Would like to get some advise from anyone that has been thru this scenario.
I have LTD that I purchased in 2012.
I was stupid and did not purchase when I started my job in 2011 so this has come up to bite me in the booty.
Because of this you have a year wait time before you become eligible under this policy.
No problems medically for me in 2012 then in 2013 I began showing signs of high liver function so we began looking for why. In August of 2013 I went to my dermatologist to have him look at some red dots coming up on my arms and he asked if I had been checked for autoimmune. I said no but told him about my liver, he suggested to have my PCP run tests. We did this and I came up with a positive ANA so she made an appointment with a Rheumy for me as she could not say whether it was lupus or not.
By the time I was able to get into a Rheumy I was now in my "eligible" time frame for LTD.
That doctor saw me and wrote that although I had a positive ANA he did not believe I had lupus but rather it was due to osteoarthritis.
Because of this my doctor and I just continued monitoring my labs, etc., until Nov. 2014 when they became so high that she sent me to a new doctor and he gave me the actual diagnosis of SLE.
I have been on STD since May as I had been calling in sick and/or coming in late to work way too much and I believe they are trying to find a way to get rid of me.
I applied for LTD a few weeks ago and yesterday they called stating it was denied with the reasoning that I was showing widespread pain prior to my eligibility date. There was not a diagnosis of Lupus/SLE before my eligibility date so I am wondering if I have a good case to fight this.
I had been speaking with a disability attorney already for SSDI but he doesn't really do LTD (not enough money to be made) so he suggested I just write a letter of appeal stating the fact that widespread pain is too general, etc.
I really need the LTD in order to manage the wait time for SSDI.
Would you drop the attorney I have and get a different one for LTD, try to appeal it on your own with the new letter from my doctor that states prior to the eligibility time frame the doctor was trying to determine a diagnosis but it can be assumed no clear cut medical evidence was found until 2014
OR my financial advisors do help with this but I'm not sure how much legal advise they have especially with ERISA(?).
I need help!