by jspaar » Sun Feb 15, 2015 09:05 pm
I was on short term disability last year after having surgery for cancer. I returned to work in Louisiana before going on long term disability but a claim was opened in case I needed to do it. Now I am being laid of. Can I still try for disability? I am unable to speak clearly & have extreme fatigue. Finding another job will be almost impossible. My doctor suggested filing for disability.
Posted: Tue Feb 17, 2015 07:22 am Post Subject:
Can I still try for disability?
There is nothing stopping you from applying. Collecting is a different matter entirely.Posted: Tue Feb 17, 2015 02:32 pm Post Subject:
I understand that. I was just wondering if being laid off made it impossible to file. I have a severance offer with 45 days to accept. It is much less than long term & doesn't include the medical coverage I need to continue my care. Should I risk the severance to try for long term? I am 60 so too young for regular social security & medicare. My cancer doctor says I am disabled.
Posted: Wed Feb 18, 2015 12:18 pm Post Subject:
Your "severance offer" is completely separate from any disability claim, so there is no reason not to accept that offer if it is acceptable to you. You would simply continue to pursue your disability claim. Your disability claim isn't going to provide health insurance either, so that's not a concern.
If you have coverage under a Long-Term Disability policy, then you might be able to collect a benefit -- depending on the language of your Long-Term disability policy, any continuing income could be an offset against the disability benefit payable (you would not get the full amount of the LTD benefit + the continuing income . . . the LTD benefit could be reduced by the other income, so that the total you receive is the same as what the LTD benefit would be by itself).
You might also expect to have your LTD claim denied, and then you would probably want an attorney or other claims advocate to assist you with the appeals process and any litigation that might result if the claims denial is an example of bad faith on the part of the insurance company. Regardless, failure to precisely follow the appeals process if a claim is denied will prevent you from winning a lawsuit for insurance bad faith. Missing a deadline by even one day is fatally disastrous, so you don't want to do this on your own unless you completely understand the process.
When it comes to continuing your health insurance, you have two options: (1) continue your employer's health plan under the provisions of COBRA (you will have to pay 100% of the premium) or (2) use this "life change event" of being laid off to enroll in health insurance through the federal health benefits exchange https://www.healthcare.gov/ (since "open enrollment" ended on Feb 15).
Do not fall victim to the fake exchanges such as lahealthexchange.com or healthinsurance.org -- Louisiana does not have a state-based exchange.
Your income could qualify you for significant premium tax credits to pay for some or most of the insurance premium. You would probably be able to find a health plan in which your current physician is a participating provider, so in all likelihood you wouldn't have to change your cancer treatment regimen. You cannot be refused health insurance because you are being treated for cancer.
If your income falls below the 133% Federal Poverty Line amount for your household size (example: $15,654 for a household of 1 -- $32,252 for a household of 4 in 2015), you would be eligible for Medicaid (you would not be eligible for premium tax credits to pay for private health insurance but could still purchase private health insurance and would have to pay the full cost.) This could involve a change of physicians depending on whether or not your physician participates in Bayou Health (the Louisiana Medicaid Managed Care Plan), and might not be acceptable to you. If that's true, then you would probably have to use the COBRA option and figure out how to pay the premiums. As a disabled person at the time of being laid off, you can continue under COBRA for up to 29 months.
If you are currently disabled, I would strongly advise you to file for Social Security Disability IMMEDIATELY!! You should have done that already. There is a 5-month waiting period before benefits could begin, if you are approved right away. If denied, you would then appeal that decision and would probably eventually be awarded your disability claim -- it would be retroactive to the date you applied for SSDI. After 24 months of SSDI, you would get a pass into the Medicare system, even before turning age 65. Your cost of insurance would be the Part B monthly premium ($104.90 in 2015).
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