Author Topic: Case study: Disability is not the ER I anticipated...  (Read 4935 times)

Dr Kidstache

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Case study: Disability is not the ER I anticipated...
« on: April 20, 2017, 08:41:59 PM »
What financial planning would you be doing in my shoes?

Life situation: I became disabled only 6 months after finishing 10 years of medical training.

Before becoming disabled in a random accident ~18 months ago, I was a good little Mustachian practicing frugality skills honed over years and had a plan for FI within 10 years of finishing medical training. I had just started earning a high salary as an attending physician after 4 years of med school + 6 years of residency/fellowship *cough*indentured servitude*cough*.  I drove my 12 year old bought-in-cash Hyundai only when necessary, biked in a bike-hostile city, took the city bus to my office (to the befuddlement of the other doctors). My net worth had broken zero (a big milestone for me on the path to FI given my medical school debt and long post-graduate training).

Yíall, being disabled is expensive! I have never spent as much money as I have since my injury despite scaling back what I can. Most people can imagine the medical bills, but there are also expenses like legal bills and the cost of paying others to help you with daily activities. At the same time, I am unable to work. It is unlikely Iíll ever work as a physician again. Itís unlikely that Iíll ever work in any type of job again.

Iím relatively fortunate in my situation. I have long-term disability insurance that is currently providing me with income support. Many people are bankrupted within months of becoming disabled. I havenít faced that yet. But my source of income is incredibly tenuous and I worry about my LTD benefit being unfairly terminated every day so Iíd like to prepare for the future as much as I can.


The numbers:
Monthly gross income: $15,611  [Income is entirely LTD benefits (from employer-based & individual policies) and subject to being cancelled capriciously at any moment. SSDI pending which will be ~$1,600/mo but will be offset by a reduction in LTD benefits. I expect LTD insurer will continue to aggressively try to cut my benefits BUT I donít think theyíll cut the $4500 non-taxable monthly benefit from my individual policy.]
Taxes: ~ $2250 monthly / $27,000 annually in federal income tax [$4500 of monthly gross income is tax-exempt.] No state income tax, no payroll taxes or pre-tax deductions. Single, no dependents.
Average monthly expenses: $5150  [Averaged from YNAB for past year]
Travel: $1162 (23%) [Do NOT flame me for this. Partly this is because I had the accident while traveling and partly because I am short-term renting occasionally in a different city for medical care. This number is what it is.]
Medical expenses: $1113 (22%)
Rent + utilities + insurance/maintenance/furniture: $903 (18%)
Food: $550 (11%)
Legal expenses: $375 (7%)
Shopping: $311 (6%)
Gym/physical training: $190 (4%)
Transportation expenses: $170 (3%)
Entertainment: $111 (2%)
Charitable contributions: $100 (2%)
Misc: $123 (2%)

Net worth: $290,000
Assets:
Cash/checking: $26,321
Savings: $43,686 (8 month emergency fund with goal of 12 months)
Taxable investments:
1. $33,600 in Betterment 40% stock/60% bond for 6 month emergency fund
2. $54,000 in Betterment 41% stock/59% bond for anticipated tax bill in 2020
3. $42,000 in Betterment 90% stock/10% bond
Tax-deferred/free investments: 
1. $56,000 in Roth IRA (in TIAA-Cref & Vanguard Target Date 2040 funds)
2. $92,000 in 401(a)/403(b) (mostly TIAA-Cref Target Date 2040 fund)
Liabilities:
Estimated $50,000-ish tax liability for Total & Permanent Disability Discharge of student loans (the discharged amount will be reported as income in 2020 after the 3-year post-discharge monitoring period) 

 
Question: What financial planning would you be doing in my shoes?

