Jump to content

Severe Depression / Work Issues


dfmike71

Recommended Posts

I opened up a short term disability claim for severe mood changes, concentration issue, depression and just couldn't focus. I work for a large communications company and tried to find a psychiatrist that was in my network but not one out of the entire list. There was one, but not accepting new patients for at least 3-5 months. So I scheduled a consultation with an out of network and was charged $350. I did not like the doctor. She picked up her phone twice during my consultation and her phone just kept beeping and beeping. She was working out of a back pack and it looked like she just leases the office when needed. It is basically a large apartment building with some doctors taking up a few floors. Anyway when I presented her some paperwork she almost seem insulted. This is paperwork I need to be filled out so I can at least get compensated while I'm off work. She said if she really had to deal with papers all the time things would never get done. This was towards the end of my consultation. Another appointment was scheduled but I canceled that thinking I could find another doctor. Anyway, my disability claim was denied of course and was told I have 180 days to file an appeal. Work has a program called Employee Assistance Program (EAP) and said I should contact them, but when I asked if they have medical degrees I was told no. They just are trained therapists. The original doctor did diagnose me with severe depression and I already have work calling me leaving me messages because they know my claim was denied and they think I can just hop right back to life like nothing happened. I do not know why I'm having these issues, but it is very difficult to even pick up the phone to call anyone, because just the anticipation of bad news freaks me out. The original doctor did prescribe me medication (Wellbutrin) and even though I did not like her I started taking it to get anykind of relief. I thought maybe if I gave it a couple of weeks I would at least feel better and get back to work. Obviously if I was rich and didn't have to worry about anything financially I would care if company gave me issues, but that's not the case. I'm not looking to abuse the system here, I've worked 20 straight full time years with the company and have a top notch record. Unfortunately corporations seem to just treat everyone like a number and think because they have all their information online and therapists to call 24/7 everything is good. I opened up the disability claim on November 2nd. My company burned my last vacations days on those first 7 days, and then I've been out of work for 3 weeks after that. I have even tried to contact Accolade, which is to help me through this process and asked them please find a doctor that is in my insurance network and I don't have to drive 50 miles. They responded and told me only 1 doctor available that's 40 miles away in another state but first available appointment is in about 2 months. What? What am I suppose to do now? I'm very afraid if I just go back to work I will get worse since that may have been why I'm feeling this way. I don't know what to do. When I initially called the claims department all they kept asking me if this issue is work related or not. I kept telling them I do not know. And that's another reason why my short term claim was denied. Should I just call the EAP people and ask them I need help or something? Why is getting behavioral help so hard and impossible to deal with. 20 solid years I've been paying my taxes and fees and now when I need help for funds that I have EARNED, impossible to get. Just thinking about all this raises my heart rate, gets harder to breathe and I just lose focus and concentration. Any suggestions? 

I am male. 44. Live alone.

Link to comment
Share on other sites

I'm sorry you are going through this.  

 

Did the crappy doctor at least fill out the paperwork?

 

And yes, I would at least give the EAP people a call, even if not doctors they are still a resource and may be able to give you some assistance.

Edited by ellemint
Link to comment
Share on other sites

Also, maybe with the psychiatrist see if you can be put on a cancellation wait list.  Psychiatrists have tons of cancellations.  I had a 4 month delay before I could see a psychiatrist, but called and said I was available any time they had a cancellation, and got a call the next day to come in.

Link to comment
Share on other sites

Hello, dfmike71:

 

So sorry to hear that you're suffering like this.

 

I actually understand quite a bit about what you wrote, and I have a little experience with some of it.  So I might be able to help you.

 

Let's start with the Short Term Disability (STD) insurance.  The basic concept is that STD will pay a percentage of your salary if you must be off work for an extended period of time for any medical reason that is covered by the policy.  The medical reason can be either a physical illness, or a mental illness.

 

In one way, it kinda/sorta doesn't matter whether the physical or mental illness is work-related or not work-related.  BUT in another way, it does matter.  Here is a big clue about why they keep asking you that: in addition to Short Term Disability insurance, a large corporation also has Workers Compensation insurance.  That would cover a physical or mental illness that was directly caused by the workplace.  It's a different insurance policy, with different guidelines, the payments come from a different source, etc.

