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disability insurance
Oct 29, 2002

I hope you can answer a couple questions, thank you. My partner and I are both HIV+ and mid 40's. First about him. He has approached his company about going on LTD and tells me they've approved him and all he needs is a doc's note. He hasn't been to his doc in 6mos-1yr and isn't taking his meds so his numbers will be low. I think he just wants to stop working.

I'm scared he's going to mess himself up. He's been with his company 12 years and they are aware of his alcholism and he's taken more days off than he has. He wants to get out before he's fired so he can keep his insurance. What are the chances that someone who would respond to meds, but isn't taking them in the situation I've described above would be denied LTD. Is it his company, his doctor or his LTD insurance carrier that makes the final determination? I want to try and get him the right information before it's too late and he loses his job and his insurance and has nothing because he's not truly disabled.

Now, my situation...I was laid off as a travel agent after 9-11 and have just now been hired by another company although just a few days a week. If a permanent position opens up will my part time employment disqualify me from LTD based on pre-existing as I switch to full time or should I have them end the part time position and rehire me as a new hire for the full time position?

Finally, regarding disability. It seems to me it's like porno..I don't know how to define it but I know it when I see it. If people in wheel chairs who blow through straws to move a cursor fight for the right to work, what makes us disabled because we are tired at the end of a work day. I know we both have 2 terminal illnesses that create fatigue, but my upbringing makes me want to fight and stay in there...his seems to make him want to quit. I'd like to rationalize in my head that my extreme fatigue were enough to go on disability but I would only have Social Security. Would Social Security recognize fatigue as a disability (I also have documented nueropathy in my hands for 10 years now that just gets worse) but I can still type, as you can see.

We're both seeing the same doctor next week regarding this so I'd really appreciate an answer to all these questions before we go in.

thanks

Response from Ms. Franzoi

The LTD insurance carrier will make the determination whether or not your partner qualifies for long term disability benefits. This will be based on his medical records, his doctor's statements and if the insurance carrier requests, a medical exam by a doctor of their choice.

If you were to be hired in a full time positioin eligible for benefits and you enroll during the initial eligibility period which is usually 30 days, you should be able to get the coverages regardless of your health staus. However, there might be pre-existing condition exclusion periods under the medical and LTD plans. This means that medical claims for HIV-related illnesses would not be covered during that pre-existing condition period (which cannot exceed 12 months and must recognioze prior periods of medical coverage unless you have a break in coverage of greater than 63 days). For disability coverage, if you become disabled due to an HIV-related illness during the pre-existing exclusion period, you would not qualify for LTD benefits.

You should discuss with your docotr whether or not you would qualify for Social Security disability benefits. He should be able to answer this based on your current status. However, if you apply for Social Security benefits and are denied, you can appeal.



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