I havenít really had the ability to consider my financial big picture since becoming disabled. My biggest fear is affording to live independently if my LTD benefits are suddenly terminated (plus enduring the additional expense of the legal battle to get them reinstated Ė my LTD insurer is well-known for illegal and unethical attempts to get rid of claimants through a war of attrition). But I donít really have a plan for the future other than just stashing every penny I can in my savings account for the time being. Is there a more thoughtful strategy?
« Last Edit: April 21, 2017, 10:08:00 AM by Dr Kidstache »

snacky

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Re: Case study: Disability is not the ER I anticipated...
« Reply #1 on: April 20, 2017, 10:13:55 PM »
I'm in a similar boat- been unable to work for just over a year and my disability insurance company is constantly trying to drop me. It's stressful and shitty.

I have no advice, but lots of sympathy.
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Dr Kidstache

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Re: Case study: Disability is not the ER I anticipated...
« Reply #2 on: April 21, 2017, 09:41:43 AM »
I'm in a similar boat- been unable to work for just over a year and my disability insurance company is constantly trying to drop me. It's stressful and shitty.

I have no advice, but lots of sympathy.

Thanks, Snacky, for responding. And for the commiseration. I'm so sorry that you're going through a similar experience. Becoming disabled is traumatic - dealing with LTD insurers is like being re-traumatized daily. They giveth with one hand while beating you with a stick with the other. How do these companies stay in business while violating contracts and even laws left and right? There's a blog that I have found super-helpful in understanding what my LTD insurer is up to: https://lindanee.wordpress.com/ . It looks like you're Canadian so might not be as informative.

snacky

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Re: Case study: Disability is not the ER I anticipated...
« Reply #3 on: April 21, 2017, 11:23:26 AM »
The insurance industry's business model is based on denying as many claims as possible. Quite literally, their job is to not do their job. It's a nightmare for those of us caught in it.

The alternative is not having work-based disability insurance, and that would be worse. Living on some form of state welfare is not easier.
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Papa bear

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Re: Case study: Disability is not the ER I anticipated...
« Reply #4 on: April 21, 2017, 11:28:13 AM »
I have no idea what your disability is, but could you do work from a computer remotely?  There is always a need for physicians to work in CDI, recruiting, telephonic wellness coaching, etc. 

Good luck with everything! 


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jooniFLORisploo

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Re: Case study: Disability is not the ER I anticipated...
« Reply #5 on: April 21, 2017, 11:33:12 AM »
Dear Dr Kidstache,

I hear ya.

I'm not able to dig in to a case study at the moment, but I wanted to tell you I wrote a book for you :)      It's not specific to disability, but it certainly comes out of that experience in me and thousands of people I've assisted in such a boat. It is a few hundred pages of commiseration, understanding, and -by far the bulk of the content- direct, practical tips for navigating such a life. Linked to via my signature. It is literally every single thing I have to offer in such a situation.
I'm FIRE: Financially Intact, Rejuvenating Everyday

Dr Kidstache

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Re: Case study: Disability is not the ER I anticipated...
« Reply #6 on: April 21, 2017, 12:53:13 PM »
I have no idea what your disability is, but could you do work from a computer remotely?  There is always a need for physicians to work in CDI, recruiting, telephonic wellness coaching, etc. 

Good luck with everything! 


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Papa Bear - thanks for the encouragement! Work like you're describing is my medium-term goal. Maybe I could do something part-time like that within 3-5 years. At the moment, though, I'm too functionally limited for any type of work. For example, I can only use the computer for a few minutes at a time [I won't even tell you how long it took to prepare my case study post!]. And I'm not reliably able to complete tasks. I can take care of things that are more free-form in time but my lawyers have power of attorney for things that involve forms, deadlines, or consequences for failing to complete the task.

Dr Kidstache

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Re: Case study: Disability is not the ER I anticipated...
« Reply #7 on: April 21, 2017, 12:54:23 PM »

I'm not able to dig in to a case study at the moment, but I wanted to tell you I wrote a book for you :)      It's not specific to disability, but it certainly comes out of that experience in me and thousands of people I've assisted in such a boat. It is a few hundred pages of commiseration, understanding, and -by far the bulk of the content- direct, practical tips for navigating such a life. Linked to via my signature. It is literally every single thing I have to offer in such a situation.