 

When it comes to a PHYSICAL injury, it's very important for the corporation, the insurance company, and the individual to identify whether the injury happened on the job, or happened in private life, because that determines whether the payments come from the insurance company who provides the STD or the insurance company that provide the Workers Comp.

 

When it comes to a MENTAL illness like depression, it's harder to prove whether it was caused by work or not, so it's probably just simpler to assume that the depression is not caused by work, so any time off that is paid by insurance will be paid by STD rather than Workers Comp.

 

Now, how does one get a legitimate medical reason to be off work for an extended period of time because of inability to work caused by depression?  I'm pretty sure that you don't need a psychiatrist to make the original medical authorization.  For example, I believe that a regular primary care physician (PCP) or family doctor or GP can make the initial medical recommendation, and submit it to the corporation and the insurance company "Joe Schmo is not capable of work because he is incapacitated by his current depression and anxiety."  I believe that's all you need to get the initial "X" number of weeks off work with a percentage of your salary paid by STD, usually 60% of your regular salary.  Now, to get additional weeks off, then the insurance company may need additional proof that a mental health professional judges you as incapable of work.  That's why the psychiatrist would need to complete paperwork.  The insurance company may require that you show proof of participation in an out-patient hospital group program for your depression.

 

Now, the EAP is totally un-related to all of this, however the EAP will be a valuable resource for you, too.  The EAP will not be the determiner of whether you are depressed enough to get paid while you're off work.  But, the EAP will set you up with a talk therapist.  A competent talk therapist will help you to understand yourself better, and learn to develop different thinking patterns.  The therapy will be more effective when the medications calm your mind. 

 

Or, it's possible that the therapist may serve the role of proving that you're getting treatment while you're on disability leave.  Or, the insurance company may accept or require reports from the therapist to determine whether your mood changes, depression and anxiety continue to be debilitating enough that you can't work.

Edited by Lynn1954
Link to comment
Share on other sites

My message above got long, so I wanted to post it and then just add just a little more.

 

In today's mental health world, the only role of the psychiatrist is to prescribe the medications and monitor whether they're working.

 

You don't really need to have a psychiatrist that you like, it's just that it's better if you do.  But, in general, you won't be getting any talk therapy from the psychiatrist, only a minimal check-in to confirm whether the meds are working or need changing.

 

Let me paint a scenario where your STD claim would probably be approved.  Here are your legitimate symptoms that you described.  severe mood changes, concentration issue, depression and just couldn't focus.  You call up your primary care physician and tell him honestly whatever describes your situation: Doctor, I'm kinda freaking out at work and at home because of severe mood changes.  I get panicky, restless, I can't focus on my work.  I've been pacing the floor, wringing my hands, etc.  I feel like I'm going crazy.  I saw a psychiatrist who prescribed some Wellbutrin that I'm taking, but it hasn't calmed me down yet.  I'm really not capable of working; I'm as useless at work as much as if I had the flu or pneumonia.  I think I need to stay home until the anti-depressant get effective.  I think I need to get some intensive therapy.  Can you help me to submit all the paperwork that my corporation and their STD insurance company requires to prove that I have a legimate and serious illness that makes it impossible for me to work.?"

 

Oh, by the way, different subject back to STD: usually the STD insurance company requires that the first 7 days that you are off work, you either use corporation sick days or vacations days, or take those days without pay.  In other words, the STD benefits don't begin until after you've been off work for 7 days, and the STD benefits are not retroactive back for those 7 days.

Link to comment
Share on other sites

Okay, I re-read your message again, and you have been off work for the seven days, plus the three weeks after that.

 

I'm betting that your STD claim will be approved if you re-submit and assure them that your depression is NOT work-related, and you have supporting medical statements from your primary care physician, indicating that you're not capable to work.

Edited by Lynn1954
Link to comment
Share on other sites

Okay, I re-read your message again, and you have been off work for the seven days, plus the three weeks after that.

