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Pre existing condition :(

Amanda S YanisAAmanda S Yanis Posts: 124
edited 06/11/2012 - 8:37 AM in Health Insurance Issues
Looks like my insurance is denying any and all claims due to pre-existing conditions. I knew when we went without insurance for those 2 1/2 months that this would my bacome into play, I just was hoping it wouldn't. So now I'm screwed. I have close to $3000 in dr. bills right now, not including my last ER visit, which was just a mess, and will end up being a pre existing condition too because it wound up being my gallbladder (or so they say). I didn't end up having surgery, but was told to follow up with the surgeon.

Then on top of all that, my dr filled out my paperwork for my Disability Income Insurance, and she said I can return to work on light duty. Which they won't allow, but since she put on the form that I can, I will no longer get that money each month. So it looks like I'm gonna have to get a full-time job, just to pay my bills. I don't know how I'm gonna do that when I have to wear a fentanyl patch and take lortabs round the clock, but I guess I need to just suck it up. I was going to appeal my SSDI, but I figure why bother, when my dr isn't going to back me, and I can't do anything about my back until I get my insurance figured out.

It's just been a crappy week all around.


  • Amanda. You should take a long hard look at your LTD policy because I don't think that they can stop paying you if you are only released for light duty. You must be able to do the same exact job and hours for most policies to consider stopping payment for at least the first 2 years that you collect. Some states have programs to help with bills that are not covered because of the pre existing clause. Check out your states web site and see what you can find. You may want to consult with an experienced ERISA attorney if your LTD tries to stop paying you. Good luck and keep us posted.
  • What I have is an insurance through State Farm that is for if i ever became disabled for longer than 1 mnth that I would receive $500/month for the duration of the disability for up to one year.

    What are these programs you are talking about though?? I've been researching stuff all night, and am about to go to bed. But I did find out that since I went in November 07 and found out about my gallbladder and have doen nothing about it since, They should have to cover that atleast. Thankfully my ER visit was caused by stomach pains, then I was told I would have my appendix taken out the next morning, then they decided no surgery, but it was my gallbladder and a cyst on my ovary. So hopefuly nothing in that bill mentions my back. (but those pain meds they gave me sure helped my back LOL)
  • I am sorry. I thought that you had an employer provided LTD plan. I am not sure about the private plans. They do not fall under the ERISA guidelines and rules. I had my gallbladder out back in 1997. I went misdiagnosed for about 10 years before the surgery and the pain of a gallbladder attack is the worst pain that I had ever felt in my life. Good luck.
  • isnt private i got it through my company which doesnt allow for light duty either. when i had my sugery 2 years ago the doctor did write level 4 light duty clerical work only with breaks and since the company didnt allow it i still got to draw my money. I would definately check into this if your company wont let you work because you cant perform your duties how can they stop your disability payments you paid for these in case this situation ever arose and now they are stopping it? I would definately appeal their decision but thats only my opinion.
  • SpineAZSpineAZ WiscPosts: 1,084
    My Short Term Disability (STD) through my employer was continually approved as I could return to work at light duty with no travel. But my job requires frequent plane travel and at least medium work. I actually just got the call that my LTD has also been approved. I had a 6 week gap between STD and LTD due to the way the policy is structured.
    2 ACDFs, 2 PCDF, 3 LIFs; Rt TKR; Rt thumb fusion ; Lt thumb arthroplasty; Ehlers Danlos 
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