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C-5/6 complete - early retirement with long term disability insurance?

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    C-5/6 complete - early retirement with long term disability insurance?

    I am a C-5/6 complete since 1996 and I now think about retirement because of getting older and fracture on my femur since September last year, which is not healing fast enough. I am almost 49.
    I have a longterm disability insurance from my job and know I can get the SSDI when I stop working, but not sure about the long term disability insurance. Do you see any issue with getting the LTD insurance benefit or advice to share?

    Thanks!
    Last edited by JK; 9 Mar 2019, 6:08 PM.

    #2
    Originally posted by JK View Post
    I am a C-5/6 complete since 1996 and I now think about retirement because of getting older and fracture on my femur since September last year, which is not healing fast enough. I am almost 49.
    I have a longterm disability insurance from my job and know I can get the SSDI when I stop working, but not sure about the long term disability insurance. Do you see any issue with getting the LTD insurance benefit or advice to share?

    Thanks!
    Generally speaking, the qualification criteria for (LTDI) Long Term Disability Insurance (purchased by you or as a part of your employer's benefit package) are less stringent than Social Security criteria. So, if you qualify for Social Security Disability Insurance you will likely qualify for your LTDI benefits.

    Most LTDI policies allow you to continue collecting benefits after you have qualified for SSDI, but some don't. In many cases, LTDI policies will cut your benefit amount once you are approved for SSDI. Ask your insurance agent, human resources director or lawyer whether you can receive your insurance benefits and SSDI benefits concurrently and what effect receiving Social Security benefits will have on your LTDI payments.

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      #3
      Originally posted by JK View Post
      I am a C-5/6 complete since 1996 and I now think about retirement because of getting older and fracture on my femur since September last year, which is not healing fast enough. I am almost 49.
      I have a longterm disability insurance from my job and know I can get the SSDI when I stop working, but not sure about the long term disability insurance. Do you see any issue with getting the LTD insurance benefit or advice to share?

      Thanks!
      The case workers at the LTD carriers scan this site.

      Generally, they won't let you go out on disability. They'll let you go out for 2 years for mental health but not for the SCI. They'll call it depression or some other inability to cope. It gets them of the hook for having to cover an old SCI later on in life, if they weren't the carrier when you were injured.

      I'm not speculating here.

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        #4
        Originally posted by Patton57 View Post
        The case workers at the LTD carriers scan this site.

        Generally, they won't let you go out on disability. They'll let you go out for 2 years for mental health but not for the SCI. They'll call it depression or some other inability to cope. It gets them of the hook for having to cover an old SCI later on in life, if they weren't the carrier when you were injured.

        I'm not speculating here.
        When I decided to purchase LTDI, before I was injured, I read a lot of policies and did a lot of study. The policy I finally bought, stated that the LTDI determination of disability followed the determination of the Social Security Administration. I worked for 20+ years after I was injured. When I exercised the disability option a number of years before I qualified for Retirement Social Security benefits, I went through the steps of qualifying for Social Security Disability and was determined to be disabled. My LTDI required that I submit the Social Security determination letter and the documentation that Social Security required. They followed the Social Security determination.

        I understand that others may have totally different experiences with their Social Security Disability Insurance and Long Term Disability Insurance. I am only speaking from my experience qualifying and using my benefits.

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          #5
          I?ve worked for a state agency for 15+ years, and am in my early 40s, injured 25 years. I?ve often given thought as to how much longer I?d be physically able (or willing) to work. We have the option of disability retirement should we qualify, which in my case I believe could be supplemented by SSDI. If on disability retirement, we also have access to our health insurance (vs after 25 years). I often think I?d make out better financially by going this route than by working (though at this time I prefer to continue working). But my biggest question is, having worked there since disabled, how would I then suddenly meet the qualifications for disability retirement?

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            #6
            A very grey area. A year or so ago I thought I would need to pull the plug on work due to some nonsense being put upon my group during a location move. Researching the going out on LTD option revealed that...it really depends on where this LTD is coming from, and who is administering qualifications for this.

            In my case...my employer contracts Sedgwick to operate that program. And the sole existence of this company seems to be a royal pain in the ass barely meeting legal requirements and barely dodging lawsuits in the goal of denying claims (as well as getting sued a lot also). At least that's what the internet would indicate. Direct experience with coworkers being pushed back off short term disability too soon after say...open heart surgery too soon leading them to making a whopping 3 hours before needing to leave, or someone in active chemotherapy needing to basically sleep the day out back because she was being forced into work confirms this. Curiously, Sedgewick notes 'fatigue' is not a disabling condition in an odd FAQ of sorts introducing the program. I'm not too versed in Cancer treatment, but I suspect that is the angle they use to combat this form of disability. And they are glad to note that while you might be SSDI qualified...don't hold your breath thinking Sedgwick will reach the same conclusion. Also, it seems they have a network of doctors of unknown qualification on the payroll which curiously override your own doctors opinions without actually seeing the patient and via only reviewing records. And the administrative stonewalling of communications via fax machine seem to be another weaponized form of wearing down claimants.

