Samantha:
My wife is on long-term disability from her employer due to health issues not related to an acoustic neuroma that I would prefer not to go into here. However, I
can give you an outline of the procedure, although I suspect that every company has a slightly different policy.
My wife, a supervisor in a national insurance company and an employee for over 10 years, first went on short-term disability for three months, then, when she couldn't return to work, she applied for long-term disability benefits. That required not only her doctor's statement explaining her medical condition but an examination by a doctor designated by the company to confirm (or deny) her condition. He confirmed it. At that point the company began paying her benefits (70% of her former salary) but required her to apply for government Social Security disability benefits because, as they explained it, this is an 'entitlement'. We interpreted this as meaning:
why should we (the company) pay you money when the government (other people's tax money)
will pay it? She went through the Social Security bureaucratic labyrinth as instructed, including numerous examinations by various SS-designated doctors . Many trees died supplying the paper for all the documents generated by my wife's employer-dictated quest to secure disability benefits from her government. Finally, growing frustrated, she engaged an attorney that specialized in obtaining disability benefits from the recalcitrant Social Security Administration for his frenzied clients. He succeeded and after two years, my wife was 'awarded' monthly benefits from the Social Security administration. Heartfelt cries of
'Hallelujah' were heard in our home that day. The neighbors just thought we were crazy. We didn't care.
At that point, her company began deducting the amount Social Security now paid her (monthly) from the amount the company's coverage paid her (70% of her former salary). So, she receives two checks every month (Direct Deposit, actually). One from Social Security and one from her company. Combined, they amount to 70% of her former salary, as stipulated in her agreement with her employer (she is technically still considered an employee). Oh, and when she finally received the money she should have been getting from Social Security for the past 2 years in a lump sum, the company demanded she fork over a proportionate amount to them based on the fact that they had been paying her the full 70% for the past 2 years, which they now considered an 'overpayment' because she qualified for Social Security disability benefits. Are you still with me? In effect, the Social Security administration pays about 50% of the amount the company promised to pay her and the company pays the rest. She ends up with the correct amount each month but from 2 checks and after a lot of hassle. Certainly more than was necessary.
My wife is required to be examined by a doctor the company designates, once per calendar year. The company pays his (or her) fee. My wife's PCP also has to submit a form every year attesting that she remains disabled. We have to pay his fee (about $75.) If
either doctor ever claims that she is no longer disabled, she would lose her company benefits. To my knowledge, the Social Security administration does not require her to submit forms or undergo an annual examination. I could be wrong on that, but I doubt it.
The takeaway from all this is that a company can be rather difficult about paying long-term disability benefits and if they require you to apply for Social Security benefits too, it can be a long slog. However, with determination and tenacity, you can prevail, as my intrepid wife did. I hope this somewhat lengthy account of one person's experience is helpful to you- and I wish you well in your attempt to secure what is due you from both your employer and your government.
Jim