Wow, great! I'll take a look at it when I can. Thank you for responding!

BlueHouse

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Re: Case study: Disability is not the ER I anticipated...
« Reply #8 on: April 21, 2017, 12:55:09 PM »
Dr. Kidstache,
I feel for you.  As I was reading your introduction, I just kept thinking "Thank god, he was frugal and paid off his loans early".  Your situation would be so different now if things were different.  Still, it sucks that what you were working for is gone for something so random.  I'm really sorry about that. 

While I don't have specific financial advice for you, it struck me that your writing skills are excellent and that your brain is still working.  Any chance you can find something in your experience that might help others and monetize it?  i.e.  Speaking on how to navigate the system? Consumer-rights advocate against these disability companies?  Blog-writer on the experiences?  Could you team up with your former employer and create a new job to assist other patients who become disabled as an advocate? 

I'm sorry...you probably need to focus on your own medical care for now and may not be able to devote any time to anything else.  Just hoping your skills can be used again in the future some time. 

I'm rooting for you and hope the best for you. 
Sometimes nothing can be a real cool hand

AlanStache

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Re: Case study: Disability is not the ER I anticipated...
« Reply #9 on: April 21, 2017, 01:22:00 PM »
290,000$ net worth / 5150$ expenses per month -> 4.6 years

So you are not in immediate danger if LTD went away today.  And you said you would like to return to the labor force in a few years when you are able; given your education and writing ability you will be able to cover that level of monthly expense when you are able to work. 

There is some fat in your budget but all in all I think you are asking more about the big picture security than cutting your charity expense.

Do you have family that you could live with?  Would they be open to you living with them; maybe you pay off there mortgage and get free rent hence forth - that might not be the best dollar wise but it could buy you a feeling of security?
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aperture

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Re: Case study: Disability is not the ER I anticipated...
« Reply #10 on: April 21, 2017, 01:29:46 PM »
Dr. K, reading with great sympathy.  I teach my kids that financial independence is about freedom, and sometimes it is about survival.  Your experience splits the difference. I have two small comments:

My wife had a TIAA-CREF retirement account from a previous employer and it was opaque on fees.  We could not figure out what we were paying to be in that system from a 20 minute web search and made the quick decision to roll that account over to Vanguard. Likely the Target Date retirement fund has a low expenses and may mirror the Vanguard Target Retirement Fund.  If that is the case, then there is probably no need to roll that one over, but otherwise rolling over to Vanguard is fairly painless and then all your accounts are under a single login.

I assume you are in the Target Retirement 2040 funds because they have the asset allocation that you want.  Vanguards:
Total Stock Market Index 51.9%
International Stock Index: 35%
Total Bond Index 9.2%
International Bond Index 3.9%

I think most people eventually arrive at the conclusion that they can get slightly lower fees (0.05% - 0.06% vs. 0.16%) while dialing in the exact allocation they want by choosing individual funds/etfs (e.g VTSAX, VXUS, VBTLX).  I do not know that you will arrive at better long-term returns with this approach, but you may feel more in control if you personally select your asset allocation. 

I wish you the best, aperture.
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Bimmy

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Re: Case study: Disability is not the ER I anticipated...
« Reply #11 on: April 21, 2017, 03:40:49 PM »
I was afraid you were going to say "Im a disabled doc- with $500,000 in student loans, a $400,000 house, and $32,000 boat, and a $55,000 truck to tow it." You did a great job of being financially sound.

I think it will take time, but I suspect you will find a way to work around the incident. Like others pointed out- you would be totally fine to take 5 years off to recover. That's not what you wanted to do, but you set yourself up for success. Best of luck. Hope you get better.
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Dr Kidstache

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Re: Case study: Disability is not the ER I anticipated...
« Reply #12 on: April 22, 2017, 08:11:34 AM »
As I was reading your introduction, I just kept thinking "Thank god, he was frugal and paid off his loans early".  Your situation would be so different now if things were different. 

