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Applying for LTD
May 10, 2006

I've been in involved in an HIV Vaccine trial for a couple of months and recently found out that I'm HIV+. It is a very recent infection and I am planning to see my doctor in the next week. The clinic I go to for the trial, has already given me the test results but explained to me that these results will not be in any of my permanent medical records since all volunteers are only id'd with a number. When I go to my doctor to discuss the results, I've been told that he will want to do another test that will then be in my record. I work for a small employer and pay for my own health insurance. But now I'm concerned about having supplemental insurance such as LTD. I'm 32, so probably won't have to worry about using it for some time, but still think it's good to have. If I don't get tested throug my doctor right away, and quickly apply for LTD supplemental insurance without disclosing my condition, what are the issues I should be concerned with? I realize that this is like insider trading except that this is related to my health care rather than a huge windfall from a stock sale. I'm struggling with this issue because of ethical concerns, but at the same time looking to ensure that I plan well for any future illness. If I change jobs and go to a large employer I am eligible under their LTD group policy as long as I sign up during the initial enrollment. Are there legal issues I need to worry about as well as the obvious ethical ones?

Response from Ms. Franzoi

In applying for an individual LTD policy, you would have to answer a health questionnaire and you should not lie about your HIV status. Not only is that insurance fraud but if you actually need the benefit, the insurance company could discover that you lied and deny you the coverage, at the very least. However, if you were to become employed in a job that offered a group LTD program, you would be eligible for basic coverage (probably not supplemental, if it is offered) without medical evidence as long as you enroll during the initial enrollment period.

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