Friend has cancer. What should be the next steps?

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haranoth
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Friend has cancer. What should be the next steps?

Post by haranoth » Wed Aug 28, 2019 2:44 pm

Asking inputs for a friend's situation.
We found out about a month ago that he has brain cancer and went for surgery 3 weeks ago. Now he will be starting his chemo this week.
The thing is, he has pretty aggressive cancer and the prognosis is 1-to-5 years , with the median being on the lower side of 1.5 years.

We are still in sort of disbelief about the whole thing. He is super health conscious and only turned 31 this year.
In anycase, we are trying to figure out some next steps for him financially.
I have seen a friend's uncle go through the same cancer with chemo, and seen what it does to people. Granted that my friend is much younger and healthy, but I don't forsee him continuing to work while getting chemo.

He works in a decent mid-range company as a software developer.
Wife stays at home.
He makes around 120k in HCOL area.
Just bought a new car. ~500$/month is loan.
The other car is fully paid off.
Rent 1400$

has about ~110k in 401k

has about 4k in savings

another 10k in brokerage account

another 3k for some crypto.. current value might be less that 400$.

Life insurance 1xSalary

He is going on short time disability through work( 100% pay) for 3 months.
after that long term disability (60% pay) for 6 42 months.

Unsure whether he will be able to keep job/insurance for cancer treatment beyond that point. HR sent some vague response saying, they follow Family and Medical Leave Act (FMLA) of 1993. Which I can't decipher at the moment.

Parents can help out somewhat with money, if needs be. Although, we are not sure how much cancer treatment costs, if he looses his job/insurance?

They are also european country citizen where some of their treatment can be covered, if need be. But they want the treatments to be done in the States, as the facilities, chances of clinical/experimental treatment is better here.


So, there goes it... We are not sure what to do here.. Should we talk to someone?
Thanks in advance for everyone chiming in
Last edited by haranoth on Wed Aug 28, 2019 2:59 pm, edited 1 time in total.

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ResearchMed
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Re: Friend has cancer. What should be the next steps?

Post by ResearchMed » Wed Aug 28, 2019 2:47 pm

Such a sad and scary situation!

It sounds like there are no children?
That makes a difference in terms of planning, etc.

RM
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haranoth
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Re: Friend has cancer. What should be the next steps?

Post by haranoth » Wed Aug 28, 2019 2:48 pm

Arggh.. this should be in Personal finance section.
Can someone help me , move the post to the correct location? thanks

ohai
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Re: Friend has cancer. What should be the next steps?

Post by ohai » Wed Aug 28, 2019 2:48 pm

Hi. That sounds pretty tough. I would think that the hospital offers some consulting or has contacts to some organization that does offer this service. They are probably your best resource.

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haranoth
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Re: Friend has cancer. What should be the next steps?

Post by haranoth » Wed Aug 28, 2019 2:48 pm

ResearchMed wrote:
Wed Aug 28, 2019 2:47 pm
Such a sad and scary situation!

It sounds like there are no children?
That makes a difference in terms of planning, etc.

RM
No Children. They were trying for one. But now, all of that is on hold.

rascott
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Re: Friend has cancer. What should be the next steps?

Post by rascott » Wed Aug 28, 2019 2:54 pm

Really sorry to hear....what a terrible story.

Not to be harsh, but this is why everyone needs proper life insurance if someone is counting on their income... and full scale long term disability insurance. What kind of LTD only covers 6 months? That's not long-term in anybody's book.

delamer
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Re: Friend has cancer. What should be the next steps?

Post by delamer » Wed Aug 28, 2019 2:59 pm

A very sad situation. I am sorry for your friend.

He should start with finding out the status of his health insurance coverage while he is on both short-term and long-term disability.

I expect that he’ll continue to be covered, but he needs to be sure. He also needs to find out if he’ll have to make a contribution toward the premium cost (assuming that he does now).

Then he should ask about eligibility for COBRA coverage, which allows an employee to continue health insurance through a former employer for 18 months. But he would have to pay the full cost plus an administrative fee.

In the longer run, he may become eligible for Social Security disability if he can’t return to work.

Topic Author
haranoth
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Re: Friend has cancer. What should be the next steps?

Post by haranoth » Wed Aug 28, 2019 3:00 pm

rascott wrote:
Wed Aug 28, 2019 2:54 pm
Really sorry to hear....what a terrible story.

