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  1. #1
    Join Date
    Mar 2008
    Posts
    10

    Question When Your Employer And Doctor Agree, But Not Your Disabilty Insurance

    My dr had put me on FMLA for a month, then after that it was indefinate. He stated that I was unable to work any longer. Our HR dept sent the forms to me & I filled them out sent them in & after 6 denials I contacted an attorney on line to find out that it was kind of a bait & switch deal. I just wanted to know how can several dr.s who have treated me find that I am unable to work, the government office terminated me (though they said I resigned) because of my health, but the disability ins co. that we pay for denys any claims? Do I have legal recourse to the ins co & the county office I was employed with? NW FL

  2. #2
    Join Date
    Jul 2005
    Location
    Texas
    Posts
    254

    Default Re: When Your Employer & Dr Agrees But Not Disabilty Ins.

    fmla and disability insurance have nothing to do with each other. FMLA is a leave and std is income replacement. How long had you been out? FMLA only covers you for 12 weeks and then you are no longer protected under the law.

  3. #3
    Join Date
    Mar 2008
    Posts
    10

    Default Re: When Your Employer & Dr Agrees But Not Disabilty Ins.

    I have not worked in over 18 mt. I was told by the drs. & my employer that I needed to go on long term disability. Unfortunately the ins co did not see it that way. I worked for local government ie the county I live in. I worked 4-10hr days. In short I was the complaint dept for our county, among other things. I developed severe migraines (severe enough to be hospitalized), chronic daily headaches, severe fibromyalgia, ect. This past week while at the pain mgt clinic I ran into a fellow co-worker who informed me that one of my co-workers had become disabled due to the mold ect in the office next to me had caused severe neurological damage. Our offices were divided by a dr the ceiling was a drop ceiling that connect to his as well as the fact that his "storage room" was above my desk, constantly dropping ceiling dust on my desk, me, my pc, ect. Several times we had to leave our offices because they had failed to use exhause fans (their dept was vehicle repairs-from cars to ambulances to doziers, or there was a fuel spill. Knowing that the fumes would cause a migraine they would send me home for a few hours while they cleared the fumes. There were times when I would have to buzz him or bang on the wall & tell them to turn on the fans because the fumes were killing me. Since the drs can only attribute the occipitial lobe migraines as well as the severe fibro to stress it makes me wonder if perhaps what has happened to him could have also caused the neurological problems I have now. We have been fighting with the ins co trying to understand how specialist in fields of neurology, rheumotology, internist, ect, can all reach the conclusion that working consistantly is impossible for me. But a physician I have never met decided that I could work without too many problems. When I asked who would hire someone who cannot be consistant in attendance, they told me that was not there problem. My employer felt sure that the ins co would step up to the plate and terminated me because my health problems prevented consistant attendance as well as ability to concentrate due to all the meds the drs had put me on. So now I'm confused. Sorry so long.

  4. #4
    Join Date
    Jun 2006
    Location
    Massachusetts
    Posts
    24,521

    Default Re: When Your Employer & Dr Agrees But Not Disabilty Ins.

    What state are you in? It makes a difference.

  5. #5
    Join Date
    Feb 2008
    Posts
    578

    Default Re: When Your Employer & Dr Agrees But Not Disabilty Ins.

    Quote Quoting sheilannwfl
    View Post
    I have not worked in over 18 mt. ... I developed severe migraines (severe enough to be hospitalized), chronic daily headaches, severe fibromyalgia, ect. This past week while at the pain mgt clinic I ran into a fellow co-worker who informed me that one of my co-workers had become disabled due to the mold ect in the office next to me had caused severe neurological damage. Our offices were divided by a dr the ceiling was a drop ceiling that connect to his as well as the fact that his "storage room" was above my desk, constantly dropping ceiling dust on my desk, me, my pc, ect.
    Have you considered petitioning for worker's compensation? You have 2 years from the date of injury or when you reasonably would have known that the injury was work related. Yours is a very unusual situation, but given your circumstances there is the possibility that the proximate cause or aggravation of your illness is work related.

