S.S. vs Private Long Term Insurance

[Ginny]

I have a question about LTD. I was just denied SS in the state of New Jersey. I have been out of work 4 months.

I also have a private Long Term Insurance policy at work. I am filling out the paperwork now.

I have 60 days to decide if I want to appeal the S.S. If I am awarded the policy from work I will get 60% of my salary. Is it worth it to appeal the S.S. at this point? I will have to pay a lawyer. I believe the way it works is my private plan will deduct the amount of money that Social Security pays. If I am going to get it from the private plan I don't know if it is worth it to put the money out for a lawyer.

Any ideas?

Thanks,
Ginny

[Berkshire Road]

If you don't get approved for LTD by your private insurer, you'll want the SS, right? So, I would begin the appeals process just in case. You can always drop it.

You don't really have to pay a lawyer, it is possible to appeal on your own. If you want to give me a call, I might have a bit of advice for you. I'll be away until Wed. June 13, but after that I'd love to get together with you again, anyway.

Good luck with all the paperwork!

[Elle]

One thing to keep in mind is that your LTD company may actually require you to apply for SSD after a period of time (lots of times it's 2 years). If that's the case, I would go ahead and appeal the SSA denial. You can go through an appeal without an attorney and win. I did it without hiring an attorney, and so did lots of others on this board. I would just hate to see you lose any back $$ and then be forced to apply anyway.
One other reason to go ahead with the appeal is that if you are approved, your SS requirements as to the number of credits required are frozen. If you don't apply and you remain unable to work through retirement you may end up without enough credits to even qualify for retirement pay. And, most LTD companies only pay benefits up to a certain age. That would depend on how close you are to retirement and whether you're able to return to work at a later date, but I would definitely keep it in mind while making your decision.

[Ginny]

Wow, Ladies you gave me a lot to think about.
I called work, S.S. and the Private Long Term carrier and got no help at all.

Let me ask another question. If I appealled (which I will now that I have this information) without a lawyer and was turned down will I still get to appeal again with a lawyer.


Thanks again,
Ginny

[Elle]

If you appeal and get turned down at the Administrative Law Judge (ALJ) Hearing, you can appeal again to a regular court. Most people that stick it out seem to get approved at the ALJ level from what my case worker said. I was actually surprised at the hearing. I had done all of my research, had letters from all of my Drs and was really prepared for the hearing. Once it started, my judge was extremely nice and understanding. He told me that day that I was approved and even back dated my date of onset back to the actual day my symptoms began.
There's so much info available on the web and the SSA site. You can most definitely do this on your own if you feel comfortable doing it. You can also request a copy of your entire case file from SSA. Just call your case worker and she can get it to you. Be sure to ask for all of the Medical Examiner's notes and any other notes submited by your Drs or other SSA parties. In my case record, I actually found out that the original ME had my dx listed as "a recurrent UTI" - even though I hadn't had a UTI for many years prior! Once that was on my record, it's my guess that the person who reveiwed it during the reconsideration appeal didn't look very hard, simply b/c they thought all I had was a UTI. At the hearing, this actually worked in my favor b/c the judge was royally ticked that the ME didn't review my records more thouroughly. He even apploigized for the error. Getting a copy of your record, as well as the disability packet offered on the IC site, can really set you on the right path. And, of course, we're all here to help along the way!