Appealing A Disability Rejection
Holly was recently kicked off her private disability plan. After a year, she won back coverage. In this series, she walks us through the various steps she took and what it was like to navigate this experience.
After receiving a notice from my private disability insurer that I had lost coverage, I hired a lawyer to represent me in my appeal. That lawyer, who specialized in migraine claims, told me to prepare for a difficult year ahead.
What did I prepare for in the year ahead?
I was told that the appeal would be comprehensive and time-consuming to prepare. My lawyer stressed that the process would be emotionally difficult due to the required evaluations, gathering of support letters, and the long wait all while being financially stressed.
Which evaluations would strengthen my appeal?
Outside of the time-consuming process of gathering existing medical and other records related to my case, I was encouraged to pursue additional evaluations to strengthen my case. To strengthen a disability case (either during the initial application or appeal), it can help to get a cognitive neuropsychology evaluation (CNE) and/or a functional capacity evaluation (FCE). Both of these examinations are lengthy (between 4 and 8 hours each) and are costly (between $300 and $1200) and often not covered by insurance. It can be especially difficult to cover these expenses when financially strained due to loss of coverage. The CNE tests for cognitive decline through a long series of memory, auditory, visual, and speech tests. The FCE, conducted by a physical therapist, tests for physical capabilities through a series of exams involving repetitive movement, lifting, coordination, etc.
How would letters of support help my case?
My lawyer asked that I gather as many letters of support as possible. Asking all of the people in my life to write letters outlining my challenges with migraine was a hard experience in itself. Whether it be family members, friends, neighbors, or previous coworkers it can feel embarrassing and humiliating to ask people to outline your difficulties with migraine.
These letters were heartbreaking to read. I hated asking loved ones for these letters as I already ask so much of them. Reading my grown child’s perspective of how migraine impacted our world was the hardest. It was painful seeing (in every letter) the number of ways I’ve missed important events, left gatherings early- and asked favors of everyone in my life to assist me with transportation, errands, or dog walking. It left me feeling sad about my migraine-related shortcomings; grateful for those who wrote support letters, and only further indebted to each of them for their help and assistance in my life.
How would a migraine diary help?
My lawyer also requested that I keep a migraine diary to track my attack frequency, severity, and medication intake. I had stopped keeping a diary years ago because seeing and tracking the comprehensive reach of migraine in my life in black and white was more defeating than helpful. Having to return to this practice of tracking my condition was emotionally difficult.
How did the appeal cause financial, emotional, and physical stress?
The reality of receiving less than half of the income on which I’ve depended for years was incredibly stressful. Hiring a lawyer to compile the appeal was a huge financial hit. Every single expense I incurred caused gut-wrenching worry. And, it was terrifying to consider that I might lose the appeal as that would’ve meant facing potentially life-changing decisions including selling my house and moving in with family.
The stress was immeasurable and of course, caused my migraine attack frequency to increase. Already on the thin side, I lost half of my hair and 20 pounds over the year. I haven’t weighed that amount since middle school.
How long did I have to wait?
I had six months to file the appeal after which the insurer had up to 4 months to respond. This window of time was excruciating and felt interminable.
Have you had to appeal a loss of disability coverage decision? Or, is this something you worry may happen? Tell us about your thoughts and experiences. We are grateful to learn from you.
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