            Ok, now that I took a dump on my employer's choice of contractor...yours might be quite different. But keep in mind in this modern era there is a thriving industry of such operations which 'economize' employer benefit programs...and not to the benefit of the employee.

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              #7
              This thread is interesting. I'm considering buying relatively cheap disability insurance in the next year or so through my job because I'm in training and qualify for group coverage.

              One would think that an unhealed femur fracture would qualify as at least a temporary disability. I'm curious what others have experienced. No point in me paying $100 a month for disability insurance going forward if the company is likely to deny any claim I have in the future due to SCI complications (since that's most likely to end my career) especially if, as Andy would leave me to believe I could be beheaded and kept alive by machines and the insurance company would still make me take them to court or report to work as scheduled.

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                #8
                It is important to know how disability is defined. When I was working, I carried a private disability policy that wrapped around my (very limited) federal employee coverage. The federal policy considered you disabled if you were unable to do any work for more than 6 months. My private policy defined disability as being unable to do my current job for more than 6 months. Big difference.

                (KLD)
                The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

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                  #9
                  I also tried to apply a long term care insurance through my employer but I wasn't qualified because of the pre existing condition.
                  For Long Term Disability Insurance, it has this statement. I think I might be covered based on the second condition... I hope. Is there any case that Quad, complete, is not approved for SSDI? My doctor said he doesn't have any problem to write a letter based on my disability. I will update this thread when I really retire.
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                    #10
                    It may not be in your best interest to pursue the SCI as the disability. You may be better off pursuing the disability claim through secondary conditions. Because that way it's not a preexisting condition perse. For example, if you worked for 20 years with a SCI, then they'd make the case that you can continue to work with an SCI. They'd be right and you'd be at a loss to fight that. But if your doctor says that certain conditions (like autonomic dysreflexia, intractable spasticity, bone fractures, skin breakdown, neurogenic bladder and bowel) have reached a state that are disabling, they really can't use against you the fact that you worked with an SCI for 20 years. Because it's not the SCI perse that is the reason for the disability claim. Know the rules and be honest and you shouldn't have a problem. Try to pull a fast one and you'll be in for a losing fight.
                    Last edited by August West; 13 Mar 2019, 11:58 PM.

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                      #11
                      Originally posted by August West View Post
                      It may not be in your best interest to pursue the SCI as the disability. You may be better off pursuing the disability claim through secondary conditions. Because that way it's not a preexisting condition perse. For example, if you worked for 20 years with a SCI, then they'd make the case that you can continue to work with an SCI. They'd be right and you'd be at a loss to fight that. But if your doctor says that certain conditions (like autonomic dysreflexia, intractable spasticity, bone fractures, skin breakdown, neurogenic bladder and bowel) have reached a state that are disabling, they really can't use against you the fact that you worked with an SCI for 20 years. Because it's not the SCI perse that is the reason for the disability claim. Know the rules and be honest and you shouldn't have a problem. Try to pull a fast one and you'll be in for a losing fight.

                      This was my main question too. I've worked 15+ years for my employer (all since my SCI), and so my thoughts have always been, how suddenly would my SCI become "disabling". But as you mentioned, I imagine at some point sitting up in my chair the length of time I must now, may be an issue.

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                        #12
                        Originally posted by landrover View Post
                        This was my main question too. I've worked 15+ years for my employer (all since my SCI), and so my thoughts have always been, how suddenly would my SCI become "disabling". But as you mentioned, I imagine at some point sitting up in my chair the length of time I must now, may be an issue.
                        Correct. Let's compare SCI that leads to medical complications to faulty household wiring that leads to a fire. The fire insurance company won't pay to fix the wiring. But they will pay to repair the fire damage. The analogy is that the injury is like the faulty wiring (not covered) and the medical complications from the injury are like the fire damage (covered by insurance). If you have skin issues and your doctor says you can sit up for no more than 2 hours at a time, then that is justification for a disability claim. Whether it is 100% or some lower percentage of disability is to be determined. But from what you are saying, you are like me. You wouldn't let that stop you if you had a choice and you'd prefer to work longer until there are more (several?) issues that prevent you from working at all. Personally, 50% disability would be a terrible situation for anyone with a higher education and a profession. Because you're not going to find a half-time job like that. Then how do you survive on 30-35% (they pay 60-70% of the 50%)? If you are able to find a job that pays enough at 20 hours per week, then that's a different story. But that's unlikely.

                        It's unfair of them to force you to take any job just because your disability isn't 100%. A good policy will require you to seek employment only within your field. Of course, the requirement to seek employment doesn't apply if your disability is 100%.
                        Last edited by August West; 14 Mar 2019, 5:59 PM.

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