Gerrit

I certainly can sympathize with your desire to have a few good  years before the
PD really takes hold.  It sounds as though your motivation for the job is shot
and that might well have predated  the development of PD.  I doubt whether an
insurance company is going to call you disabled if you haven't reached the point
of taking Sinemet.  I think the examining physician would say that you must be
tried on at least the standard treatment-  be the best that you can be before
recommending LTD insurance benefits.

If the job was not satisfying prior to PD then you might consider the
possibility of Clinical Depression-  a common complicating factor in PD. That is
potentially treatable and it might change your mind about retiring this early.

Otherwise, you are still in a relatively good position for the approach that you
have been taking to work since presuming you are not "fireable" (in the States
the Americans with Disabilities Act would protect you).  Then your employer may
benefit from your retirement.  If there were an outside insurer then the longer
they put off the retirement the greater the profit-  but that isn't your case.

I hope that you are able to get disability benefits or if not that- then at
least be able to get more fulfillment from your job if you have to stay there
longer.

Charlie

"Kleynscheldt, Gerrit" wrote:

> Hi you all!
>
> I recently sent a question (a couple of questions actually) to this forum
> and want to thank you all for the wonderful response.  It makes it all
> worthwile if one can share on a (literary) global scale - all the feelings
> that I thought was unique to me gets verbalised by other P'sWP and this has
> the effect that I feel more "normal"!
>
> The rest of this E-mail is a copy of my original question, with reaction to
> that from Dr Charles Meyer and with my response.  I place this because it is
> a way of sharing.
>
> (From Charles:) First let me ask some questions.
>
> 1.      Do you have private or governmental  insurance or a combination?
>                                 I have private insurance - a pension and
> provident fund with disability benefits to the extent of a lump sum payment
> and a subsequent monthly income of about 75% of current income.  I also have
> an anuity with disability benefits.
> 2.      If you receive these benefits will you have enough (with savings,
> spouse income etc. to live on in a reasonable fashion?
>                                 Yes - at least for a number of years, not
> knowing what interest rates, inflation etc will do in future. (our current
> bond rates drift in the area of 21%!)
> 3.      How much do you want to (have the energy and motivation) to continue
> work?
>                                 Not much - none in fact.  It seems as if I
> have lost all impetus & drive.  Fatigue and lack of initiative is a
> constant.  I believe furthermore that I should get the opportunity to retire
> now for a couple of sunshine years with my wife & kids - postponing the
> introduction of L-dopa in the process -  before PD takes over completely.
> The insurance houses will not agree to this I suppose, but I want the
> benefit of the doubt - see your question 4.
>                 In other words  if you were in an environment where what you
> produced didn't matter would you want to continue working or do you think
> its time to quit?
>                                 Time to quit.  I have such a lot to do - I
> have procrastinated myself into a situation where I have enough To Do's & To
> Read's for years to come.
> 4.      How much do you think your production has been compromised?  Do you
> think that your employer is losing money on you?  How much does your
> employer know about your illness?  When was he told? How did he/she react?
>                                 I believe I am being "carried" at this stage
> by a very understanding line manager.  Tasks have been reduced to very
> little.  My employer is an insurance company (disability benefits therefore
> in-house, but in another department) and we are attempting to introduce
> managed health care to South Africa.  This is a very aggressive & volatile
> market and the company do not really want to have to carry some employees.
> We have been through a restructuring exercise, with another one looming.  I
> survived the first, do not know about the second, and is not clear about how
> the company will treat me.  Retrenchment will be a financial disaster.
>                                 Risking it all I decided to play clean and
> put all my cards on the table, giving all relevant information to my
> employer.   I was concerned that the different departments within the
> company (e.g. HR and insurance) will make decisions within the ambit of
> their own devices, so I wrote a letter to the head of the company, asking
> that my plea for disability be looked at holistically. (Placing me on
> disability will mean that the payment of my income will not come from the
