We invited readers who have coped with long-term illness or disability in the workplace to advise a reader who was anxious about claiming disability benefits. Some of the best responses are below.
Don’t wait too long
“I would be worried that if I stayed on the job I would be a target for a layoff or [reduction in force] if I was not able to put in a full workweek and was not able to perform at the level needed when I was at work,” Charles McComas of Durham, North Carolina, said in an email. McComas retired early on disability with a neurological condition.
Firing someone for having a disability is illegal under the Americans with Disabilities Act, but that’s hard to prove if the employer can argue that it based its decision on performance issues and was unaware of your condition.
Ellen Bresnahan manages the disability appeals department for Fairfax, Virginia, law firm BenGlassLaw. Bresnahan explained via email that her firm advises anyone going on disability to first make sure they have the support of their doctor or medical team. Ideally, the doctor should be willing to fill out disability paperwork with clear details about the diagnosis, the corresponding limitations and restrictions, treatment plan, prognosis, and evidence based on test and exam results.
And once you have your doctor or medical team, be sure to cooperate with recommended treatments and follow-up appointments — not just for your well-being, but also to document your condition and progress.
Look for a lawyer sooner rather than later
“Everybody considering the possibility of long-term disability should consult an appropriately specialized attorney. When you realize that you definitely need one, there is way too much time pressure,” said Michael O’Donnell of Colorado Springs.
That doesn’t necessarily mean expensive hourly legal fees. Bresnahan says her firm offers flat-fee consultations to review claims before they’re submitted to the insurance company. Her firm also reviews claim-denial letters free of charge to help people understand why their claims were denied and how to approach the appeal process.
Although the basic path from short-term to long-term to federal disability seems straightforward, “the reality is that there are obstacles every step of the way that create more stress and challenges for people trying to use their benefits, and many simply end up giving up,” Sue Popkins said in an email. Popkins is a Northern Virginia resident with a chronic illness.
Disability insurers may deny claims at the outset — or they may later suspend or cancel benefits unexpectedly.
Keep going anyway
O’Donnell said his insurer canceled his disability benefits even though there had been no change in his health or medical information. Fortunately, he had already lined up an attorney who immediately started the weeks-long process of preparing an appeal.
O’Donnell had to wait six months for the insurer to respond to the appeal; once that clock ran out, his benefits were re-approved, and he received back pay. O’Donnell does not recall receiving an explanation why the benefits were canceled or reinstated, but he said he was “99% sure that the presence of the attorney and our apparent willingness to go to court if necessary determined the outcome.”
And even if you’re successful in gaining disability benefits, you could lose other benefits you thought were safe.
Retired human resources professional Ronald Weissmann of Elk Grove, California, said he was shocked when a life insurance provider in 2012 tried to avoid paying survivor benefits for an employee who went on disability for cancer because she was not considered an “active employee” when she died. Many life insurers will suspend premiums and consider employees on disability to be active so their survivors will receive benefits — but it’s best to review your plan’s certificate of coverage to be sure.
Read up on your rights
“I read and reread my companies’ leave policy and the disability companies’ plan,” McComas said. “Checked to see what my SSDI projected payment would be and researched my illness in the Social Security Administration’s ‘Blue Book’ to make sure I had symptoms that qualified me for SSDI [federal disability benefits]. … I bugged the hell out of my wife, HR and my financial planner with stupid questions. I kept asking my wife, ‘Read this, does this say what I think it does?'”
Washingtonpost.com online commenter “Be wise and kind” recommended creating a one-page summary of your condition and how it affects you: “Be honest with yourself here — for me, it was a real eye opener to have to really write it all down and see how changed I was from the person I had been, yet it eventually helped me be more realistic and make better choices.”