 

I'm betting that your STD claim will be approved if you re-submit and assure them that your depression is NOT work-related, and you have supporting medical statements from your primary care physician,

Thank you Lynn and the others who responded. I did call claims and they said I need to appeal the disability claim because it was denied for no paperwork. I kind of knew that would happen. I also just called the EAP and they just said they usually talk to people that are having really bad days, a loved one died, stuff like that. I don't think right now whatever is going in my mind talking about it over the phone will help, at least not in the long run. They just recommended that they wait for a call back and they will try to give me some therapists in my area. Not psychiatrists. I feel pressured as it is and really just want to get myself better. I've put on such a good face at work when I told my supervisor they were shocked. Pretending to be happy and cheerful to other people when my job is to help them really frustrated me. I also do not have a primary doctor, I never needed one. I was always healthy, don't drink, don't smoke and never had issues to actually see a doctor. So I'm just in a tight spot not knowing what to do. I am waiting for the EAP to call me back with the therapists/psychologists in my area. I asked them if I could find them online myself and they said since they are the EAP and everything is confidential they only have access to the doctors that are in my insurance plan. Everything is through Magellan Behavioral Health. Sometimes it is just really hard to deal with these large companies, especially when lots of people are trying to "steal" from the system. It really makes it harder for people that really need the help to get it. I don't know the law, but if I keep going to a person to person therapist and I have documents related to those sessions my company just can't fire me, right? I just think it was a little odd that my disability was denied then I get two calls from work fairly soon after asking how I am doing and if there is a possibility return to work. 

Thanks again. And yes, it does take me forever to write this much...I would be able to write this much in 5 minutes, but now it takes me 30+ minutes just to write out emails since I can't concentrate and focus properly. There has to be some light at the end of this long tunnel.

Link to comment
Share on other sites

Hi, Mike:

 

I so totally relate to what you're saying about how hard it is to understand and deal with the paper trail and the bureaucracy.  It's funny, though, after I learned all of it, it all makes sense.

 

So, your STD claim was denied for no paperwork.  No problem: get a primary care physician who is in your network, go see him/her ASAP, and get the paperwork completed and sent to the insurance company.

 

It's actually not odd that right after your claim was denied, and then work called you.  In the process of sick leave, application for STD, acceptance or denial of STD, etc. everybody in the loop is informed.  So, as soon as insurance co. informs your corp's HR person that claim was denied, then the HR person (understandably) thinks that means that you're ready to come back to work, so she informs your supervisor or team, and they call you up to see when.

 

Before I continue on the specific topic of disability leave, EAPs, etc. let me tell you what are normally the basic steps to identify your problem and then get well.  This has nothing to do with who pays for what, it's just the three steps that you need to accomplish for your own physical and mental health.

 

Make an appt and see your primary care physician or family doctor for a physical exam to confirm or rule out any physical illnesses.  If you haven't had one up until now, you need a good baseline annual exam anyway.

 

Make an appt and see a psychiatrist for a complete eval and accurate diagnosis of your mental condition, and a prescription for appropriate medications to treat your symptoms.

 

 

Make an appt and see a therapist who will help you to understand yourself and your current thought patterns, and how to develop new healthy patterns of thinking.  The therapy will be most effective after the medications calm your mind.

 

Also, one more thing when you have the energy to answer.  Which company provides your standard health insurance coverage?  Most standard health insurance policies for big corporations would include coverage for physical illnesses and mental illnesses.  You would identify medical doctors or psychiatrists or psychologists or just regular talk therapists by looking at your insurance company's website.

 

Usually the EAP is not part of, and not related to, your standard health insurance company.  It's an extra benefit that your corp pays for to serve you.  When you call their telephone help-line, there's no charge.  But, if you need to go and see a therapist, like maybe one time per week, then the EAP doesn't cover that, it's paid for by your regular insurance company, so that's why you need a therapist who is in your network.  So, my question is, where does Magellan Behavioral Health fit into this?

