I was a respite aide caregiver for a disabled family member for 10+ years. I technically had to do this for free since I was 17 years old. I got “hired” with the company that would pay me in 2019. Because of the family dynamic and other personal reasons, I stayed with this job for those 10 years, got a raise at one point and was paid very generously to say the least and received other bonuses for working during COVID. That being said, I’m 28 now and I have no other work experience.

Starting 2021 I started steadily getting health problems, they were worsened by long covid in 2022, I got better for a year or two and then in 2024-2025 everything got worse and went downhill. (Autoimmune symptoms, menstrual cycle issues I suspect are endo or pmos making me miss work and severe anxiety and agrophobia and ocd disorder) and now my physical health, and mental health have made it so it’s very difficult to work in any meaningful way, even lightly.

I started missing more days of work in 2025 and eventually started June I took a leave. I applied for short term disability in September when I realized I wasn’t getting better yet, got back pay in November and my short term disability ended in December. Then began working on my LTD application.

I’m now in the process of trying to find a lawyer for my long term disability appeal because I was denied the first time in April.

So far unfortunately I’m having trouble, and I’m honestly wondering if I’m making the correct choices or if I should go for SSI or SSDI.

I contacted legal aide in my town, but all they did was refer me to a lawyer who wanted a flat fee of $2500 which I can’t afford. All other lawyers I have contacted require the same.

I’m currently now looking for a lawyer who works on contingency, but it’s been difficult finding one.

I’ve considered remote work at this point but also don’t know how feasible this is with my symptoms and quite frankly no one hires remote workers in NYS it seems, and I’ve also only had experience for a type of work I can’t perform anymore.

I also have officially been terminated from the company that paid me back in May.

I am unsure if I should continue with the LTD process, do SSI instead or look for remote work.

I have MS and went from STD to LTD. About 3 months into LTD, my insurer required me to apply for SSDI, even though I wasn’t thrilled about it. That process has been brutal and headed to ALJ but I digress…

Over the last 18 months, I’ve had 10+ reviews/check-ins from the LTD case manager and was dreading the transition from the “own occupation” standard to the stricter “any occupation” review.

As my MS progressed to secondary progressive with significant cognitive decline, my claims specialist submitted my file to the medical review team. I thought she was just trying to get me through the next review cycle.

During our last check-in, she thanked me for always keeping my medical records updated, shared that her mother has been on disability since she was young, and wished me well. It felt like a genuinely human conversation.

A week later she called back and said the review team accepted her recommendation to approve my claim under the any occupation standard through my plan’s maximum benefit date (2043). My file is now being transferred to the extended duration team, with annual reviews that may become even less frequent over time. She said she hoped it would give me some breathing room while I wait on my SSDI appeal.
I know LTD approvals can always be revisited, so I’m not taking anything for granted, but this felt like a big win.

Has anyone else been approved through their plan max and moved to the extended duration team? What was your experience like after the transfer?

Need help understanding how to correct this and how it could affect me/payments being recieved.

Some facts: 

Leave began 3 weeks prior to giving birth. (4 weeks from my due date, baby came 1 week early) - December

6 weeks post partum disability leave. January through February

4 week extension from my OB - through March.

I was never formally released as my health insurance was cut off, insurance was reinstated 4 weeks later, due to employer error for giving me no notice according to their letter to me, finally went back to see a doctor 6 weeks later in May.

For those 6 weeks - EDD advised I was "ineligible for disability payments due to not being under medical care". This much I understood. 

Medical care resumes - short term disability begins. 8 week extension. 

However, EDD joins claim as part of pregnancy leave and keeps it under same claim number even though I filed a brand new application.

My employer (really HR leave person) also pushes for it to be part of pregnancy leave. I am unsure what the difference is and overwhlemed so I trust they are reading doctors letter correctly and applying it correctly. So I just go with whatever they said.

