Posted 10/22/2018 6:22 AM (GMT -7)
Thanks for the input. I do have the summary plan description and have read it extensively. Yes, my company plan would pay up until i am 65, assuming it continues to get approved by the LTD company. I am doing things (have been for 3-4 months now) like keeping a Daily diary of joint pains, number of BM, Fatique and BP levels. The interesting thing is the fact that both SSD and the company policy only want to know what has happened in the last year. They ignore all the other issues that compound the problem. The attorney said that this info comes out in the trial period in front of the judge. And usually is how most cases get approved. He did say that a pure crohn’s approval is one of the most difficult to get approval on its own since very few of us are the same. He said the SSD blue book is so tightly written tha few qualify. But having other long ter medical issues including multiple surgeries is extremely important during the appeals phase. He said, the paperwork will be filed, and it will be declined within 6 months ( he said he see about 90% decline on IBD) then they file an desk review, which reviews the initial claim for any errors int he decision and such, and that will be declined usually in 4- 6 weeks. Then we file for a hearing with a judge. In NC the wait period is 20 months for a hearing. He told me about a case he has with a young ladie who has ulcerated colitis. He is filing his third application for her. She has had 3 surgeries for UC and now weighs 85 lbs. she still did not meet the specific blue book criteria. During the two other trials, each of the judges remarks were something like, she can talk on the phone, so she could do some work. He said the judges do not understand urgency issues we dea with the fatigue and such. He wanted me to know how difficult it was.
He also said he understood if i needed my own legal attorney to work with him.
surgeries: 2 resections at terminal ilium, open heart surgery, infected lymphocele surgically removed, crainotomy to remove benign tumor; adominal hernia,
Failed: remicade, cimzia, methotrexate, humire, 6MP, entyvio
medications: stelara , verapamil , quinipril, labetalol, clorithidone, atorvastatin, alluporinol, elliquis, Xanax ER