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Help! I Tried Fmla And Short Term Disability. I Have Health Insurance But My Job Won't Pay Me!?

Disability Insurance News & Discussion

Help! I Tried Fmla And Short Term Disability. I Have Health Insurance But My Job Won't Pay Me!?

Postby Elidor » Sat Sep 23, 2017 2:08 pm

I JUST met my year's anniversary, making me eligible for FMLA.
The company I work for is odd with regard to FMLA.
However, I've had increasing anxiety, escalating to panic attacks.
My doctor has been recommending FMLA for a long time.
I'm just now eligible.
I'm borderline housebound from the stress/paranoia from the job.
They refuse to pay me as I was released under "review" status in early October.
Mid October my letter states that I'm on Administrative Leave, making me ineligible for pay on FMLA.
Crap! So I'm struggling to get a short term disability claim approved.
It's showing as DENIED, but my provider states left & right that they're "reviewing documentation." I've had a rocky road with my employer lately, and have been subj. to an "investigation," which they will NOT let me be privvy to the what's and why's of... all I know is they tried to send me to a doctor (???) of their own before I got approved for FMLA w/o pay.
How can I get app. for short term dis & get well?
Elidor
 
Posts: 50
Joined: Wed Jan 01, 2014 5:18 pm

Help! I Tried Fmla And Short Term Disability. I Have Health Insurance But My Job Won't Pay Me!?

Postby Padruig » Mon Sep 25, 2017 1:38 pm

Denial = "technical" per representatives, they've been reviewing (only 5 pages!) my HCP's faxed-in documentation for over a week and a half now.
They state that I should call the automated line or check online, but keep holding me off and keeping me back to wait it out, I believe; however, they're just sitting there w/ a "DENIED" status; however, they keep saying over and over that it's "TECHNICALLY" not denied, which I find to be ridiculous.
I'm just sitting here.
What's worst, I think, is that I was relieved under "review" status, which is NOT admin leave, they said so themselves, then they automatically FLIP me to leave so I can't get paid per FMLA (my company does unless I'm off under any type of Admin Leave) so that I don't receive pay.
They coaxed me to go the FML route, not the disability route.
Under-handed Fortune10 companies.
Padruig
 
Posts: 49
Joined: Wed Mar 12, 2014 11:56 am

Help! I Tried Fmla And Short Term Disability. I Have Health Insurance But My Job Won't Pay Me!?

Postby Weardleah » Tue Sep 26, 2017 2:31 am

Time for a lawyer. Too many times the employer will drag out the paperwork in hopes that you will just give up in frustration. Call a law firm that deals with medical claims.
Weardleah
 
Posts: 47
Joined: Sat Jan 04, 2014 3:39 pm

Help! I Tried Fmla And Short Term Disability. I Have Health Insurance But My Job Won't Pay Me!?

Postby Krystine » Wed Sep 27, 2017 7:09 am

FMLA is not typically a paid benefit. Some companies will allow you to use your sick time while out on FMLA. It sounds like they put you on admin leave which is why your STD is being denied. What a mess, I don't really know what to tell you. Good luck.
Krystine
 
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Joined: Sat Jan 04, 2014 9:16 pm

Help! I Tried Fmla And Short Term Disability. I Have Health Insurance But My Job Won't Pay Me!?

Postby Golligan » Fri Sep 29, 2017 12:00 am

K! Get a lawyer that spec. in med. claims Per Steve! Before doing that, (I want to keep my job!), the specs: 1yr anniversary met as of early Oct, Early oct, released due to some strange "Investigation," released under "review" status; sent me into a panic attack, immediately applied for FMLA, got it, no pay, due to Admin Leave status (leave of absense=inelig for pay); however, "Review" does NOT mean leave of absense, I even called to verify this per HR. However, my short term disability claim is "denied" per Metlife; they state it's just "being reviewed," not denied... my empl. wanted me to go to an IME/Indep med. examination for NO disclosed reason, I don't use drugs, drink, nothing. Ever. However, I blew the whistle on some folks and they wanna push me out. I've met w/ union several times. I'm pos. they're fishing for ways to push me out the door.
Is there any way to expedite this or to know where I stand or to get paid? They've lied thru documentation. Fortune 10 company.. a joke
Golligan
 
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Joined: Tue Jan 14, 2014 2:32 pm

Help! I Tried Fmla And Short Term Disability. I Have Health Insurance But My Job Won't Pay Me!?

Postby Cagney » Sat Sep 30, 2017 4:43 am

OK, WHY is the short term disability claim denied? Is there a 90 day waiting period, or are panic attacks/stress/mental illness excluded conditions?

I don't know of any employers who pay employees during FML.
And until a judge says otherwise, you're not entitled to see any investigation report you didn't pay for.
It's not YOURS, even if it's about you.


If the reason for the claim denial is NOT in accordance with policy terms, you can file a complaint in writing with your state insurance commissioner.
If it IS in compliance with the policy terms, well, it's not COVERED, so you'll have to resort to your savings account.
Cagney
 
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Joined: Thu Mar 06, 2014 4:32 pm

Help! I Tried Fmla And Short Term Disability. I Have Health Insurance But My Job Won't Pay Me!?

Postby Scolaighe » Sun Oct 01, 2017 6:24 pm

I've been off work since june awaiting an operation on my knee. My insurance company started to pay then just stopped & now they quit returning my calls. What should I do? Lawyer?
Scolaighe
 
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Joined: Wed Feb 05, 2014 5:14 pm

Help! I Tried Fmla And Short Term Disability. I Have Health Insurance But My Job Won't Pay Me!?

Postby Dermod » Mon Oct 02, 2017 5:08 am

1
Dermod
 
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Joined: Fri Feb 28, 2014 8:42 am

Help! I Tried Fmla And Short Term Disability. I Have Health Insurance But My Job Won't Pay Me!?

Postby Kagan » Mon Oct 02, 2017 7:35 pm

You are entitled to FMLA; whether or not your employer will pay you while you are on it is another issue. That is something that you will have to contact your HR about. Some places will allow you to use your sick leave, while others will allow you to use short term disablity. Others, you won't get paid at all. But, they have to allow you the time off of work, they cannot deny you that, especially with a doctors notification.
Kagan
 
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Joined: Fri Feb 21, 2014 1:54 pm


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