Thanks, BlueHouse. I really am enormously fortunate that I had been so frugal pre-disability. You give me too much credit, though - I didn't pay off my loans. I was 6 years into IBR payments (so mostly interest-only payments because of my low income during residency/fellowship) in the hopes of qualifying for Public Service Loan Forgiveness. My loans were discharged a few months ago through a Total & Permanent Disability discharge. The loans get reported as income, though, so it's more like a debt buyout.

Oh, and I'm a she, not a he.

gaja

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Re: Case study: Disability is not the ER I anticipated...
« Reply #13 on: April 22, 2017, 09:03:59 AM »
I'm glad you have found someone to help you with deadlines and paperwork. Those things are difficult enough when you are healthy and have surplus energy. When you are struggling with short term memory or pain, it gets really challenging. DH is heading towards permanent disability due to psycological stuff. For him, the struggle has been realizing and accepting that he is not capable to work anymore. Sure, he can and should keep the hope that he will be able do some sort of work in a few years, but clinging to that idea the last years has made him sicker, not better. As long as he has disability benefits from the Norwegian state, he'll keep the payments from the insurance company. So far he has had temporary disability, while they are figuring out his disability grade. This is capped at four years, so unless they reach a decision to grant him permanent disability before October, we are fucked. Until then, we only have to make sure we send all the correct paperwork every two weeks. Still, it is a big source of stress. I've heard from a lot of people who have gone through the process, that they have gotten better after they got granted permanent disability. With the safety of regular paychecks, and less critical paperwork, they have could use their remaining energy to do other stuff, and sometimes even paid work.
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BlueHouse

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Re: Case study: Disability is not the ER I anticipated...
« Reply #14 on: April 22, 2017, 10:07:42 AM »
As I was reading your introduction, I just kept thinking "Thank god, he was frugal and paid off his loans early".  Your situation would be so different now if things were different. 

Thanks, BlueHouse. I really am enormously fortunate that I had been so frugal pre-disability. You give me too much credit, though - I didn't pay off my loans. I was 6 years into IBR payments (so mostly interest-only payments because of my low income during residency/fellowship) in the hopes of qualifying for Public Service Loan Forgiveness. My loans were discharged a few months ago through a Total & Permanent Disability discharge. The loans get reported as income, though, so it's more like a debt buyout.

Oh, and I'm a she, not a he.

Sorry about that Kidstache.  I'm a she too, so no excuse for my gender-typing.  Great image too!
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seattlecyclone

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Re: Case study: Disability is not the ER I anticipated...
« Reply #15 on: April 22, 2017, 01:38:43 PM »
On the income side, you mentioned that you think your $4,500/month individual policy is relatively safe. That plus your SSDI will total $6,100 a month when all is said and done. That right there is more than your monthly expenses, plus you have a pretty solid savings cushion to fall back on. I'm sure fighting with insurance companies can be incredibly stressful. Try to let your lawyers handle that, and spend as much of your personal attention as possible on improving your health. Your financial situation seems solid enough for the time being. Focus on your health.
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ElleFiji

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Re: Case study: Disability is not the ER I anticipated...
« Reply #16 on: April 22, 2017, 02:18:05 PM »
Hi Dr. Ladygoat!

I wanted to be a writer when in grew up. But I got too stressed out to ever submit any fiction for criticism. Luckily, I became a copywriter and it was the coolest job in the world. Then I got a surprise disability and it wasn't an option anymore.

I was unemployed, then underemployed, then trained in a new skill and was underemployed again. Then divorced and unemployed, with few options in New city. Then I trained in a new skill and I am fully employed and self supporting and saving to guard against future incidents. And my new field is an even better best job in the world.