Edited by Lynn1954
Link to comment
Share on other sites

Hi mike glad to hear U are taking. Some time from work to get treatment for mental health! It's a hard step to do but so important. Sounds like Lynn has laid out an awesome detailed plan for U to figure out your work coverage !! Don't give up and overwhelmed if u can summon he energy somehow to get the disability coverage in line now then u will be able to not worry about it and concentrate on your treatment. The only thing I would have to add to Lynn's advice would be to remmebwe you are not obligated usually to provide details to your employer about your illness. For short term usually a medical note will suffice. It doesn't matter if it's a broken leg or depression. Once it's a long term claim they may ask for more details and forms but this woukd likelg come from HR not your direct supervisor etc. I'm sure your work is eager to have U back but maybe consider just keeping your descriptions brief with them: thanks for your concern, im currently in a treatment plan for my health, I look forward to returning to work as soon as I am able. Anything more than that should be formal exchanged as requested on paper by HR.

Link to comment
Share on other sites

I agree with Wrenn:

 

when you or your doctor communicates with your company, you're not required to say what your physical or mental illness is.

 

Your doctor just needs to indicate that you are not able to work.

 

Likewise, when the insurance company communicates with your company's HR, they only report whether your STD claim has been approved initially, and each time the claim is extended, but they also don't need to say why.

 

One thing I don't remember from my experience is how much detail the insurance company is required to ask.  Somehow they must balance their need to know that you have a legit claim compared to your right to privacy.

 

I'm not sure how they do that.  If the paperwork comes from a licensed medical professional, then I think they just accept that.

 

Like, if you have a physical illness, as long as a doctor says you can't work, I'm not sure if the insurance company is permitted to know whether it's cancer, AIDS, or a broken back.  Likewise for a mental illness, they might require paperwork from a mental health professional, but they wouldn't need to know whether it's for schizophrenia, depression or anxiety.

Link to comment
Share on other sites

Thanks for the suggestions. I have a list of 4 "specialists" that the EAP gave me. I'm going to try to look them  up, but I was told they are all authorized to submit paperwork for disability claim stuff. I'm not trying to get over on the system, all I want to do is get better. And when family members do not understand depression and kind of tell you "suck it up and get back to work" that really puts a stain on everything. I'm 44 years old. My mother and father went to the old school, and depression wasn't even talked about. Both of them are so against ANYKIND of medication. Like an example is a 600mg of Ibuprofen (Advil)....my mother would think that's illegal and dangerous to you. They don't "get it" it seems. The one issue is I'm not really big on doctors. Since I have always been physically healthy I never needed a primary care doctor, so I don't have one. Several months ago I did try to visit a primary doctor to get a checkup but the experience was so bad I never went back. But I do have that list of "specialists" which I will call tomorrow to see if I can get a consultation on whatever is going on with me. I guess to get back pay for the 3 weeks that passed I will need to contact the original doctor, but will need to pay her. I guess I can send her the paperwork and agree on whatever payment she requires. She did say during my consultation my mind needs a "recharge" and I should take a break from work for a little bit. 

 

It is very calming to actually write all this and hear people respond and exactly know what I'm talking about. Everyone in my life, around me, have no idea on what's going on with me and just do not understand.

Thanks.

Link to comment
Share on other sites

To update, I did see a Psychologist through my employee assistance program. Took 3 weeks just to get all the correct information. It is almost like my disability claims people are there to block me or deter me from moving forward. The Psychologist  said in no way shape or form I should be under those conditions or being subject to the "please hold and get disconnected" scenario. Apparently I have to fight for my benefits that I've been paying for 20 years through my taxes. To get help and on the the right track is a job in itself. The Psychologist wants to see me again and also recommended I see a Psychiatrist also while seeing him at the same time. He said with both their records combined and he is a referral from my own company they most likely will approve some benefits for me. I have been keeping track, especially when I call the disability claims company. Soon as I call them I get a recording, "this call may be recorded better support". So, to keep track of everything and the information they give me I record the calls myself. So in case I need to go back and refer something. Since it is difficult for me to focus and concentrate, I have to record everything. I also let them know I am recording and verbally say, "I am recording this conversation". 6 out of the 12 calls I have made to the disability companies have just hung up the phone after I said that. I don't understand. They clearly are recording all calls, but I cannot do the same? It clearly is going to be a battle just to get myself better. Even without any information or indication from me or a medical professional the disability company already has me on a return date to work. I asked them where that date came from and I just hear "the system automatically does it". I said please I do not a "system" deciding my health. I can now see why there are so many law firms, commercials, all related to disability issues. The Psychologist said it takes some work, but there is nothing else one can do if you are a working class US citizen. The wealthy have doctors go to them and even get discounts for being rich! No wonder why everything is upside down and a surprise to me.

