Short Term Disability - Possible with T1?

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ehrin Posted: Sun, Aug 23 2009 7:14 PM

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Hi everyone - long time no talk!
I have a question and not sure if anyone here has any thoughts.  I'm at the stage of my life now where I'm thinking about pregnancy.  My work does not offer maternity leave, they do offer 6 weeks where you won't lose your job, but there is no monetary compensation.  They recently brought Aflac aboard and I am not eligible for STD, which would cover my maternity leave, because I am a diabetic taking insulin.  Is anyone aware of a supplimental insurance that would offer people with pre-existing condtions coverage?  Or am I screwed?  This is very frustrating.

Thanks!
Ehrin

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Ron AKA replied on Sun, Aug 23 2009 9:42 PM

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Ehrin, are you saying that you would be approved for STD if you were not diabetic? If so, it would seem extremely discriminatory to make you not eligible just because you have diabetes.

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Spirit replied on Sun, Aug 23 2009 10:33 PM

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Ehrin:  I wish you luck.  Pre-existing condition of diabetes is a pretty tough case to make to get an insurer to cover you.  The American Diabetes Association did some work on insurance coverage for diabetics a while back.  You might try contacting your local chapter to see what info you can get.  The local chapter may be more knowledgeable about area practices than just searching the web for general info. Might be worth the time for a phone call.

Spirit

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Simi_Papa replied on Sun, Aug 23 2009 10:41 PM

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This is one  of the things Obama wants to change with the health care reform, i.e. eliminate the prior condition clause in private insurance coverage.  Are you saying that the insurance you have where you work doesn't cover pregnancy?  I don't think the family leave act (the 6 weeks without pay) would prevent you for using COBRA to cover you during the leave period.  Although, I thought the FLA required companies to continue insurance coverage even if they don't pay your salary while on leave. (Note: I just checked and the Family Leave and Maternity Act does require an employer to provide continuing medical coverage while the employee is on leave.  So if you have insurance you should be covered unless it specifically excludes pregnancy.)

P.S.  Good to see you on the board again Ehrin!

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jen1229 replied on Mon, Aug 24 2009 10:33 AM

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Hi Ehrin:

I think you need to get a legal opinion here.  First of all the FMLA (Family Medical Leave Act) provides for 12 weeks of unpaid leave during which time your job is protected.  I do not understand why you would not be eligible for STD as a diabetic on insulin either. I am currently on Long Term Disability and was on Extended Sick Leave prior to that.  In our company ESL was accumulated weekly and was to be used like STD after you had been out of work for 5 consecutive scheduled work days.  It was meant to be a bridge to LTD.  I strongly suggest that you contact an attorney regarding the legality of the 6 week leave policy and the STD for pre-existing conditions.  It may be that you are covered anyway if your company had a previous STD policy and changed to AFLAC with no break in coverage.  If that is true, I don't think they can pull the Pre-existing condition thing, but that is why you need a legal opinion.  Also, you should request (from AFLAC) a copy of the policy provided to your company.  I think you are legally entitled to this information.

I am not an attorney, just know  a lot of this from previous experience. A year after I went on LTD my employer decided to terminate me and tried to back date it to the day I went on FMLA, a year earlier. They did this to make me ineligible for the current lower COBRA rates.  When I questioned them on it, they changed it to March of this year.  Remember, Your employer, as much as they may say they do, does not really care about you.  They are only concerned with the bottom line. The less they have to pay out in benefits, the better it looks from them.

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ehrin replied on Thu, Aug 27 2009 12:04 PM

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Hmmm - Not entirely sure I was clear on my original post.  I have health insurance and will be insured throughout my pregnancy.  What my employer doesn't offer is any sort of paid maternity leave.  So I started researching STD's, which would cover my wages while out on maternity.  The STD my employer offers, Aflac, will not over me because I am a T1 taking insulin (I'd like to meet a T1 that doesn't take insulin, that must be one special person!).  It just seems so bogus cause what, I could have prevented getting T1 at the age of 3?  GRRRRRRR

VERY FRUSTRATING!

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jen1229 replied on Sun, Aug 30 2009 10:10 AM

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Ehrin:

Do you have any accumulated sick leave, vacation time?  In all the places where I have worked women are allowed to use this time to cover their maternity leave since FMLA allows only for unpaid leave.  Still would get the opinion of an attorney skilled in employment law.  I don't see the difference in a Type I on insulin being on maternity leave and anyone else, aside from taking injections. Are Type IIs on insulin also excluded, many of us also take insulin.  Maternity Leave is a recuperation period.  I don't think diabetics recuperate any differently than anyone else.  The whole thing smacks of discrimination to me.

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Ron AKA replied on Sun, Aug 30 2009 11:32 AM

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I agree with Jen. It seems strange that they could disqualify you because you have diabetes. I would expect they would have some time limit on coverage, but it would be the same for a diabetic vs non-diabetic.

Since health care seems to be big news in the US these days, you may be interested in how this would be handled in Canada. Bill Clinton spoke in Canada yesterday and gave praise to the Canadian system. First the mother (no exclusions for diabetics or anyone) is entitled to 15 weeks of maternity leave (MAT Leave as it is often called). Then there is another 35 weeks available called parental leave. Either the mother or the father can take the additional 35 weeks. The employer does not pay salary during this leave but must keep your job for you to return to. The government run unemployment insurance program does kick in and provide benefits as if you were unemployed. Basic health care is provided to everyone in Canada, employed or not, so there is no interruption of it. Extended health care which covers prescription drugs, dental care, and other services like acupuncture etc. are covered by private plans, and some don't have them at all. In most cases the employer will allow you to stay in their plan (if they have one), but you have to pay their share of the premiums. I would not call it a Cadillac system, but it provides the basics to everyone, and full benefits to those who pay for the extended benefit insurance.