What would happen to you and your family if you were no longer able to work? Most of us go through life thinking that this could never happen to us and if it did, surely our insurance would take care of us. This is the condensed version of a disability story. The names are ficticious but the circumstances are true. It’s as frightening as Freddy Krueger or Halloween.
In early 2003, John bent over to pick up a towel off the floor. When he reached down, he had a knife sharp pain in the middle of his shoulder blades that radiated down his right arm. Thinking that he had pulled a muscle or had a muscle spasm, he lay down for awhile and applied a heat.
When it didn’t go away, he took the day off work and rested. Any movement of his head, shoulder or arm, re-awakened the sharp pain to the point of naseau. Later that day he made an appointment with a chiropracter. The chiropracter took xrays and found 3 discs in his upper back that had slipped, resulting in an 8 degree curvature of the spine. He referred him to a sports medicine chiropractor and then to a neurosurgeon.
The long and short of the medical history is that the neurosurgeon said that it was inoperable as surgery might make it worse and there was a less than 50% chance that it would improve. He gradually lost feeling in his right hand and lost the ability to look up and focus on anything due to pressure in his spinal cord.
For a construction supervisor, this was a very debilitating injury. The short term disability company researched his injury and hired a specialist to evaluate his ability to return to work. When the specialist sent in his report, the company paid him for 3 years of disability.
In the meantime, his insurance benefits had run out and he was unable to pay the high cobra fees to keep insurance. He applied to Social Security for Disability and Medicaid. If you research disability claims, you will find that they are almost always denied the first two or three times that you apply. This is exactly what has happened to John and he found himself living off his ever dwindling resources.
Five years later, he is still battling the disabilty system. Unable to afford health care, he has no medical documentation after 2005 to prove his claims. Because Medicaid is only available if you are approved for disability, he is one of thousands of people who have fallen through the cracks in the system.
John is not some bum who has lived his life off the system, he was just like you and I. He had a good job with a good income and benefits. He had worked for the same company for 17 years. He had a home, a nice car, two kids and a good middle class lifestyle.
Now he is caught in a vicious circle. His resources have dwindled until they are barely able to pay the small mortgage payment on his family home and the electric bills. He needs medical care and documentation to prove his continuing disability but is unable to afford the high cost of CT scans and MRI’s and the specialists that are needed to diagnose and treat. Without further documentation it is likely that his disability claim will be denied again. He has tried to return to work but a day’s normal activity results in weeks of pain.
He is not alone. According to Tim at My Disability Blog, more than 50,000 people in Michigan alone are waiting on disability claims. Sixty to Seventy percent of all disability claims are initially denied and have to be appealed numerous times. The chances of getting disability are not good unless you hire and attorney or disabilty specialist to represent you.
Do you know anyone who has applied for disability? What did they go through? Did they ever receive it? Are you prepared if you are ever disabled? Do you have long term disability insurance? Are you sure? Many people believe that they have it through their employer but these policies are often limited in time and will not support you during the years that it might take to get Social Security disability.
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Tags: Health Care, insurance
I know of a couple of cases where people had to go on disability. One was a 30 year old who was diagnosed with epilepsy. Her disability was approved on the first time in a matter of a couple of weeks. The other person was about 45 or so and he had some sort of spine problem. His took 3 years to finally get approved.
My husband has 1 year full paid leave disability coverage and I think 60% after the first year. I should check that.
Apparently back and spine injuries are the most difficult to get approved and account for a large percentage of disabilities.
I would look into the length of time that the disability leave covers as most company policies do not cover more than a few years. Their purpose seems to be to cover your bases while you are applying for disabilty.