So.... I would say, be okay with spending down some of the money. These first years of LTD are going to be super unfair and crappy. Take care of your health, including mental health. Sketch out hundreds of different futures for yourself. See what your body will let you do. Learn how different careers will affect you. And maybe being a doctor with your disability will work, or maybe it won't. Maybe it could work, but would crush your heart and soul because it is too close to who you thought you would be.

And keep the budget reasonable. Do what you need to. Investigate if your disability payments or a government disability program's dollars will stretch further in more comfort if you own your primary residence. Read joon's book. Read snacks's journal. Read Tami's journal.

SwordGuy

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Re: Case study: Disability is not the ER I anticipated...
« Reply #17 on: April 22, 2017, 03:01:16 PM »
There is software that takes dictation and puts it onto the computer for you.  Ditto for voice commands to the computer.

Obviously, it's got its limits, but you write well and clearly.  You might be able to get a gig to write doctor stuff and still have enough to pay someone to do the routine edits, if you have to keep keyboard time to a minimum.  Or the right company might make that arrangement for you.

Best of luck.   It looks like you'll be fine financially, so kudos to you for setting yourself up for success.

Dr Kidstache

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Re: Case study: Disability is not the ER I anticipated...
« Reply #18 on: April 22, 2017, 06:12:08 PM »
290,000$ net worth / 5150$ expenses per month -> 4.6 years

So you are not in immediate danger if LTD went away today.  And you said you would like to return to the labor force in a few years when you are able; given your education and writing ability you will be able to cover that level of monthly expense when you are able to work. 

There is some fat in your budget but all in all I think you are asking more about the big picture security than cutting your charity expense.

Do you have family that you could live with?  Would they be open to you living with them; maybe you pay off there mortgage and get free rent hence forth - that might not be the best dollar wise but it could buy you a feeling of security?

AlanStache, thanks for the reassurance. I do have family that I could live with, but that would be a last, desperate option. They live in a rural area and it would be very difficult for me to have any independence or access to rehab services there. Plus, they've really struggled with what's happened to me and haven't been able to be as present or supportive and I could use. But I do have the option if I run out of money.

Dr Kidstache

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Re: Case study: Disability is not the ER I anticipated...
« Reply #19 on: April 22, 2017, 06:15:01 PM »
My wife had a TIAA-CREF retirement account from a previous employer and it was opaque on fees.  We could not figure out what we were paying to be in that system from a 20 minute web search and made the quick decision to roll that account over to Vanguard.

Thanks for the suggestion, aperture! I've wondered about my TIAA-Cref accounts. I have all my retirement accounts synced to Betterment and Betterment frequently pops up a message that I'm paying higher fees on my TIAA-Cref accounts. Rolling them over is going on my to-do list.

Dr Kidstache

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Re: Case study: Disability is not the ER I anticipated...
« Reply #20 on: April 22, 2017, 06:19:54 PM »
I was afraid you were going to say "Im a disabled doc- with $500,000 in student loans, a $400,000 house, and $32,000 boat, and a $55,000 truck to tow it." You did a great job of being financially sound.

Haha, yeah, I've been pretty ruthless in my frugality and I thank my lucky stars now. If I had inflated my lifestyle like some early-career doctors, I would have been insolvent within months. I worry alot about my financial future since I'm dependent on my insurance benefit for now. But I am feeling better reading everyone's comments. Thanks for the encouragement, Bimmy.

Dr Kidstache

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Re: Case study: Disability is not the ER I anticipated...
« Reply #21 on: April 22, 2017, 06:23:47 PM »
I'm glad you have found someone to help you with deadlines and paperwork. Those things are difficult enough when you are healthy and have surplus energy. When you are struggling with short term memory or pain, it gets really challenging. DH is heading towards permanent disability due to psycological stuff. For him, the struggle has been realizing and accepting that he is not capable to work anymore. Sure, he can and should keep the hope that he will be able do some sort of work in a few years, but clinging to that idea the last years has made him sicker, not better. As long as he has disability benefits from the Norwegian state, he'll keep the payments from the insurance company. So far he has had temporary disability, while they are figuring out his disability grade. This is capped at four years, so unless they reach a decision to grant him permanent disability before October, we are fucked. Until then, we only have to make sure we send all the correct paperwork every two weeks. Still, it is a big source of stress. I've heard from a lot of people who have gone through the process, that they have gotten better after they got granted permanent disability. With the safety of regular paychecks, and less critical paperwork, they have could use their remaining energy to do other stuff, and sometimes even paid work.