    I'm not an attorney nor am I from FL, but in most states worker's comp attorneys work on a contingency basis at least during the initial claims and hearing stage, and a quick seach for florida workers compensation attorneys turned up many that advertised free consultation and contingency basis.

    I'm not saying that you will prevail by going this route, but the 2 year statute of limitations is still open, and there is some indication that your condition may be work related. WC isn't going to make you whole again, but if it can compensate you even partially for your lost income and pay your medical bills it's a lot better than nothing.

    http://www.flsenate.gov/Statutes/ind...0/titl0440.htm

  6. #6
    Join Date
    Mar 2008
    Posts
    10

    Default Re: When Your Employer And Doctor Agree, But Not Your Disabilty Insurance

    Thank you to all who interjected their thoughts & advice to this conundrum. I truly appreciated all information.

  7. #7
    Join Date
    Feb 2008
    Posts
    578

    Default Re: When Your Employer & Dr Agrees But Not Disabilty Ins.

    You haven't mentioned whether or not you are represented by an attorney. There just isn't any way you're realistically going to prevail in this case on your own.

    Not being trite here, but you needed a lawyer after the first denial. Get one now.

  8. #8
    Join Date
    Mar 2008
    Posts
    10

    Default Re: When Your Employer & Dr Agrees But Not Disabilty Ins.

    I am in northwest florida. And thank you for your advise about the attorney. I thought I had an attorney that worked on a conten. basis but 3 months after I had already provided the firm with all documention from the ins co as well as all the physician at my financial cost to facilitate the process after the final denial, to then be told it would require a start cost of 4K and they would not persue in misconduct should the employer be at some fault as that would require a federal trial. I told them I would have to discuss this with my husband & did not hear from them again. When I phoned the contact individual about this & requested my file back, she apologized & emailed the files, unable to find the hard copies at this time. I had hoped that if there was just cause for the case w/employer that I would need an attorney outside of my district as we really do have the true "southern good ol'boys syndrome" here as I'm sure other areas of our country does. I did not think I would need one prior to this as I thought it the normal process of deny, deny, & either agree or deny again. I cannot tell you how mentally, physically & financially this has been. I just wanted to know if there is an honest opinion of whether or not I have a case & if I do, aren't there attornies(?) that do this on a conten. basis? Again thank all of those who view this problem & offer advice as I am completely lost.

  9. #9
    Join Date
    Mar 2008
    Posts
    10

    Default Re: When Your Employer And Doctor Agree, But Not Your Disabilty Insurance

    I'm not sure if this matters to any of the above but when my FMLA time was running out HR called an appt on the 12th of Dec to tell me that I would be layed off, that I had been replaced in my position though I had been told by my supervisor that they would be using temp service as with others who had had a health issue. When told that not only was I replaced, my supervisor not allowed to speak to the ins co, I was being laid off-no health insurance. Needless to say I was extremely upset & my husband called our county commissioner to protest, I was immediately put back on lwop w/my insurance. I know they didn't have to do that but it was the right thing to do. When I asked what to do after the final denial & 18 months of being unable to work and finances being what they were, I was told by HR that that was why they placed me as laid off so that I could at least get unemployment. I was surprised, unemployment was for those able to work & unable to find work not to mention would be required to accept work if offered. If I could work, I would have been at my job that I loved, working with people I considered to be part of that extended family that you have to see Then I was terminated but noticed in the paperwork of my file from my employer there was a statement saying I resigned yet I have a termination letter stating that due to my health I would no longer be employed there. Like I said not sure if this is relevant.

  10. #10
    Join Date
    Feb 2008
    Posts
    578

    Default Re: When Your Employer And Doctor Agree, But Not Your Disabilty Insurance

    It's all relevant. But it's just too complicated to address on an internet board. There are issues in play that could result in this either being seen as a personal injury case or other tort or even a worker's comp claim.

    Maybe some others here can help you further but your situation is very complex, and the best advice I can personally give you is the good old "get a lawyer" line. It's definitely not a DIY situation even if you get many of your questions answered. Sorry I can't be of more help.

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