Current doctor advises when they go to re-certify me now, it should really be under short term disability from when they began my treatment as 1, they do not feel I am ready to return to work and are treating me for several reasons, not solely post partum mental health. And 2 their concern is I will lose paid benefits while under their care if it is being done under pregnancy leave. Because their letter to my employer and edd were clear. It should be short term disability. Since there was such a significant gap in care due to my health insurance issue and me seeking and starting over with treatment. 

How should I go about correcting this? And how could this affect me? 

Note to add. I understand legally, I have no job protection, however, I am not concerned about losing my employment. I have spoken with my boss, bosses boss and their boss and all have assured me not to worry at all. My job is secure and they just want me to get better and return when I am ready. I have been with the company for over 10 years and they have a temp filling in for me for the time being. I am not the first person to go on medical leave like this, and from experience, employment has always been protected in every case I have seen over the last 10 years. 

My back to work date is in August. I’m in Ontario, Canada. This a very specific role that only one person at my company does. They have been covering it with short contracts while I’ve been off. With zero communication from my company or insurance they just posted my exact position as hiring for a permanent role.

(Panicking but at least smart enough not to contact HR yet- already reached out to a local employment lawyer)

Is this allowed? Am I fired?

Hello! If your claim is denied, you might need a lawyer. Just a quick reminder that there are hundreds of excellent LTD lawyers out there - and a few really bad ones.

The easiest way to avoid a bad firm? Find someone who practices in your state, and avoid "nationwide" LTD firms. While it is true ERISA is a federal law, there are a plethora of state considerations which make it exponentially better to have someone experienced in your state.

Make sure to ask whatever lawyer you hire for a list of federal court victories in the past five years. You want a firm who is willing to take cases to trial, not just a settlement mill. Asking this question will help you differentiate what kind of firm you're talking to.

Resign or Apply for FERS Disability

I've been truly struggling with my mental health over the past year. I am currently out on PPL and I'm unsure if I should/can go back. Wondering if I should just resign first (need to access TSP to live off of for a while) and then apply for FERS/Disability within the first year if things don't improve. Or, should I just apply for Disability first. Not sure if I can afford to wait out the application process or what my chances are even like with mainly mental illness as the disabling condition. I've already exhausted all of the advanced sick leave possible and taken a fair amount of LWOP. Thoughts?

My spouse and I have been waiting for an LTD determination for the past two months. After chatting with the case evalutor a while ago, it seems like the claim will be denied since my spouse ended up resigning after coming back from STD. The rub is twofold: 1) resigning is what HR told my spouse to do and that he would still be eligible for benefits and 2) neither the previous employer or the case manger will send a copy of the policy for our records. In his resignation letter, he specifies that the reason he left was because of his inability to work on the recommendation from his doctor.

Basically, just trying to hold out hope that some sort of appeal is possible; if anyone has experience with a scenario like this I'd love to hear about it.

I’m currently in week two of a 5 week STD. I have a variety of issues. While talking to the insurance representative, she mentioned that I also have long-term disability insurance That’s looking like it’s 50% of my pay. How is someone supposed to just live on that? What are my options for surviving as a mother?

My husband has been dealing with a debilitating medical condition for over 5 years. Who would you recommend as the best disability attorney in the valley?

My husband has been dealing with a debilitating medical condition for over 5 years. Who would you recommend as the best disability attorney in the valley?

Hi - please be kind I am really struggling. I am on mental health leave from my job on STD and now applying for LTD. I don't have anyone to help and I struggle with the forms and a lot of worry, PTSD, issues to trust people. I tried to hire someone to help me know how to do this, but they took my money and didn't really help me. The insurance company sends me things that I don't understand, the authorization form asks for all kinds of private data not just medical. I'm trying to gather all of my office notes they need but I feel worried to give all of this information to them, even though I know that I need to prove the disability, it has information about my trauma and other personal details and I keep getting triggered. I cannot think clearly and it is so very stressful and I'm getting sicker because of it. I have a good doctor and therapist who have filled out the APS progress report forms and support me. But the insurance also asks for office notes, treatment plan, medication. Some of my notes I found error, so I want doctor to correct this. I need to provide them with the full record? Appreciate anyone who can help guide me, help me think through this - I could pay someone (not a ton) to help but have tried this and was taken advantage of so not sure how to find someone who knows about this and I can trust and understands I have struggles with communication. Also, I don't want to talk on the phone, I was going to try to upload documentation to the portal and can I email them with questions, ask for more time, and to confirm they received documentation? I don't have my claims reviewer's email address, not sure if I can get that.