> Personnel department any more, but from the disability insurance.  This is
> still the same company.)  In response to this I have had a good meeting with
> management at HR.  The jury is still out...
> 5.      Is there a possibility in the job situation and with your insurance
> program of working part-time?.  I did that for about 8 months and it helped
> me a lot in the transition.
>                                 It was suggested to me that I assist by
> doing some research for my department on the Internet.  I will gladly do
> this, but my reponse was that I would prefer to to it during disability, on
> an As-&-When basis.  My line management suggested that we start now already
> with a programme where I can do work from home on my "off" days.
>
>         Now regarding your questions:
>         "Kleynscheldt, Gerrit" wrote:
> > I have a question that I have not yet seen addressed anywhere:
> > In a debilitating illness like PD one is initially able to carry on with
> > your duties as an employee.  At some point a stage is reached where you
> are
> > diagnosed as being unable to work and thus declared disabled.
> > 1.      This cross-over stage seems to be very subjective, depending on
> the
> > report by (inter alia) the neurologist, who compares you with the worst
> > cases that he has come across.
>
> Yes it is subjective. And at least here in the States you can be almost
> guaranteed a fight no matter where you are in the  course of the disease.
> It in crucial to have your doctor behind you and to write the correct things
> to the insurance company or Social Security.  If as you have said your
> neurologist does not know a lot about PD find one who does.  I don't know
> the availability of movement disorder specialists in South Africa but I
> suspect that there must be Movement Disorder Clinics in the larger cities.
> The job of the physician is to evaluate how the symptoms that you have
> interfere with your work as defined by a job description given to him by you
> or your employer.  He should be relying on you and your employer for the
> data.
> >
> > 2.      It is very difficult to convey the non-visible effects to an
> > outsider.  How does the Dr measure exactly how much the arm is numb,  how
> > much fatigued I am, exactly how little energy I have, how much of my
> > procrastination can be blamed on PD, etc.
>
> Again that is difficult. Remember- and he should too- that loss of
> initiative is a SYMPTOM of PD.  So is fatigue.  Your employer can provide a
> lot of the data and it may be to his advantage as well as yours for you to
> receive disability - if your production is suffering..
> >
> > 3.      At the workplace I become a passenger, doing work but not
> performing
> > well at it and seeing my colleagues get ahead while I barely survive each
> > day.
>
> That is discouraging especially if you have taken pride in your work in the
> past.
>
> >
> > 4.      Compared to my colleagues of the same age - by the time they go on
> > pension to a well deserved rest I will be in an advanced state with my PD.
> > Should the insurer not consider paying the disability earlier so that I
> can
> > also have a period of relative sunshine before PD takes a stronghold? They
> > know that they will definitely have to pay the benefit, but they postpone
> > their decision, without a visible advantage.
>
> Yes I agree-  but it won't fly.  Unfortunately every check that you don't
> get is money in their pockets-  and if they are lucky maybe you will die
> young and they won't have to pay at all.
> > Has anyone thought about this and how is the insurer and/or employer
> > approached so that the case is looked at holistically and with empathy,
> > rather than the current and (for them) safer route of clinical reports.-
>
> I have thought a lot about this.  I have done some psychiatric disability
> evaluations when I was practicing and had to borrow money from my family
> several years ago when my insurer played these games and I wasn't working.
> If you answer the questions above I will try to suggest some approaches
> which might be effective (but in this business then again may not).
> Charlie
> ****************************************************************************
> **************
>
> Charles T. Meyer,  M.D.
> Middleton (Madison), Wisconsin
> [log in to unmask] <mailto:[log in to unmask]>
> ****************************************************************************
> *************************************************************
>
> Gerrit Kleynscheldt
>
> Tel:    +27 21 947 8918 (Local 021 947 8918)
> Fax:    +27 21 947 1521 (Local 021 947 1521)
>
> Please note the following:
> Because e-mail can be altered electronically, the integrity of this
> communication cannot be guaranteed.

--
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Charles T. Meyer,  M.D.
Middleton (Madison), Wisconsin
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