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Insurance Hell All insurance-related matters are here: Medicare, worker's compensation, appeals, denials, insights, wins, losses. PRICING is here too. Note: This forum has posts from 2006 forward. Older ones are in the Big File.


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  #1  
Old 09-10-2014, 12:37 PM
colorado babe's Avatar
colorado babe colorado babe is offline
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Join Date: Aug 2014
Posts: 345
Default Anyone else having problems with STD or LTD

I started STD on March 5th with a 30 day waiting period. Started getting paid in April. Received my last check on July 20th because they claimed they needed additional information. The representative used to call me back but now is ignoring me. The last word I heard was that they paid outside physicians to review my case and she has the reports back and is reviewing it before making a determination. Was told she would call me back yesterday, she didn't.

LTD is reviewing my case since STD was suppose to end on August 30th. The representative called me and tried to make up a whole bunch of lies stating I didn't see a surgeon until after the 60 day waiting period. that is not true, I saw his PA when I was told I was seeing him on april 7th and demanded that I get another appointment to see the surgeon. The soonest I could see him was on May 5th. They claim it was after the 60 day window. Really? they also sent all my doctors forms but on the forms there was nothing noted about restrictions they wanted their notes. The representative said the notes were not satisfactory so now all my doctor's are updating their notes to include restrictions showing I can't sit at a desk all day. This is a disgrace. I have paid into STD and LTD for 10 years and this is the first time I filed. They are the devil in disguise. How can they go to sleep at night?
__________________
1998- Injured neck and back in USAF
2011 - Started experiencing Severe Symptoms, Migranes, numbness, spasms in legs and feet and sciatica.
Feb 2014 - Received upper Lumbar Injection - Severe Allergy to injection
Mar 2014 - MRI of Cervical and Lumbar, protruding disc in C3-7, Herniated Disc in L5/S1, placed on STD and FMLA )
July 2014 - Stem Cell Procedure performed
Oct 20, 2014 - ADR (MOBI-C) at C5-7 and Anterior Fusion at L5/S1 by Dr. Pettine and Dr. Techy
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  #2  
Old 09-11-2014, 07:47 PM
Jerry5 Jerry5 is offline
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Join Date: May 2013
Posts: 363
Default Welcome

...to the world of Insurance.
I have gone around with them for a year, appealed and then paid, out of pocket.
I currently have a reimbursement claim, and that is only for about 80% of what I paid, and they will most likely try to only pay 80% of this...,
They will spend whatever it takes to NOT pay, their thinking is, they can use these examples on future cases.
Keep flooding them with paperwork, and talk to them on the phone, frequently.
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Jerry, Somewhere Ohio

L2-3 herniation, two days before Thanksgiving, 2012, Discectomy/Laminectomy, 3/13 Numbness in the right leg, lateral femoral, gone, July 10, 2014 L45 M6 ADR, July 15 PLIF L5-S1, Not able to access L51 Anterior.
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Old 09-30-2014, 11:04 AM
colorado babe's Avatar
colorado babe colorado babe is offline
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Posts: 345
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Update: I did receive the extension of my STD to the end of the policy which was Aug 30th and got the pay out a few days later. Now waiting on my LTD to be approved through the same company (Standard).

I also have another Long Term Disability policy through UNUM and applied just for the heck of it back in May to see if it would be approved and how much they would pay me weekly--still waiting. Even if they would approve my disability claim I would not go through them. They have had my claim for almost 5 months and have done nothing but harass my doctors and I and will do everything possible to stall the process. If you have a policy with them, switch it to another company. The Standard has been pretty good and very nice and compassionate when I talk to them which is usually weekly. Unum on the other hand will not return your phone calls and you can never get a hold of your adjuster--but when she calls she is a stick of dynamite.
__________________
1998- Injured neck and back in USAF
2011 - Started experiencing Severe Symptoms, Migranes, numbness, spasms in legs and feet and sciatica.
Feb 2014 - Received upper Lumbar Injection - Severe Allergy to injection
Mar 2014 - MRI of Cervical and Lumbar, protruding disc in C3-7, Herniated Disc in L5/S1, placed on STD and FMLA )
July 2014 - Stem Cell Procedure performed
Oct 20, 2014 - ADR (MOBI-C) at C5-7 and Anterior Fusion at L5/S1 by Dr. Pettine and Dr. Techy
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  #4  
Old 11-07-2014, 10:08 AM
colorado babe's Avatar
colorado babe colorado babe is offline
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Join Date: Aug 2014
Posts: 345
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I am still waiting for the Standard to approve my LTD. Was told by the claim adjuster that he has everything he needs and is reviewing all the paperwork and it will be reviewed by their doctors as well. I don't understand them wanting all the same paperwork again in addition to the surgery paperwork in which I understand because that is new. It's been almost 4 months of waiting. The adjuster who did my STD claim said I should be approved for the LTD. I just can't believe how they play these games over and over. I call them all the time for an update.

