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Long-Term Disability & Group Health Care
Jun 25, 2004

Hi Lynn. Can you help me with Part B of my questions? Thanks.

I need your help please. Im doing as much on-line research as I can, but I still dont feel 100% about it all.

Heres my story in summary: I work in California, with PPO coverage and Long-Term disability for 4 years with the same company. No health problems until this year when I tested positive for HIV on January 6, 2004 during my physical. I have since tested 3 times this year for T-cell count and viral load (I running about 500 and 7,000 respectively). My LAB tests have been conducted with my doctor (PPO), but I am not taking any medication as Im still considered healthy. (keep your fingers crossed).

Heres my concern: Im now actively looking to change jobs, and Im actually in final stages of interviewing with a great company. This new company is a Fortune 500, thousands of employees, great benefits, etc, etc. They are located in Wisconsin, but the job is here in California. Here are my questions:

A.) I know this new company tests new hire employees with a urine & blood test, and a physical, and will ask general health questions, including family health problems. (I do not do any drugs, and Im not taking any meds. Except for HIV, there are no health problems). By reading the forum here, I feel pretty good they do not test for (or ask about) HIV. Is this true? What are they testing for (besides drugs)? What health questions should I be prepared for, or any other insights you can provide? Im very concerned about this "testing".

B.) What can expect in terms of getting new Group Coverage, including Long-Term disability. I have asked this question before, but Im concerned about pre-exisiting coverage. According to HIPPA A preexisting condition exclusion is limited to a physical or mental condition for which medical advice, diagnosis, care, or treatment was recommended or received within the 6 month period ending on the enrollment date in a plan or policy. But, then HIPPA also states, No preexisting condition may be applied to an individual who maintains continuous creditable coverage (without a break of 63 or more days) for 12 months (18 months for a late enrollee). This confuses, and like I said, I want to feel 100% about this before I make any final decisions about changing jobs and possibly loosing coverage.

My questions are: Do you see any problems with getting new group health coverage seamlessly, or would I be denied coverage for HIV? (since I am currently getting tested and seeing a doctor regularly). What about Long-Term disability? Any additional comments or concerns? I am still very concerned about loosing my LTD benefits, and I that could be very crucial if my health turns for the worse.

Attached below is the information you provide me a couple months ago:

*******

Thank you for clarifying your situation. I've thought a lot about your question since responding, and now accept that, as you define your situation, you need to be in an active job search.

Your health insurance plan gives you continuity. Because you are now covered by health insurance, HIPAA assures you continuous coverage if/when you change jobs. That's what the "portability" in the name of the bill means. When you leave your current employer to start a job with a new one (please do not leave before you have that new job!), you will receive a document that proves your coverage and gives you the bridge to walk over to the next employer's coverage, seamlessly, without a waiting period.

Long Term Disability insurance is a different issue. You will be able to get LTD if they offer it and they're an employer of more than 50 people. In the course of an interview, if it's going well, it's normal to ask about the benefit package. They may have a summary document that outlines available benefits. To take advantage of these benefits, you will be in the strongest position if you seek a job with a large employer, at least one who employs more than 50 people. At 50, the rules change. If they offer long term disability, sign up for it at your earliest opportunity. If they offer you a job, mention at that point that you're a careful planner, that you've been covered by long term disability insurance for a while and would like to continue that benefit seamelessly. How could you do that? Many waiting periods for eligibility can be waived if they want you enough.

And if they ask about HIV? They're asking an illegal question. For that, please check the responses on this site about how to handle it when an insurance questionnaire asks you about HIV or asks you to detail your meds. A San Francisco-based employer certainly shouldn't be tripping over THAT one, but you never know.

I wish you well!

Congratulations on taking action in ways that will benefit your health and your happiness in the long term. Bravo! A great job with a strong company and good benefits: you have a lot to celebrate!

I can respond to question A. I'm going to forward my response to Lynn Franzoi so she can respond to B. If you receive a response that is confined to A, please send B again, directly to Lynn Franzoi; that is her expertise.

Pre-employment testing and questionnaire: here goes. Think of it from the employer's point of view so you can fully understand its purpose. On the gross level, they're screening you for illegal street drug use, and they're not trying to spend a fortune on tests they cannot legally use to withdraw the offer. Since you're not on meds for HIV, you have dodged the bullet of Sustiva triggering the marijuana test. If you're on any other medications for any purpose, ask your pharmacist if any of them is likely to trigger a positive response on a pre-employment drug test. If so, ask for the name of a specific alternative test that avoids an erroneous result, and request that specific test so that you and the lab avoid the expense of re-testing. You are unlikely to encounter a problem at that stage unless you actually are doing street drugs, which would be another whole issue! (And your letter says you're not. Good. I've been the supervisor of a user, and I can tell you it's a special form of misery.)

You're right: they're not testing you for HIV. Fortune 500 companies usually have more sense than to test you for something they cannot legally use to withdraw your offer of employment, and to spend money on a test whose results they cannot legally refer to as a reason for not hiring you. Ask for a list of what they ARE testing for, since it's your blood. Read the pre-blood test literature carefully. If they say they're going to screen for HIV (I'd be amazed), I suggest you carefully line out that permission and sign with a phrase like "permission given only with the exception noted above." Obtain and keep a copy of the permission form.

On to the pre-employment questionnaire: think like an employer. Does this employee have any health problem that would prevent him/her from fulfilling all of my expectations on the job? That's the concern. Yes, some employers use it to screen out people they think will cost them a lot, but logically that would eliminate anyone likely to father or mother a child, because a premature birth with complications puts all other conditions into the financial shallows. And that would limit the employment pool substantially, wouldn't it?

Does your HIV impede your ability to perform the job? Given your labs and your own statements about your health, it appears that the answer is no. You are unlikely to encounter a direct question about HIV on the questionnaire. If you do, I encourage you to leave it blank and fill in everything else. (The question is illegal.) If an HR clerk hunts you down and says you need to fill it in, respond with questions: do you really want to be the person who pushes the issue on an illegal question? Does the company really seek to learn the HIV status of all employees? Why? What action have they taken as a result in the past? (You get the idea.)

If you find anything on the pre-employment health questionnaire that would "out" you, explain that you want to talk about the questionnaire with your doc and you'll bring it back on Thursday, or whenever you know you can make contact with your doc. Together, you can strategize an answer that is accurate but high level enough to protect your confidentiality.

In general, remember that your privacy is yours to keep and now is your responsibility to protect. Sometimes you have to fight for it. I hope that so large an employer will not have some of the arcane, nosy questions we've both read about in this forum, and that you'll have a far more comfortable passage through pre-employment than you fear.

On to the insurance expert!

Response from Ms. Franzoi

Since this is a large company, they will have group plans and you should have no problem getting health care, life insurance, long term disability, long term care, etc. as long as you enroll within the time frame afforded new hires - typically 30 days from eligiblity.

With respect to a pre-existing condition period, for the health plan, as long as you have been continuously covered under your current plan for at least 12 months and you do not go more than 63 days without coverage, even if your new employer's plan has a pre-existing condtion clause, it won't apply to you.

With respect to the long term disability policy, it shouldn't be a problem as long as you didn't consult a doctor, take any medications, have any diagnostic services or get any treatment for HIV or any other illness within the 90 days prior to coverage commencing (this is the usual period but you will have to check the LTD plan to see what period it has). Even if you had seen a doctor, received treatment, etc. during that "90-day" period, the LTD coverage would be available for any illness you didn't receive treatment for during that period and for an illness you did receive treatment for, you would have coverage for a disability related to that illness after 12 months of coverage.



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