Not to be harsh, but this is why everyone needs proper life insurance if someone is counting on their income... and full scale long term disability insurance. What kind of LTD only covers 6 months? That's not long-term in anybody's book.
I am sorry, it's actually 42 months.. The fine print on the LTD document is so vague and so long, that we misunderstood.
Sorry for the wrong info

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haranoth
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Re: Friend has cancer. What should be the next steps?

Post by haranoth » Wed Aug 28, 2019 3:03 pm

delamer wrote:
Wed Aug 28, 2019 2:59 pm
A very sad situation. I am sorry for your friend.

He should start with finding out the status of his health insurance coverage while he is on both short-term and long-term disability.

I expect that he’ll continue to be covered, but he needs to be sure. He also needs to find out if he’ll have to make a contribution toward the premium cost (assuming that he does now).

Then he should ask about eligibility for COBRA coverage, which allows an employee to continue health insurance through a former employer for 18 months. But he would have to pay the full cost plus an administrative fee.

In the longer run, he may become eligible for Social Security disability if he can’t return to work.
Thank you for the kind words.
So, if it's terminal cancer.. (which it basically is. Its stage 4 brain cancer. ) , isn't there some law to ensure that insurance companies / employer keep paying. Regarding COBRA coverage do we talk to employer or insurance?

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Re: Friend has cancer. What should be the next steps?

Post by Dottie57 » Wed Aug 28, 2019 3:09 pm

Employer for insurance.
ACA insurance after Cobra.


I suggest wife start thinking of employment.

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Re: Friend has cancer. What should be the next steps?

Post by Dottie57 » Wed Aug 28, 2019 3:11 pm

haranoth wrote:
Wed Aug 28, 2019 3:03 pm
delamer wrote:
Wed Aug 28, 2019 2:59 pm
A very sad situation. I am sorry for your friend.

He should start with finding out the status of his health insurance coverage while he is on both short-term and long-term disability.

I expect that he’ll continue to be covered, but he needs to be sure. He also needs to find out if he’ll have to make a contribution toward the premium cost (assuming that he does now).

Then he should ask about eligibility for COBRA coverage, which allows an employee to continue health insurance through a former employer for 18 months. But he would have to pay the full cost plus an administrative fee.

In the longer run, he may become eligible for Social Security disability if he can’t return to work.
Thank you for the kind words.
So, if it's terminal cancer.. (which it basically is. Its stage 4 brain cancer. ) , isn't there some law to ensure that insurance companies / employer keep paying. Regarding COBRA coverage do we talk to employer or insurance?

There is no law which will fix this situation.

runner3081
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Re: Friend has cancer. What should be the next steps?

Post by runner3081 » Wed Aug 28, 2019 3:14 pm

haranoth wrote:
Wed Aug 28, 2019 2:44 pm
Unsure whether he will be able to keep job/insurance for cancer treatment beyond that point. HR sent some vague response saying, they follow Family and Medical Leave Act (FMLA) of 1993. Which I can't decipher at the moment.
Unfortunately, that means he will get 12-weeks of protected employment absences (within a 12-month rolling period). After that point, they can let him go.

If let go, he could stay on benefits with COBRA for 18 months.

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Re: Friend has cancer. What should be the next steps?

Post by willthrill81 » Wed Aug 28, 2019 3:16 pm

I don't think that the insurance company is obliged to suspend premiums for terminal illness. But if your friend's life expectancy is only ~18 months, continuing to pay for the premiums via COBRA might not be a terrible option. Going back to Europe for treatment may be necessary though.

Their finances may not allow it, but if this happened to me, I would quit work as soon as possible and enjoy spending every moment with my family and friends that I possibly could. If there was anything big on my 'bucket list' that I hadn't done yet, I would do it. But that's because we have adequate life insurance in place, so I wouldn't be worried about taking money away from my loved ones who needed it.
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Re: Friend has cancer. What should be the next steps?

Post by FootballFan5548 » Wed Aug 28, 2019 3:18 pm

This is devastating, I'm so sorry to hear this. I wish nothing but the best for your friend and his family. I couldn't even imagine.

https://www.cancer.org/
I would get to know this website and have your friend call the hotline. The American Cancer Society (of which i'm a donor) is a great organization that can help answer some very tricky questions. This would be the first place I'd start to read up on what some options are.

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ResearchMed
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Re: Friend has cancer. What should be the next steps?

Post by ResearchMed » Wed Aug 28, 2019 3:25 pm

haranoth wrote:
Wed Aug 28, 2019 3:00 pm
rascott wrote:
Wed Aug 28, 2019 2:54 pm
Really sorry to hear....what a terrible story.