Update on Unum. I found out since my employer was paying my premiums for Unum and I was paying for the Standard I am entitled to collect from both companies. Unum is still playing games with me. However, when I had a shouting match with my adjuster and told her I was done talking with her she called me a few minutes later and told me they were going to cut me a check for one month for restitution and if my claim does get denied because I don't fit the parameters of "disabled" I will not owe the money back. I guess I scared her when I said I want to speak to her supervisor. I also told her I have three attorney's in my family so don't mess with me. This was back on Oct 24th. It's almost time for me to give her another call back.The last time we spoke she said they were close to a determination. I think it's been two weeks - they should have come to a determination by now.
__________________
1998- Injured neck and back in USAF
2011 - Started experiencing Severe Symptoms, Migranes, numbness, spasms in legs and feet and sciatica.
Feb 2014 - Received upper Lumbar Injection - Severe Allergy to injection
Mar 2014 - MRI of Cervical and Lumbar, protruding disc in C3-7, Herniated Disc in L5/S1, placed on STD and FMLA )
July 2014 - Stem Cell Procedure performed
Oct 20, 2014 - ADR (MOBI-C) at C5-7 and Anterior Fusion at L5/S1 by Dr. Pettine and Dr. Techy
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  #5  
Old 11-12-2014, 10:10 AM
colorado babe's Avatar
colorado babe colorado babe is offline
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Join Date: Aug 2014
Posts: 345
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The UNUM representative called me and told me my STD was denied because they thought I was able to do my job at work. They are now opening up a new claim for LTD which has a two month waiting period. What a joke. I am still waiting to hear back from the Standard. They have no waiting period since I was approved for the STD and received it to the end. I have heard so many horror stories about UNUM and am so thankful that at least I was able to collect from the Standard.

I have an attorney reviewing my UNUM case and waiting to hear back from her after she reviews the denial letter and review of my policy certificate. She said we might be able to fight them for a lump sum. So many people have been screwed by UNUM. They are known for their denials but they don't seem to realize who their fighting with.
__________________
1998- Injured neck and back in USAF
2011 - Started experiencing Severe Symptoms, Migranes, numbness, spasms in legs and feet and sciatica.
Feb 2014 - Received upper Lumbar Injection - Severe Allergy to injection
Mar 2014 - MRI of Cervical and Lumbar, protruding disc in C3-7, Herniated Disc in L5/S1, placed on STD and FMLA )
July 2014 - Stem Cell Procedure performed
Oct 20, 2014 - ADR (MOBI-C) at C5-7 and Anterior Fusion at L5/S1 by Dr. Pettine and Dr. Techy
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  #6  
Old 11-21-2014, 10:43 AM
colorado babe's Avatar
colorado babe colorado babe is offline
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Join Date: Aug 2014
Posts: 345
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The Standard approved my long term disability retro to August 30th which is good news. Only plan on being on it for another month. If any of you have Disability insurance I highly suggest you not use UNUM. They were a nightmare. They plan on approving my LTD after 60 days which is when I'll be off of disability. I am calling them today and telling them to forget about it. They are not worth my time and effort.
__________________
1998- Injured neck and back in USAF
2011 - Started experiencing Severe Symptoms, Migranes, numbness, spasms in legs and feet and sciatica.
Feb 2014 - Received upper Lumbar Injection - Severe Allergy to injection
Mar 2014 - MRI of Cervical and Lumbar, protruding disc in C3-7, Herniated Disc in L5/S1, placed on STD and FMLA )
July 2014 - Stem Cell Procedure performed
Oct 20, 2014 - ADR (MOBI-C) at C5-7 and Anterior Fusion at L5/S1 by Dr. Pettine and Dr. Techy
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