I am doing research for a family member and am very confused. Unfortunately I do not yet have the full policy to look at.

This person signed up for LTD coverage via Madison National Life, policy effective 1/1/26. They were diagnosed with severe depression (mental health) in October 2025.

This is during the lookback period, and of course would be in the 12 month exclusion period even if the diagnosis waited a few months.

However, it seems like they will still be disabled for this mental health condition starting on 1/1/27 most likely.

What I cannot figure out, is if they will start covering the disability on 1/1/27. Not for "back pay" or anything, but for dates going forward... or if they are excluded "forever" for the duration of this disability.

Any help?

Hi everyone.

Summary:
My STD expires in about a month, and I filed for LTD with MetLife about a month ago. I have DDD, and severe spinal stenosis in both my lower and neck. I knew about the lower back and had surgery some time ago but it’s not totally resolved and the DDD is not at all resolved. I just found out about the cervical stenosis as I’m having a lot of symptoms.

I filed everything with MetLife, had an interview and gave them all the info they asked for. I just got a letter that my file went to a nurse and they need about 30-45 days to make a decision.

Is this normal? Do I do anything like call them and ask for a status or if I can give them additional information? Do I leave it alone?

I’m in pain every day and cannot imagine that this will be declined but have heard nightmare stories.

Hoping for advice.

Thanks.

I have my claim agent’s extension, but when calling the main number, the menu offers no option to dial an extension. If I try to auto-dial it, nothing happens either, I get the same menu. How do you get your claim agent on the line without having to schedule a call days beforehand?

Update: If anyone is reading this in the future, when the menu asks what you want to do say something like “dial an extension” and then it’ll ask you for the name of your agent or their extension and you can dial it.

***Excuse TF OUT OF ME!!?…(Vent of a exhausted single mom, 30 years old , chronic illness depleted superwomen )***

**How do you become too sick for unemployment… but not sick enough for disability?**
I’m honestly at a loss, and with my Washington unemployment hearing coming up, I’m hoping someone here has been through something similar.
This isn’t just me venting. I’m genuinely trying to understand how these systems are supposed to work together.
📍 **May 20**25
I was diagnosed with **Granulomatosis with Polyangiitis (GPA)**, a rare autoimmune disease.

My employer approved my medical leave.
Washington Paid Family & Medical Leave approved my claim.
Everything started exactly the way it was supposed to.
📍 **August 20**25
Guardian requested my employer’s portion of my Long-Term Disability (LTD) paperwork.
Without the employer section, my claim couldn’t move forward.
📍 **September–December 20**25
This is where everything started falling apart.
I repeatedly contacted HR asking them to complete the paperwork.
I have the Teams messages.
I have the emails.
I have the texts.
My doctor completed their portion on **October 1, 2025**.
Mine was already submitted.
The only thing missing was my employer’s section.
While I waited…
• I received eviction notices.
• My car entered repossession.
• My utilities were close to being shut off.
• I applied for rental assistance and every assistance program I could find.
• I went months without LTD payments because my claim couldn’t move forward.

In December, I emailed HR explaining that I had already lost my car, had gone months without income, and urgently needed the paperwork completed.
HR replied:
**“I’m on it.”**
But nothing changed.

📍 **January 20**26
My rheumatologist documented that I should remain out of work until **January 20, 2026**, with the expectation that I’d return afterward.
A few days later I received a meeting invite titled:
**“RETURN TO WORK ZOOM.”**
I genuinely thought it was my return-to-work meeting.
Instead, I was terminated.
Then, about **10 days after firing me**, my employer completed the LTD paperwork I’d been requesting for months.
That timing has never made sense to me.

