So Wal-Mart's third party disability claims handlers (there are 2, one handles short term disability & one does long term)are evidently letting me go ( long term can't process payment to me without either pay stubs or a work schedule & Wal-Mart is providing me with neither. Shot term says they can't give me anymore time off. When I talked to human resources today, I had to tell them I'm in too much pain to come back to work with my artificial joint coming apart. She tells me I gotta call one of the claims companies to let them know & since I can't tolerate being out of my bed, I can't work, the only option is termination.
This is the only job I've ever had where I'm not crying over losing it, but I can't help feeling a lot of anxiety about what this will mean financially as far as treatment coverage for either my cancer or any revision surgery on my bad hip arthroplasty. I have Humana Medicare Advantage, but I don't think they cover meds. I've been a week & half without my Ibrance 21 days dose. They told me the copay is $2900. Onc is trying to work with Pfizer that I can continue getting it without the copay like I was doing before. I'm not used to this feeling. I've always been "Hey, no sweat. I'll just do this.... or I can do that & everything will be alright. Problem solved." I'm scratching my head right now "um, ok.....so now what do I do?"
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OneLump22
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Reading your entry makes me raving mad too! Please do not despair and, for goodness sake, do not quit Walmart! There is a solution to this that is good for you. Where are you? I'm in NJ. Try working from the local resources such as the office for Senior Citizens, the local health department and the State resources. Also, if, after a very short time, you do not get a satisfactory result, write a thing in the newspaper. Human difficulties recorded in the newspaper really do energize people to action. Write a way for people to help you get the best of Walmart. Good luck to you and please keep us informed.
If you have MBC, under social security it is automatically a full disability so I can’t see how it would not be for the long and short term disability companies. You could contact a local legal aid office or volunteer attorney program to help you fight this. If neither of those programs can help you ask if they have any ideas of where you could find an advocate to help you. Sometimes the local social work office has someone who can help you navigate this. Don’t stop trying - I am sending strength to keep up the fight. (If only it were that easy). Where do you live?
They have time blocks apparently where you have to go back to work for a block of specified time before you can take off again. Guess employers (Walmart anyway) feel that otherwise they're paying you to sit around on your butt & they're not about to do THAT.
Thank you jersey-jazz & everyone else who's responded. As of the date of this last post, I have been with my Oncologist, signed a form that was sent to Pfizer (or will be), & they'll be scheduling a meeting with a councilor at Baptist Health Cancer Center of Southern Indiana (where I live). I didn't know about the rest. Getting a lawyer.....forgive my trepidation, I've never dealt with those folks in my entire life. First things first, but I'll keep that in mind. Again thanks I really was at a fork in the 🛣️ road. huggs & to everyone else.
Most Medicare Advantage plans do cover meds so check into that.Your Dr can help you apply with Pfizer for their patient assistance program where you can get Ibrance at no cost. Approval is based on income. There is also the PAN foundation that can help with a grant to help pay for meds. They may also help with transportation. Your onc should be able to help with all of this. Ask your Onc office if they work with a social worker who can guide you through all of the assistance available, including the application for disability through SS if you decide to do that.
I would call the American disabilities office. I don’t think they can let you go as long as you’re under disability and have a doctors note so this is definitely a time that I would have a lawyer call them.
In addition to the suggestions provided here, Email Doug Mcmillon the President of Walmart. The insurance companies are Walmart’s agents. Walmart has oversight over how they preform on Walmart’s behalf. Large corporations have offices of the President who handle complaints on behalf of the President. Your complaint will be directed to the appropriate people within HR who will be enlisted to help you. Remember HR is there to protect the company not you, however they may be able to help you resolve this. I work for a large corporation and had to escalate an issue regarding health coverage. After going in circles with the Health Insurance company, once I brought the issue to the attention of Executives, it was quickly resolved. Sometimes it is just a matter of connecting with the right people within your organization.
I am in Germany, and everything is different here, but I know there are compassionate use programs in the States. I would call everyone, including your local TV news affiliate. I would call Pfizer. I would run a GoFundMe--I did that here when I wanted genomic testing, and doing so seems to have shamed my insurance co. into paying. I have the money and will either use it for desperation oncology or donate it to cancer research.
I'm so sorry that you are having to go thru so much! It's so awful that situations like this are so common here in the US! It's hard enough just living with this lousy cancer, and then the bureaucratic bs on top of it is unconscionable! I applied for Social Security Disability so long ago that I have no idea if the application process isi the same as it was then but I was able to make an appt first thing in the morning at the closest SS office the day after the day I called! I made a point of telling the appt person that I have terminal metastatic breast cancer. I took copies of medical records with diagnosis, and provided employment info. Oh, I had to end employment before I called for an appt. With MBC, if we have worked enough quarters (10 years, 40 quarters) at jobs that deduct SS from our paychecks, we qualify. The biggest difficulties are that there is a six month wait for SSDI to begin, and then a 2 year wait after that for Medicaid. If our post employment income is low enough, we may qualify for Supplementary Disability Income and/or Medicaid. So much bureaucracy, phone calls, forms to fill out.................. (My diabetic brother has Medicare and Medicaid and is able to get the meds he needs, but Medicaid is state related and varies by state) I hope you get what you need to sort thru all this and that the cancer will respond well to treatment. Know we are her for you!
