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Disability Denial Tennessee

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  • Disability Denial Tennessee

    Hello, I have a question about being placed on bedrest but being denied by disability. I was placed on bedrest due to having 8 fibriod tumors while I was pregnant, that were causing me severe pain. Originally I was approved for my first episode. I then started feeling better and asked my employer if I could work part-time from home. After about 3weeks my symptoms returned and the pain was more violent than before. This time I was DENIED. I appealed and still lost. Can someone tell me if I should seek a lawyer or let it go. I was out from 7/02/2010-09/22/2010. I delivered my baby on 9/29/2010, so they paid me regular maturnity leave from 9/23/2010-11/23/2010. So I was denied 9wks or 10 wks of pay before delivering.

  • #2
    What was the basis of the denial?
    The above answer, whatever it is, assumes that no legally binding and enforceable contract or CBA says otherwise. If it does, then the terms of the contract or CBA apply.

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    • #3
      They denied it stating the baby was not in threat. They could care less if I was in pain basically. They felt I could still work since I do computer work. My doctor ordered bedrest which was to lay on my sides for the majority of the day, and only get up for meals and restroom to control the pain and alleviate the pressure from my uterus. I previously had spotted, but the bedrest stopped the spotting. Since there was no longer any spotting, they felt I could continue to work. There was no way I could work with all the pain I was in, and sitting up 4-6hrs straight a day, would cause me to relapse with pain and possibly resume the spotting. There was no way I was going to risk that. I have 180 days to appeal again, but think I should seek a lawyer, but most attorneys only deal with SSI disability.

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      • #4
        Originally posted by cbg View Post
        What was the basis of the denial?
        I am new to this forum, here's my reply:They denied it stating the baby was not in threat. They could care less if I was in pain basically. They felt I could still work since I do computer work. My doctor ordered bedrest which was to lay on my sides for the majority of the day, and only get up for meals and restroom to control the pain and alleviate the pressure from my uterus. I previously had spotted, but the bedrest stopped the spotting. Since there was no longer any spotting, they felt I could continue to work. There was no way I could work with all the pain I was in, and sitting up 4-6hrs straight a day, would cause me to relapse with pain and possibly resume the spotting. There was no way I was going to risk that. I have 180 days to appeal again, but think I should seek a lawyer, but most attorneys only deal with SSI disability.

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        • #5
          Certainly contact a lawyer if you wish; however, if you do not meet the definition of disabled under the terms of the policy (which is not necessarily the definition your doctor uses), they are not obligated to pay.
          The above answer, whatever it is, assumes that no legally binding and enforceable contract or CBA says otherwise. If it does, then the terms of the contract or CBA apply.

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          • #6
            Oh you have helped me so much, that is what I needed to know, so basically I need to find out what their definition of Disable is in order to appeal again. I didn't realize that, I just thought I met that definition since my doctor was treating my pain with bedrest. Thanks so much for your reply.

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            • #7
              You need to ask for a copy of the Summary Plan Description (SPD) which should tell you what you need to know. They are required by law to give you one upon request (within a reasonable length of time; they don't necessarily have them to hand). They are obligated to abide by their definitions - as indicated, they are not obligated to use someone else's.

              Good luck.
              The above answer, whatever it is, assumes that no legally binding and enforceable contract or CBA says otherwise. If it does, then the terms of the contract or CBA apply.

              Comment


              • #8
                Originally posted by cbg View Post
                You need to ask for a copy of the Summary Plan Description (SPD) which should tell you what you need to know. They are required by law to give you one upon request (within a reasonable length of time; they don't necessarily have them to hand). They are obligated to abide by their definitions - as indicated, they are not obligated to use someone else's.

                Good luck.
                Thanks again, I am requesting this now. I am so glad I found this site. Maybe I can do it without a lawyer.

                Comment

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