LTD issues with SunLife

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EMSG1
EMSG1 Member Posts: 17
edited June 2014 in Canadians Affected by Breast Cancer
LTD issues with SunLife
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  • EMSG1
    EMSG1 Member Posts: 17
    edited February 2008

    Hi all,

    I m currently on LTD from SunLife X 9 months. I had mastectomy, dose-dense chemo, radiation and second mastectomy and hysterectomy and am currently on Femara. I experience extreme fatigue, muscle/joint/bone pain and "mental fog". SunLife just cut off my benefits saying that my job was "sedetary" and I could rtw. My GP wrote them that I could not RTW due to the cognitive changes (at this time)...my job involves high level cognitive functioning and travel thru the province. SunLife didn't even communicate with any of my specialists and only used a functional assessment of my ability to stand, lift, walk etc to determine if I could RTW. I'm 55 and I've always worked, loved my job, but I clearly would not last a day in that position with these cognitive changes, fatigue and msk pain...and my employer has a track record of terminations. I've told SunLife that I wish to appeal. Has anyone been thru the appeal process? With thanks,

    EMSG

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  • Ontario
    Ontario Member Posts: 99
    edited February 2008

    I can relate. Sunlife also cut me off saying that though I could not return to MY job I could do other work IF I have my high School (which I don't) I worked at the same place for 33 years. Sunlife sited such jobs as Call centre worker, Complaints Clerk, Customer service clerk as the jobs I could do. I am currently appealing their decision also. Interestingly I have just been approved by CPP for a disability pension. Wonder why I qualify for that and not the Sunlife. Will be interesting to see what comes of it all. I have been off work since December 05. I have heard that a lot of people have trouble with Sun Life. They want to ditch you ASAP. Well I think we just won't let them! You might want to apply for CPP as well.

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  • EMSG1
    EMSG1 Member Posts: 17
    edited February 2008

    Thanks for your response Ontario. The frustrating thing is that I'm only 11 months into the 24 month "own occupation" period and that my MD clearly informed them that I couldn't perform my previous job. I have contacted a law firm about the appeal but I'm waiting to meet with them. According to the SunLife case manager, I must appeal to her with medical information that has not been reviewed by them. I would think that there is an appeal board or another process. I was told that I did not qualify for CPP, and I never did appeal that decision, perhaps I might now.

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  • snowyday
    snowyday Member Posts: 1,478
    edited February 2008

    Each insurance company has an Ombudsman you need to contact the person at your insurance company.  I did that years ago withe Great West Life over work related problems especially the RTW and it worked try it. Pearl49

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  • Ontario
    Ontario Member Posts: 99
    edited February 2008

    EMSG

    If you have been turned down by CPP i can suggest you call your MP's office and have them write to CPP on your behalf. I have known others that have done this and got approved, Apparently I am the exception rather than the rule. Most people get turned down from them first try and wind up appealing. Good luck

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  • CherylG
    CherylG Member Posts: 194
    edited February 2008

    Hi EMSG

    When I went on LTD I was working at a government job in Hull (an hour and a half drive on a good day) Last year I got a job offer in another gov't department in town here (5 minutes walk from my house) The job was as a receptionist 2 days a week. I discussed it with my claims officer and she thought it was great ... all I needed was a paper from my doctor to prove that I was able to return to work 2 days per week and they would consider it rehabilitation. I got the paper no problem  and they sent me back a letter saying that they required proof that I could not return to work full time!!! WTH?? It dragged on for 2 months until I almost lost the job offer. I gave up and informed Sunlife I was going to accept the job. No problem they would recalculate the benefits. In June I was given full time employment and called to inform Sunlife that I was discontinuing LTD. Three months after that I received an invoice for $3900 saying I had not declared that I was working!!!!! UGHHHH!!

    Don't we have enough problems to deal with!!

    Hugs

    CherylG

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  • hi5
    hi5 Member Posts: 374
    edited February 2008

    snowy... very interesting...I am on ltd with Great West Life.... I've had to go through all the rig a ma roll a few times but they are finally getting the hint.

    I am a teacher and am starting what is called "work hardening" where I will go in 2 x's weekly and observe etc.  I had bilat with reconstruction in may 2006, rads, tamoxifan, exchange feb. 2007, ooph and hyster sept. 2007, nipples dec. 2007, got hypothyroid after rads so on tamoxifan, synthroid, coversyl plus (high blood pressure pills..developed high bp as well), effexor, and nexium for acid reflux.... It seemed like my battle never ended but they continued to give me a hard time.  I am adjusting well to my meds but I don't think they realize how difficult it is to get back together.  with the ongoing situations that have kept arising I don't think I really have had the time to r and r.  My therapist says that I haven't had time to heal.  I also have an extremely high maintenace, problematic adult son who has been staying with me for the past 7 months.

    I don't believe that ltd gives one the time to get it together. 

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  • EMSG1
    EMSG1 Member Posts: 17
    edited February 2008

    Thanks everyone for your responses. It is a struggle. There is a reason that everyone hates insurance companies. It is so frustrating to watch the SunLife TV commercial where SunLife "protects you for life"...I've hired a lawyer which is good because I simply don't have the energy to take this on. I wish you all well

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  • Carmelle
    Carmelle Member Posts: 388
    edited February 2008

    I was on disability for 18 months. Sunlife for short and RBC Insurance for long.

    They did not try to force me off.

    I would definitely appeal...considering the 9 million $ a woman won in US last week for being cut off during therapy (mental suffering)they may be easily turned over.

    Michelle

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