Do you have a social worker where you are treated? If not, check your state's Dept. of Health website. There is a special Medicaid in place for women (and others). I was put on this special medicaid bc I had no coverage and was diagnosed with stage iv. It covered me completely until Medicare kicked in. I live in NY and the below is for NY but I am sure other states have this type of plan in place also.
Medicaid Cancer Treatment Program (MCTP): Breast, Cervical, Colorectal and Prostate Cancer
Eligibility for the MCTP:
Breast Cancer: To be eligible for Medicaid coverage for the treatment of breast cancer or pre-cancerous breast conditions under the MCTP, applicants must be:
Screened for and diagnosed with breast cancer or a pre-cancerous breast condition by a New York State licensed health care provider, OR, if diagnosed with such in another state, were screened and/or diagnosed by that state's National Breast and Cervical Cancer Early Detection Program;
Not covered under any creditable insurance at the time of MCTP application;
In need of treatment for breast cancer or a pre-cancerous breast condition;
A resident of New York State; and
A United States (U.S.) citizen or an alien with satisfactory immigration status.
If an individual who meets the above requirements appears to be eligible for Medicaid in any of the mandatory categories, the individual will be given Medicaid coverage under the MCTP for a limited time pending a Medicaid eligibility determination.
I feel so bad for you! How terrible that you have to fight the bureaucratic system while fighting for your life!
Do I understand that you exsasted 6 months of the short term disability and now trying to get long term disability? Does Walmart provide long term disability to the employees and is it automatic or you need to sign up and pay for it?
In my company you have an option for paying for long term disability as part of the benefits.
You also have an option to apply for disability within social security. You’ll be approved right away, but will receive money in a few months and Medicare in 2 years I wonder if you can apply for a Medicaid in the meantime.
Try to schedule an appointment with Social Security office they’ll be a good source for information
Good luck my friend! Hope your pain will resolve and you’ll find the best solution!
Ah, applying for SSDI is one of the earliest things I did & yes! I was approved right away. Had to wait 2 years to get Medicare, but I have it now. As for Walmart, that's a hairy, confusing mess.
hi. I too am confused. you are not allowed to work in order to receive SSDI.....with the exception of perhaps approx 10-15 hours/week up to a max of $1,350/per month. that is my understanding? do you work very part-time at Walmart? not being nosy...lol. just trying to understand.....
and please forgive me for not saying this first. I empathize with your frustration and that awful feeling when on stress overload. I hope🙏 that meeting goes in your favor. it is so wrong for you to be off your meds while all this is happening. Pfizer should give you a couple months cost free asap, as the humane thing to do, while all is in the works. and also sorry to hear about your artificial joint issue...hope you have appropriate pains meds🤞. too much on your plate once. you are very strong. xo
You're ok to ask. 👍 Not a problem. When Company SD was exhausted I had to return or quit & I hadn't qualified for Medicare yet so I was still dependant on Co. medical coverage, but I asked if I could work part time. They allowed me 4hr./ day 4days /wk & I checked with SS & that's in limits. But around June (I think) they changed my schedule & actually I found that I didn't even have a schedule (yes companies can do that when you can't physically work, but on LD (long term disability), which is supposed to be periodic LOA not permanent, & SD is exhausted. Not on schedule means no pay so all I'm collecting is SSDI & staying off my bad hip (not walking around) as much as possible til I can get it fixed. I keep to my bed a lot except for using my walker to hobble to the fridge & the bathroom.
Like I said, you work for a company like that, don't get sick cause the red tape is a mess.
yes...such a mess! I feel so bad that you are having to go through all this. I have pretty severe mobility issues so I can absolutely emphasize with the bedrest and hobbling...not fun. I hope that meeting takes place asap and thumbs up to you on getting a lawyer. keep us posted on that. will be thinking of you!
glad you got SSDI and Medicare now! Can you help me understand how Walmart disability can be received when you’re already on SSDI? Would be very helpful.
Job MLOA is less your reg pay so is allowed, but then SSDI is affected. I haven't received what a non working person would. This could change as I have been informed that I may have to be terminated due to I can't stand & the store manager has made the customer host (aka door greeter) position a standing job only now. Actually, our store doesn't have sit down jobs. No idea if this is Walmart policy or just him, but HR said I got to discuss with the company third party that handles SD claims. They tell the company your fit to come back or not based on dr recommendations. Mgt won't allow any movement without their paperwork.
This is Walmart, its a mess & I learned to stop asking "why" a long time ago because they either just look at you / they give you answers that spin you in circles, make you scratch your head, & eventually tear your hair out & wish you'd never asked.
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Who has experience with quickly getting a 2nd opinion at another hospital?
New York is in such pain. Pray, pray, pray
