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Question

I went on Short term disability back on July 15th. The company insurance carrier at the last minute denied my LTD and closed off my short term disability 2 weeks prematurely. My doctor has not cleared me to go back to work. I now have been told to return to work by November 9th or be placed on an unsecured leave without a job guarantee. I am aware that they will probably terminate me if I go back to work. It is wrongful termination. My question is do I give up the right to appeal the LTD carrier denial and apply for Social Security if I go back to work and then am fired?

Submitted: 20 days and 2 hours ago.
Category: Legal
Value: $15
Status: CLOSED
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Posted by JB Umphrey 19 days and 22 hours ago.

Info Request

Thank you for using JustAnswer!

 

What is the reason for the denial of LTD?

19 days and 20 hours ago.

Reply

They said that the doctors did not supply enough documentation on objective findings for my illness which is BP mixed and severe.. That is a croc because the specialist commented, very strongly on my depresssion, lability, agitation, anxiety etc. They took the fact that i had improved in one area as the basis to show that I was improved enough to go to work. Hell I remain disorganized and depressed. They also claim that the physicians did not personally return enough calls from Cigna seeking information on me.. They sent in plenty of written documentaion to the questions asked. The docs did not return a couple of calls but that was because of the time difference and they are busy as hell. MY chief Psych sent in plenty of information.It goes on and on with twisted reasons. It is not factually accurate in many areas. But a big reason why it was denied was the fact tha the social worker said I was improved, which they thought contradicted the Psych's documentation. I was slightly improved only in the particular life events that we were working on but not in my overall symptoms. I remain depressed, hopeless, and lethargic. I am getting high blood pressure and more agitated now when I get really worked up over this denial. It is a difficult situation to describe. I hope this added info helps.

Thanks

Posted by JB Umphrey 19 days and 20 hours ago.

Answer

Thank you. If you return to work, you still have the ability to appeal the LTD denial and, if you're terminated, you still have the ability to apply for social security disability.

 

Good luck and best wishes for better days ahead! I hope that you find this information to be helpful and this answer to be ACCEPTable!

19 days and 19 hours ago.

Reply

But isn't going back to work an admission that I am not disabled( I am still very ill) but the company is forcing my hand because if I stay out when Nov 9th rolls around, my position becomes open to be filled from outside and I am termed an inactive employee at most.

I just want to make sure because the shortening of my STD and the denial of the LTD has to be appealed.

Posted by JB Umphrey 19 days and 19 hours ago.

Answer

From the facts you describe, it's because of your condition that you'll be terminated so that nullifies that point.

 

And medically, for Social Security, your records are your records. Your condition is your condition..

19 days and 19 hours ago.

Reply

Before I went out I was given a warning on sales performance even though others were performing poorly and my sales were climbing. The warning letter came out of nowhere. So when I go back, they could say it was because of performance even though performance is measured over a year period instead of at July. a few others older like me got warnings also and their track records were solid going into this year.

Posted by JB Umphrey 19 days and 19 hours ago.

Answer

If you are terminated because of poor sales performance then a person can't claim wrongful termination.

19 days and 19 hours ago.

Reply

The issue is can I still appeal Cigna's denial if they terminate for that reason? The wrongful termination is another crazy thing.

Posted by JB Umphrey 19 days and 19 hours ago.

Answer

If you're terminated for poor sales performance, then the LTD issue is a non-issue. They are totally separate matters. There's no need for LTD if the person would be terminated for performance.

19 days and 18 hours ago.

Reply

so your advice is to stay out on unpaid leave and appeal the denial. That way I avoid their poor performance trap!

Posted by JB Umphrey 19 days and 18 hours ago.

Answer

I can't recommend one course of action over the other. I can only make you aware of some of the considerations you want to take into account in making your decision.

19 days and 18 hours ago.

Reply

I believe they are pressuring me to come back so they can terminate. I am not ready to come back do to illness so my LTD appeal would be in jeopardy if they claimed poor performance even if it is at the very least questionable.?

Posted by JB Umphrey 19 days and 18 hours ago.

Answer

It's not questionable if it's solely performanced-based and has nothing to do with the disability.

19 days and 18 hours ago.

Reply

So if they terminate based on"performance" I lose my right to appeal the LTD denial

Posted by JB Umphrey 19 days and 18 hours ago.

Answer

You have no right to LTD when you're not an employee.

19 days and 18 hours ago.

Reply

If I was terminated because of the condition, I wold not be an employee either but I could still appeal the disability right?I could also sue them for discrimination!

Posted by JB Umphrey 19 days and 18 hours ago.

Answer

You could try to use that as an argument to appeal the disability. The facts you describe do not suggest as basis for discrimination. Under the Family with Medical Leave Act, they only need to keep your job open for you for 12 weeks and that window closed a long time ago.

19 days and 18 hours ago.

Reply

You are a good defense attorney. I lose to both the company and to Cigna!

Posted by JB Umphrey 19 days and 18 hours ago.

Answer

Sorry, I try to be objective based upon the facts. I can't even begin to count the number of novel theories I've dreamed up over the years to get around a legal mountain and pretend that it doesn't exist. Sticks of dynamite are few and far.

19 days and 18 hours ago.

Reply

This is a legal nightmare for me? That is the last question.

Posted by JB Umphrey 19 days and 18 hours ago.

Answer

If a person can go back to work, they should try to go back to work and then work on performance improvement. Try to eliminate the reasons for them to terminate and then everything else will fall into place.

19 days and 18 hours ago.

Reply

I am in pretty deep and I am still pretty ill but I will heed your words.

Thanks alot.

Accepted Answer

Good luck!

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Expert: JB Umphrey
Pos. Feedback: 97.7 %
Accepts: 
Answered: 11/3/2009

Attorney

Michigan lawyer who explains basic criminal, consumer, and contract-related matters.

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