Hey gaja, I'm so sorry about your husband. I totally sympathize with the difficulty of accepting my limitations. I even fired my lawyers a while back because I just couldn't believe that I really couldn't take care of my own affairs. D'oh. I was totally wrecked within a few days! I have moments almost every day when I think, "well, maybe I really could do ....." I'm hoping for the best for his disability decision!

AlanStache

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Re: Case study: Disability is not the ER I anticipated...
« Reply #22 on: April 22, 2017, 06:41:23 PM »
... Plus, they've really struggled with what's happened to me and haven't been able to be as present or supportive and I could use. But I do have the option if I run out of money.

Sorry, I know how it is to have family that is not as supportive as you would like (or should expect...) regarding a disability.
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RedwoodDreams

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Re: Case study: Disability is not the ER I anticipated...
« Reply #23 on: April 24, 2017, 08:20:24 PM »
Hi Doc-- Sorry to read your case study. I can relate to a lot of what you wrote because I've also been out of work on disability for 16 months or so, was approved for both LTD at 50% income replacement and SSDI, but have been horrified and shocked at the poor treatment by the LTD company, and their constant badgering and looking for ways to drop my coverage.

You can't fathom what this whole experience is like until you're the one plodding through it. In addition to the surprise, shock, stress of going from able-bodied to disabled, and at a time when your focus should be on your health and well being, you're wasting valuable time on paperwork, phone calls, endless letters, and it's all VERY stressful and somewhat humiliating.

After 9 months of coverage, LTD co. (codename SNOOPY) decided to consult an "outside physician" about my case, some hack doctor who basically tells them what they want to hear: "Nah, she isn't disabled. She can work." My MD is one of the world's foremost physicians at Stanford, and some paid dufus hack can essentially dismiss his diagnosis and treatment. So they dropped me last month. It was quite a shock, though as you say, you know you're always on thin ice with these LTD co's. It's criminal. I'm in the middle of an appeal (more paperwork, calls, groveling for doctor's letters--thankfully my doctor was furious about the drop and is willing to help me build a case). I don't know if the appeal will work, but I'll try. Thanks to my mustachian ways and the SSDI, including a stipend for my son (thank you, social safety net), I think we'll be OK, though standard of living has certainly dropped. But I'm glad we won't lose everything ...(unless lack of affordable health insurance takes me down, but that's another story)...

But again, when you need to focus on healing and improvement, having to deal with this garbage is horrendous and unjust. My former employer paid SNOOPY LTD insurance premiums on my behalf for 28+ years, but heaven forbid I actually need to make use of said policy! What a scam.

Well, enough about me. I wanted to say I can relate, and hang in there, definitely keep good records, keep seeing your doctors so that you have clear records should an appeal be necessary, and make use of a good lawyer if you can. I suspect that these LTD companies have tried and true techniques for getting some proportion of people to just give up, whether it's because of lack of energy or resources to fight back, or lack of a doctor who's willing to slog through the paperwork and fight on your behalf. I think they figure it's worth a try to drop you, but only x% will fight back, so they succeed in dropping some %. Evil! (I even wonder if they get a sense that you're using a lawyer if they'll back off...)

I second other posters' opinions that you are OK financially for now (bravo!), and that you should focus on your health. You have a decent cushion to draw on if needed. Try not to live in fear of the LTD going away, though I know it's hard not to worry. The SSDI will help, and once you get approved you'll get a chunk of back pay for at least one year's worth of disability (18 months minus the first 6 months of disability), and after two years you'll be eligible for Medicare, which will lessen your medical costs.