Link to comment
Share on other sites

1. Thanks for the update!

2. So glad you're seeing a psychologist

3. Agree you should also see a psychiatrist

4. Very glad the psychologist seems to be your advocate to get your disability claim approved

5. Yes, the "return to work" date is automatic, probably because you've not yet filed everything you need to get the claim approved and then extended.  Don't worry about it, after your psychologist and psychiatrist submit all the paperwork then your claim will be approved and your "return to work" date will be extended.

6. Dealing with the disability claims company is VERY frustrating, but try to stay calm about it.  Focus on getting well, which I hope you will get well as quickly and completely as possible.

Link to comment
Share on other sites

Yes unfortunately the bureaucracy is dreadful to navigate. When I went on leave I took General illness for about three months which is like short term disability. Every three weeks I had to go back to doctor and get a new doc note. At the time I worked for a horrible place (government) and my direct employer tried all kinds of trickery and bullying to scare me into comig back to work or trying to say I was lying. It was really horrible. But the way to protect yourself is don't talk to your employer in person or verbally, and get everything they say on paper . Lots of times they don't want to put their request on paper or as U experienced, be recorded. Because it's all about liability.

That's why human resources directly requesting info is more legit because they know all the employee rights rules and are usually smart enough to not play any games. And the people directly in your departments like bosses etc are the ones who are doing an emotional reaction.

Unfortunately like everything else in life there are a few bad apples ruining it for everyone else. Of course there's peeps out there scamming Workers comp and long term disability ETC and so they have all these checks in place to try to catch them. But it sucks for the rest of is honest people with a serious chronic illness that maybe mental. A close friend of mine pursued long term disability and workers comp for ptsd for an incident that was clearly a work incident(extreme trauma) it was literally years of fighting -and I really believe he fight made her depressed as well. For me I felt it was easier to go on short term disability as long as I could about three months and then went back to work and quit two weeks later after finding another job.

Link to comment
Share on other sites

Thanks for putting up with my rantings. I'm finding new information on a daily basis. I'm very glad the psychologist I saw identified what is going on and said he will coordinate and help me out whatever he can to submit the appropriate information. It will be coming from both doctors. The form packets for each doctor is about 30 pages! One packet for disability and then another for family medical leave act. I also live in NJ, so I also have to file with the state itself. My companies internal website seems to be developed by someone with short term memory loss. You'd think all the disability information would be in that section of their site, but the information I need is spread out over about 5 different internal domains and a lot of the information are just "guides" that indicate what to do but not supply you with the forms. I am "assuming" the disabilities company I am dealing with is following the laws, but there seem to be a lot of deadlines with stuff. For example when I first called out for my disability claim they basically told me the clock is ticking and I have 15 business days to submit all my paperwork or my disability will be denied. Then if I want to appeal I have 45 days and can only appeal one time. If it is denied again, then I can't re-submit. Do I even know if these are policies by my company or the law? I guess I would need to look into everything again or even try to have a consultation with a disability lawyer just to get the real facts and what I can expect. I know this forum is for depression, but being clinically diagnosed with severe depression and having to go through the disability battle actually works against me trying to get myself better. I can clearly see how people just give up. I think going forward I will need to not have communications directly with my immediate manager and all go through the disability company. I'll just need to try and relax. I was very happy and sociable years ago with no medication/drugs at all, and that's what I'm trying to get to. Thanks for listening again.

Link to comment
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now
×
×
  • Create New...