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Any HR experts here? Or work benefit-type lawyers?

Posted by amethyst114 
Any HR experts here? Or work benefit-type lawyers?
October 21, 2014
There is an incredibly convoluted situation going on in my life that I alluded to over in The Living Room in one thread.

Essentially, my cousin (one of the ones I actually like) is in the middle of an unholy mess regarding FMLA, disability benefits, health insurance and liability insurance. This is going to be long, so I apologize in advance.

For a very brief background, she works as a janitor in a warehouse making next to nothing - the only job she could find at the time - but has paid into disability insurance (long term) from day one and has health insurance through her company. It is an incredibly physical job. She has never been given an option to pay for short term disability. She's worked there about 18 months. She just went through a divorce that ate up the meager savings she did have, and it was finalized last Friday. She is BROKE.

About 10 days ago, she went to a friend's apartment to get her safe (friend was storing it for her), and went walking to her car, tripped over something, fell, and fucked her shoulder up. She went to ER and was referred to a surgeon and to an MRI facility to see if she would need surgery or just a long time of physical therapy. She was told it would be at least 6-8 weeks before she could go back to work, IF the news was good.

She put in for FMLA and was approved - but they told her they will only hold her job for 90 days. She then applied for short term disability and was turned down. Apparently, for this company, hourly workers only get short term disability coverage after 2 years. Fine. She was freaked out, but not distraught, because she believed that she would only need a few weeks of therapy and she'd be fine. Between my parents, another cousin (whom she is living with at the moment), and myself, we'd get her bills paid until she could go back to work.

She completely tore her rotator cuff off the bone and needs surgery. The surgeon she went to told her this is going to be at least a 5-6 month ordeal before she's cleared to go back to work.

So, she called her work and put in for long term disability. They told her that she isn't eligible for it because she has to get 6 months of short term disability first, before she qualifies for long-term and she isn't eligible for short term because she hasn't been there two years. Yet, someone who got hired on a salaried a week before she did got full disability benefits within a week because she has a "difficult" pignasty. (I realize different jobs have different benefits, but I think the pignasty vs something else is more what's going on.)

The surgical center the surgeon works with wants 2 grand as a *deposit* and the apartment complex is refusing to pay it and the surgical center is refusing to bill them. The apartment complex has agreed to pay for medical expenses - but only as reimbursement and with reciepts/bills. They haven't said if they are going to reimburse her for lost wages or not. She doesn't have the money to come up with the 2 grand deposit, nor do any of us, nor do we even put together, and the surgeon is refusing to refer her to someone else/a hospital who might be able to work with her financially. They told her to take out a loan, which she can't do because she won't be able to work and pay it back.

She has health insurance, but since this is an accident and someone else's liability is paying for it, is that the reason they won't just run the health insurance and bill her for the rest later?

Her job has told her that as soon as the 90 days are up, she's fired, medical documentation or no. The state of Texas sent her a letter years ago telling her that she will never be able to file for unemployment again in the state, because they over paid her and nearly a year later, when they contacted her about it, she couldn't pay it back. Her job is claiming that she isn't eligible for disability. I told her to contact Medicaid, but she's not pignant and doesn't have crotchfruit so we all know how that is going to turn out.

So to the HR people/lawyers here - is FMLA really only 90 days? I was under the impression that it was 6 months or more. God knows moos gets more time than that for a voluntary condition.

The things her job is telling her about her disability claim strike me as very off. How could they be charging her for long-term disability (and making her pay for it) all while knowing full well that she isn't eligible for it, or else denying it to her because of something else that isn't eligible for? I told her that reeks of fraud. (And apparently the paperwork for the long-term disability that she bought says it's after 13 weeks of being out of work, not 6 months.)

Does anyone have any input on the unemployment thing? That sounds weird to me too. And this was nearly a decade ago that she got the letter. While I realize that this is Texas and it probably hasn't changed, does anyone have an input on that?

Right now she wants to just give up. She's already depressed, and I'm worried about her ability to deal with all of this. I'm driving down in a few hours to discuss what options there are.

TL;DR: Yet another single, loaf-less adult getting fucked because the world only panders to breeders.

"Selfishness is not living as one wishes to live, it is asking others to live as one wishes to live." - Oscar Wilde
Re: Any HR experts here? Or work benefit-type lawyers?
October 22, 2014
i don't know what to tell you except your cousin needs a lawyer, someone who is familiar with labor laws in your state.

. I suspect the company is telling her falsehoods because they hope she will go away.

Can you contact Legal Aid or the Bar Association in your state and see if they have low cost legal services for poor people? Emphasize that she has zero income at the moment.
Re: Any HR experts here? Or work benefit-type lawyers?
October 23, 2014
Thank god she lives in the country with the best healthcare system in the world, instead of a socialist hellhole with a national health system![\sarcasm]

Unfortunately, I don't have any advice, except to call legal aid.
Re: Any HR experts here? Or work benefit-type lawyers?
October 24, 2014
Well, now that I'm back home, I can update a little. We finally found a place that will do the surgery for her, taking the 80% her insurance will pay and eating the other 20% as charity care/tax write off. She's waiting on an appointment with the surgeon, and once s/he sees her, the surgery will be scheduled. She is in *much* better spirits than she was a few days ago, now that she knows she'll definitely be getting the surgery.

There is a legal aid type place not too far from where she lives, and she's been there before for her divorce, the problem is getting there since she can't drive. So, until I go back down there, the legal issues surrounding her disability are on the back burner. I told her to get all her benefits paperwork together in the meantime, and get copies of every single doctor's report about her shoulder. As soon as someone is able to take her down there, she'll be going.

Thanks to you both for responding! We both honestly forgot all about the legal aid place with everything else that was going on. It was a good reminder.

"Selfishness is not living as one wishes to live, it is asking others to live as one wishes to live." - Oscar Wilde
Re: Any HR experts here? Or work benefit-type lawyers?
October 27, 2014
I'm a HR pro but in Canada, so I don't know about specific US labour laws.

But I don't get how they can say she's covered (and paying) for LTD but not STD. That makes no sense. You don't go straight to LTD, you go through STD and then that extends into LTD if needed/approved.

If there is a Labour board/commission and she qualifies (i.e. employed for X months minimum, for example), that would be her legal recourse.

I really feel for your cousin; that is a horrible and very scary situation. I wish her the best.
Re: Any HR experts here? Or work benefit-type lawyers?
November 02, 2014
Unfortunately, Medusa, Texas is a 'right-to-work' state, meaning that the employee has no rights.
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