One thing I've had to do, and it's a process, is accept where I am physically, and be open to applying for / taking other assistance that's available. With LTD payments, we don't qualify for things like food stamps or energy assistance, but if my appeal doesn't work, living on SSDI we're essentially "low income," and that means eligible for things like food stamps, energy assistance, reduced DSL costs, etc. I've never begrudged others needing to draw on assistance, but somehow it didn't fit with my mental model of myself. I never wanted to be that person. (Who does, though?) But I've slowly come to both accept and appreciate that the assistance even exists to keep us afloat. Also reminding myself that my taxes and working for 30+ years paid into said systems.

Focus on your health, and in a few years see how you're feeling. On SSDI you're eligible to earn up to $1170/month and still receive your full SSDI, so maybe you'll feel well enough to do something PT if needed. But hopefully the LTD will be sustained!

Best wishes and please keep us posted as you're able to!

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Re: Case study: Disability is not the ER I anticipated...
« Reply #24 on: May 18, 2017, 11:25:32 AM »
Hi, Dr Kidstache.

I am a nurse who has been disabled from Multiple Sclerosis. It affects both my body and my memory. I think that the biggest adjustment was that I could no longer take care of people like I once could: even with my own family my husband must back my efforts because I forget things entirely. It took me years to accept this.

At any rate, it sounds like you have a handle on your basic expenses, though I have found that time regularly spent at it helps to keep the household running smoothly. I have found that I make a pretty fair housewife, and when I became organized I learned I only needed intermittent help with it. This is a come down as my dream was to be a commercial farmer, funded by my earnings as an RN. And, I cannot do either, now.

The life I am now living is not what I intended, but at least I can live a reasonably normal life. And, being a housewife does have its own rewards: the one and only thing wrong with it is that I did not choose it.

 So, I am a housewife, with a hobby farm in my back yard. Because, disabled or not, I am still the person that I have always been, and agriculture has always been my first choice. I actually enjoy being a housewife, though I cannot stop trying to figure out how I can farm as well, and I have been disabled now for 14 years. Intellectually I know it is not going to happen, but my thoughts keep going in that direction.   

At any rate, you are a doctor. In time you might be able to function as one, but I suggest that you come up with a plan B and a plan C. Because you do not know your future. I have seen one stroke victim so impaired that she could only move a couple of fingers, but a year later she was walking around and she was continuing to progress the last time I saw her. There is no way of predicting the future.

At any rate, I wanted to share a couple of tips about running a house while handicapped. It is possible that you will be doing this for a bit.

Do you remember A, B, C? (for the other readers, it is Airway, Breathing, Circulation. Medical people check this when assessing an injured person). Well, when running a house, think "living things first", because when your body quits it might literally quit. That means to set a high priority on things like dinner tonight and water for the pets. And, for day when I am not good for much, I have canned meals in a cupboard. If you take a box of rice -a-roni and open a can of chicken it makes a meal, and I can put them in my rice cooker with a handful of frozen peas. That way I do not have to watch a pot on the stove because on a mental day I might forget it, and what is in a rice cooker will not burn. I also keep my pets water dish in the bathroom so I cannot forget to fill it. When I get the mail the bills get put in ONE spot, and I pay them on Fridays. If I forget one Friday there will not be anything overdue the next Friday.

So,  living things first is "A". "B" is the quality of your life. For myself I am supposed to exercise, under the theory of "If you do not use it you will lose it". So, I talk on a homesteading forum and I have a garden in my back yard. To make the garden possible, I got my youngest to help me roll out weed barrier and I punched holes every 3 feet. Each hole accepts one plant, be it a cabbage or a pepper or????? I garden for 15 minutes a day, which is my exercise. I simply sit down and I care for whatever I can reach with hand tools. I water with a drip irrigation system, though I have not gotten the bugs worked out, yet. And, I have some miniature trees that do not get more than 4 feet tall.