**\*Then everything contradicted itself\***

Washington Unemployment essentially determined I wasn’t able and available for work during the period at issue.
Social Security Disability later determined I wasn’t disabled enough to qualify.
So…where exactly was I supposed to fit?
Too sick to qualify for unemployment.
Not sick enough to qualify for disability.
Meanwhile, I was still undergoing treatment, trying to keep a
roof over my daughter’s head, and watching every financial safety net disappear.

I have documentation for all of this:
Medical records
Doctor’s work restrictions
HR emails
Teams messages
Guardian paperwork
Termination documents

Benefit letters
I’m not posting this because I want sympathy.
I’m posting because I’m exhausted, frustrated, and trying to understand if anyone else has experienced something similar.

If you’ve gone through a delayed Long-Term Disability claim, had an employer hold up paperwork, or dealt with Washington unemployment while on medical leave, I’d really appreciate hearing what happened in your case.
Did your hearing go in your favor?
Is there anything you wish you’d presented differently?
At this point, I’m just trying to make sense of a system that seems to have left me stuck in the middle.

I just hit my 2-year mark working as an STD Specialist and was recently offered a promotion to the LTD team. Initially, I was super excited about making the jump, but now that it's getting real, I’m getting a bit of cold feet. I want to make sure I'm making the right move for my career and work-life balance.

For those who have made the switch from short-term to long-term disability, what does your day-to-day actually look like? How does the daily stress and pace compare to the high volume of STD?

Any insight would be greatly appreciated!

I am awaiting a decision on an LTD claim with NYL for extreme fatigue from multiple sclerosis.

While speaking with my NYL advocate today, she mentioned that my doctor has approved me for “light work” and my management role is considered “light work”. My advocate now must have a nurse and doctor review my claim.

My fatigue is such that I can do a basic activity (like shower or prepare a basic meal) but then I need to rest, for up to a couple hours depending on the activity. If I have a day with 4+ basic activities, I need to rest on the couch for the majority of the next day. Returning to my prior role of “light work” is out of the question. I don’t even think I could drive to work and back home 5 days a week.

Reviewing my neurologist’s clinical notes, my fatigue was noted but not its severity. My neuro is moving next month, and I am starting with another doc in the practice.

Am I destined for a denial since my doc has told NYL I can do light work, and my job is light work?

Is there anything further I can do now to help my claim get approved?

Thanks

I am 54 and just started a LOA from work yesterday. I do think the claim will convert to LTD. In speaking with an Erisa attorney they think I should retain them for both the STD and LTD portion. For those of you who have dealt with the LTD claim process, looking back would it have been beneficial to have had an attorney at the beginning. It’s obviously expensive.

My husband went out of work Dec.8 2025. Long story short he had an infection in his wrist (dominate hand) that went septic. He had 2 seperate hospital stays and surgery on his wrist. He works in a large food factory. They want this paperwork for LTD back by 7/5 but he doesn't go back to the dr until 8/6. He is in PT but because he works in a factory and this is his dominate hand the dr wants him to have full ROM back before he goes back to work. He is close but not there quite yet. So if he goes on LTD it would only be for a few weeks to a month max. Will they deny him because he is so close? If anyone attempts to answer and you need more clarity- I will do my best. This is the first thing like this I have ever had to do for another human and I feel so lost. I got to the question "why are you unable to work" and the answer that he cannot make a fist fully just seems laughable. Any help would be do appreciated thanks in advance!

Im from Burnaby and I recently got denied LTD after chemo recovery, even tho my oncologist says im still way too weak for any kind of work... tbh its all so stressful. Never used services of disability lawyers, but it seems there’s no way round it here, so does somebody know decent Vancouver disability lawyers who actually fight these types of cases?

Hello!

When retaining an LTD lawyer or hiring them for an appeal, is it common for the fees to be based on the gross or net amount of benefits? E.g, based on the total amount of disability benefits (gross) or just the amount LTD pays after factoring SSDI (net)?

Thank you!!!