The Disability Jerk Around

[Guest]

I think that sentence would mean more if John wrote it.

Well, there is no way I would sit down and have a drink with you. And I couldn't mean that more.

Can't wait until I have to pay part of the insurance coverage for that fat bastard Michael Moore - the king of fiction movies.

How do you account for the fact that he is more popular than you are (and everyone else in the US healthcare business)?

Yeah, I know. Everyone wants a free lunch, everyone is irresponsible, everyone would rather have a boat than insurance, the illegals are all on welfare or are stealing jobs, and it's not YOUR responsibility to worry about anyone but yourself... because after all... greed is good.

Did you go or send your kids to public school? Do you drive on public streets? Do the cops and firemen come to your house? Does the state license you to sell insurance?

Do we really NEED all of those services? You never had a fire or called the cops... so obviously you should not pay for that. And you and your kids went to private school, so why should you subsidize someone else's kid to get an education? And you don't play golf, so why should you pay to keep the pubic courses open?

You should buy a large island and name it the State of Bronstein (SOB) where there are no taxes, no services, and where everyone lives a survivalist, self-sustainable life depending on no one else and where you pay for everything you use and if the next guy can't, well that's the way it is in SOB.

 

[GreenSky]

Well, there is no way I would sit down and have a drink with you. And I couldn't mean that more.

I don't recall offering.

How do you account for the fact that he is more popular than you are (and everyone else in the US healthcare business)?

He's not in the healthcare business. He's in the entertainment industry.

George Bush is more popular than you are and that even includes those in your family who can stand to be around you. How do you account for that?

Rick

 

[Dave020]

Not to change the subject, but didn't something similar to this happen to Unum Di? I seem to recall Unum was a very strong DI carrier with good claims payment track record right up until they merged/acquired Provident. Then suddenly a lot of complaints about slow claims processing, requests for rediculous supporting documents, and an army of private investigators spying on those receiving disability benefits.

I wonder if your brother is sadly stuck with a similar situation regarding Guardian/PennM?

 

[retread]

Actually Al, trying to get on Social Security Disability is far worse.

Never a truer statement... I have several SSDI duals on my client list, and they all have one thing in common: they spent most part of a year or more trying to get on the rolls. The only good thing is that when they were finally approved, their disability date was backdated so that they were very close to Medicare eligibility, and the back payments were a welcome relief.

John, I thought that DI carriers required proof of income BEFORE enrollment, so that the amount of payment would be a % of that on claim submission. ???

 

[Dave020]

From what I read it sounds like John may be describing an attempt by claims to consider the possibility of a "reduced" monthly DI amount based on last year and in consideration of the 7 previous to that. It sounds like they may try to come back with a lower amount by using the a reduction in income if they can prove one.

Have not looked at a DI contract in ages. For you DI gurus on the forum, are there any contracts out there that have a condition whereby the amount of coverage would be based on the "current" income (whichever years they initially use to determine the monthly benefit amount) but could be reduced upon claim if it can be demonstrated that the insured was making less income than when the original benefit amount was purchased? I'd be curious to know.

 

[Crabcake Johnny]

Not if you hire an attorney. There is an type of legal practice which specializes in SSI law and they get a percentage of the back payments up to $5,000 (it may be more now.)

See:
Social security lawyers ssi ssdi social security benefit attorneys
Social Security Lawyer, Lawyers, Attorney, Attorneys, Law Firms - Lawyers.com

In my area I recommend Bruce Hagel of Olson, Hagel & Fishburn

I've never known Bruce to lose a case. I send a lot of folks to him... and I never hear a bad word.

Al
Preserve your memories

...so this is the model for gov't run health care? Just hire a lawyer and sue - then you'll get that operation.

 

[retread]

Actually Al, trying to get on Social Security Disability is far worse.

Wait a minute, John... are you raising another issue your brother is having difficulty with, or just bemoaning the fate of those on SSDI?

I thought your brother was having difficulty with his LTDI carrier processing his claim.

These are two separate issues... you ran a rabbit across the bear trail... which one are we going to pursue?

 

[bobson]

...so this is the model for gov't run health care? Just hire a lawyer and sue - then you'll get that operation.

Yes, when you are sick you bring your doctor and an attorney to a government 'billing office' to finaggle over what should be covered. Some $7.50 an hour office clerk can listen to the arguments from the MD and the JD. If he believes them he approves the procedure. If he doesn't he can pass you onto a manager making $10.00 an hour.
- - - - - - - - - - - - - - - - - -

Wait a minute, John... are you raising another issue your brother is having difficulty with, or just bemoaning the fate of those on SSDI?

I thought your brother was having difficulty with his LTDI carrier processing his claim.

These are two separate issues... you ran a rabbit across the bear trail... which one are we going to pursue?

I'm no expert on John's brother but I might hazard a guess that he is having issues with both....

 

[Crabcake Johnny]

I don't like the system now - trust me, it's broke and needs fixing. The answer is NOT to literally have some gov't employee who's waiting for the lunch bell to ring to decide of my mother gets her hip replacement surgery.

For the good bad and the ugly one things works - incentive. You take a way incentive and you get....well...France. Hey, you hear about the latest French space shuttle? Neither have I.

 

[bobson]

Not if you hire an attorney. There is an type of legal practice which specializes in SSI law and they get a percentage of the back payments up to $5,000 (it may be more now.)


Al
Preserve your memories

So the government sets up a program to help those who are disabled and can't work but you need to pay an attorney a percentage of the benefit? What sense does that make?

Instead of getting the money promised by law, you have to give up some of it to an attorney?

I suppose you are a member of the trial attorney assocation as well?
- - - - - - - - - - - - - - - - - -

The answer is NOT to literally have some gov't employee who's waiting for the lunch bell to ring to decide of my mother gets her hip replacement surgery.

Yes, but that government employee would have had at least a 4 hour course on claims handling. And we won't let them have lunch bells, that would be a disincentive. Instead we'll give them lunch credits for each procedure they den... I mean process.
- - - - - - - - - - - - - - - - - -

From what information I was able to gather, the compensation allowed for an attorney or non-attorney representative appealing and winning a SS Disability claim is 25% and is capped at $5,300.00 (as of 2007). Also, the fee agreement must be approved by the SSA.
- - - - - - - - - - - - - - - - - -
With regard to CI coverage, I think a good case can be made for that type of coverage to supplement but not replace a good individual DI policy.

Interesting. I need income because I can't work. So I have to hire an attorney to take $5300 of the money I need to get the rest of my money? Sounds like a crummy system to me.

I would love to see a study of cancer patients (or stroke or heart attack survivors) and see which policy was more beneficial, the DI or CI.