That is my "B", I do not know what yours will be but it should be something you care about. I also often give advice on the forum to people who say "I have just been diagnosed with diabetes, I have an armful of pamphlets on what to eat and not to eat, but I am hungry NOW!!!!" "And I do not know what I can eat". I do good work, there, and I am proud of it.

I am aware that you are not up to this yet, but there is a good chance that you will be, in time.

"C". your career. I cannot give you advice there, as it is a hurdle that I have never been able to cross. I am aware that there are government agencies that will help, but I still cannot do them. I tire far to quickly, and there are other problems. Whatever.

I have raised 2 special needs kids, both are employed, and my oldest is getting married in June. I would have liked to do more of the hands on work, but at least I was able to go shopping with DD for clothes. And, she is having the same Bridal jitters as I once had, and I have been able to talk her through that.

For my career I am a Mom, and as a hobby I have my backyard hobby farm. And, I can still give advice on-line, at least. As for giving advice, tat is also something that you can do. My memory is not good enough to have patients, but at least I can help talk people through some of their nursing level medical stuff.

My life was not what I would have chosen, but the last several years have been good ones.
« Last Edit: May 18, 2017, 11:27:57 AM by Kansas Terri »

snacky

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Re: Case study: Disability is not the ER I anticipated...
« Reply #25 on: May 18, 2017, 11:39:32 AM »
That was really helpful, Terri. Thank you.
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kelvin

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Re: Case study: Disability is not the ER I anticipated...
« Reply #26 on: May 19, 2017, 11:15:58 AM »
Great job on the frugal lifestyle up until now. Medical students are already under tremendous pressure to complete 27 hours of work in a 24 hours day, between that and the "prestige factor" there's a lot of reasons to spend extravagantly. Certainly my grocery bill goes up whenever I start working 12+ hours/day. Great job.

Is it possible you could take your wonderful, excellent education and translate it into something else? I don't know how severe your disability is. Could you work as a medical advisor for a legal firm? Run a startup selling widgets to medical students? Tutor via Skype? Write the ultimate book on how to survive med school?

You've already accomplished some pretty incredible stuff. It didn't build into the future you were hoping for, which is tragic, but who you are as a person is still the same. You'll find a way to translate it into something great. Give it time, sleep on it, and know that you're not alone.

Vaulter

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Re: Case study: Disability is not the ER I anticipated...
« Reply #27 on: October 06, 2017, 02:38:11 PM »
Hi Dr. Kidstache,

I hope you have been improving (physically, mentally, financially, all ways) in the time since you posted this. I would like to reiterate the commendations on your frugality and foresight. You sound very clear-headed and thoughtful about the whole process, despite what I imagine to be extremely trying amounts of paperwork, deadlines, pain, and other stresses. I'm also impressed by your savings and making it to zero net worth so soon after all that school debt and training. I'm so glad you had both employer and individual disability policies, even though trying to keep them is stressful.

I don't think I have any specific advice that has not been mentioned above or that you do not already know. I hope some of the dictation software can help if you have typing limitations, and/or you are able to make use of other assistive technologies to reach your productivity goals. It sounds like your pre-accident financial savvy will keep you afloat for quite some time. I'm sure the strategies you built into your initial 10-year FI plan will help with your new plans as well. Everyone's FI plans change with time, just some more dramatically than others. Mostly, I just want you to know that we're thinking of you. You are obviously a very intelligent, strong person and you will keep doing great things.

- another early-career physician

Gin1984

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Re: Case study: Disability is not the ER I anticipated...
« Reply #28 on: October 07, 2017, 07:00:52 PM »
Your net savings amount after spending every month is $8211.  That means annually you could save $98532.  Am I reading that right?  You already have enough cash to pay off the discharge debt in three years.  However you need another $1,545,000 to be independent of the insurance company.  The best option is what you have been doing except I'd increase the amount in a stock fund, probably 75% stock, 25% EF.