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Old 11-22-2009, 06:04 PM   #35
Joan M
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Re: social security disability

I don't know all the laws, but here's what I do know about metastatic breast cancer and short-term disability, long-term disability, Social Security Disability, accelerated death benefits and COBRA.

Some companies offer STD and LTD. After the STD period is exhausted (usually 180 days, but in my case it was 90 days), LTD kicks in. STD is usually an earned benefit. That is, the longer you work at a company the longer you will be paid your full salary or part of your salary during the STD period.

LTD is most likely 50% of your salary. Usually, there's an opt-in plan in which you pay a few dollars (like around $5.00) out of each pay check to get a higher percentage, like 70%, for example.

Most insurance companies (that is, your employer's insurance carrier, as they're paying STD and LTD) require a bc patient to apply for SSD when they apply for LTD.

It seems the Social Security Administration pretty much automatically approves patients with advanced cancer. SSD starts usually starts six months after you first went on STD(although I've heard not to be surprised if you get a retroactive check, even though the SSA's brochure said the benefit is not retroactive).

When SSD starts, LTD, which starts immediately when you're approved for LTD and is retroactive to the first day of your LTD, will subtract out your SSD benefits (that is, LTD - SSD = your income. There's no double-dipping here). However, private pensions, 401(k) distributions, annuity distributions, etc. are not subtracted.

An accelerated death benefit is a percentage of the life insurance your company has on you which can be advanced to you if your oncologist says you're terminally ill. Terminally ill is defined by how long you have to live, such as 6, 12 or 24 months. Of course, your company pays a higher premium for 24 months (in my case it was only 6 months, and it seems likely I'll be around longer than that in terms of my cancer -- thank goodness). However, your company may have a longer definition of terminally ill.

COBRA, or continuation health benefits, are available if you're laid off from your job. Howerver, here's the specific limitations, from the DOL:

http://www.dol.gov/ebsa/faqs/faq_consumer_cobra.HTML

Also, if it applies to you, COBRA payments are considered a medical expense for 401(k) distributions prior to age 59 1/2. That is, you pay the tax on distributions because your contributions were on tax-deferred money, but you're exempt from paying the 10% penalty to the IRS.

You have to be on SSD for two years before being eligible for Medicare, and your age is not a factor in this. Also, if you're declared disabled COBRA is extended to 29 months, which bridges the gap in medical coverage.

Hope this helps.

Joan
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Diagnosed stage 2b in July 2003 (2.3 cm, HER2+, ER-/PR-, 7+ nodes). Treated with mastectomy (with immediate DIEP flap reconstruction), AC + T/Herceptin (off label). Cancer advanced to lung in Jan. 2007 (1 cm nodule). Started Herceptin every 3 weeks. Lung wedge resection April 2007. Cancer recurred in lung April 2008. RFA of lung in August 2008. 2nd annual brain MRI in Oct. 2008 discovered 2.6 cm cystic tumor in left frontal lobe. Craniotomy Oct. 2008 (ER-/PR-/HER2-) followed by targeted radiation (IMRT). Coughing up blood Feb. 2009. Thoractomy July 2009 to cut out fungal ball of common soil fungus (aspergillus) that grew in the RFA cavity (most likely inhaled while gardening). No cancer, only fungus. Removal of tiny melanoma from upper left arm, plus sentinel lymph node biopsy in Feb. 2016. Guardant Health liquid biopsy in Feb. 2016 showed mutations in 4 subtypes of TP53. Repeat of Guardant Health biopsy in Jana. 2021 showed 3 TP53 mutations, BRCA1 mutation and CHEK2 mutation. Invitae genetic testing showed negative for all of these. Living with MBC since 2007. Stopped Herceptin Hylecta (injection) treatment in March 2020. Recent 2023 annual CT of chest, abdomen and pelvis and annual brain MRI showed NED. Praying for NED forever!!

Last edited by Joan M; 11-22-2009 at 06:09 PM..
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