Country
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State
NJ
It is unacceptable. Don't let Hartford off the hook. DH receives both LTD and SSDI. His pay from Hartford (the higher of the 2) is reduced by the SSDI that he receives.
 

plcare

Member
Joined
Mar 5, 2019
Messages
19
Reason
PALS
Diagnosis
03/2019
Country
US
State
FL
I experienced a similar fight with my insurance company regarding my short term disability payment. At first they inundated me and my doctors with paperwork and forms to be completed, then they paid very slowly, and finally they tried to deny my claim. After complying with all of their requirements, and contacting numerous individuals and the insurance company without any success I finally contacted the insurance commissioner in my State and the State where the policy was written. Remarkably, my claim was approved a few weeks later.
 

plcare

Member
Joined
Mar 5, 2019
Messages
19
Reason
PALS
Diagnosis
03/2019
Country
US
State
FL
By the way, I have since been approved for social security benefits and still receive part of my long term disability payment from the insurance company. Do not let the insurance off the hook.
 

brown

New member
Joined
May 5, 2019
Messages
4
Reason
CALS
Diagnosis
03/2019
Country
US
State
GA
Thanks! I will call them tomorrow!
 
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