Not to be harsh, but this is why everyone needs proper life insurance if someone is counting on their income... and full scale long term disability insurance. What kind of LTD only covers 6 months? That's not long-term in anybody's book.
I am sorry, it's actually 42 months.. The fine print on the LTD document is so vague and so long, that we misunderstood.
Sorry for the wrong info
Look more carefully at the terms of both short and long term disability policies. They might include access to continued health care, either at regular cost, or perhaps at even lower or no cost.
Is that 60% LTC coverage tax-free? It often is, which is why it's often closer to 2/3 rather than full salary.
But what matters, obviously, is his specific coverage.

And talk with both local agencies AND the treating hospital for extra resources, which might be both advice/support and also some financial.
Social Services (both places) should be a great start, and good for other referrals for resources.

Good luck!

RM
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deikel
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Re: Friend has cancer. What should be the next steps?

Post by deikel » Wed Aug 28, 2019 3:28 pm

Tough one

Check with HR how his employment will do after the short term disability is consumed - it is very possible that he will actually be terminated from employment after these three months. If so, he should consider going back to work at some point and delay these three months as far into the future as possible.

After termination, he will loose health care AND life insurance through employment, but the long term disability will kick in. Health care can be done by Obama care or COBRA (18 months plus possibly another 18 months depending on state - where is he located?), but life insurance at this point will be moot - which sucks, since some life insurance have options to get some money prior to death and can be used for treatment/hospice care at terminal stage - so that's out.

The other obvious financial steps are wife needs to find a job asap, both for the next 18 months and thinking beyond.

He should probably cash in his crypto and brokerage this year (take the losses and offset wins, otherwise drag the losses over to tax offsets in the next two years) and likely his 401k next year (when lower income level) - other then he plans to leave that to his wife after death.

As long as his wife stays at home I fail to see why they need two cars, sell one of them and pay the loan off. Depending how his cancer goes, he might not be able to drive sometime soon/should not drive sometime soon anyway.

Since wife has no income, move to an area where she can find a job (and he still has reasonable treatment options) - but get out from HCOL area.

Not sure where in the process he is right now, but your friend is a software developer and by training a rather scientific and logic person, hopefully he can find a new project to focus on, the project being to help transition his wife to a life without him. Yes, that sucks, but hopefully the purpose will help.

Its another story of cancer being random and hitting anyone - health conscious or not plays little role in most cancers.
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7eight9
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Re: Friend has cancer. What should be the next steps?

Post by 7eight9 » Wed Aug 28, 2019 3:31 pm

If your friend doesn't already have one a will and health care proxy probably would be in order. Also, making sure all accounts have named beneficiaries.
I guess it all could be much worse. | They could be warming up my hearse.

deikel
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Re: Friend has cancer. What should be the next steps?

Post by deikel » Wed Aug 28, 2019 3:37 pm

delamer wrote:
Wed Aug 28, 2019 2:59 pm
In the longer run, he may become eligible for Social Security disability if he can’t return to work.
Getting SSDI approved will likely take longer then he has left to live, its worth checking if he is eligible to receive SSDI (how many points has he collected so far?), but I think this is a slim chance in this case.

However, its worthwhile checking if his wife can get survivors benefits under SS (again depending if he is eligible at all)
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haranoth
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Re: Friend has cancer. What should be the next steps?

Post by haranoth » Wed Aug 28, 2019 3:43 pm

deikel wrote:
Wed Aug 28, 2019 3:37 pm
delamer wrote:
Wed Aug 28, 2019 2:59 pm
In the longer run, he may become eligible for Social Security disability if he can’t return to work.
Getting SSDI approved will likely take longer then he has left to live, its worth checking if he is eligible to receive SSDI (how many points has he collected so far?), but I think this is a slim chance in this case.

However, its worthwhile checking if his wife can get survivors benefits under SS (again depending if he is eligible at all)
He has worked 7 years out of college, all in same company, so 28 credits.
Seems like there is a chance for him to be eligible.
https://www.investopedia.com/ask/answer ... e-disabled
thanks

California88
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Re: Friend has cancer. What should be the next steps?

Post by California88 » Wed Aug 28, 2019 3:45 pm

I'm so sorry - devastating news. Being that the prognosis is so bad he might consider reading up on places like The Gerson Institute in San Diego.

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Re: Friend has cancer. What should be the next steps?

Post by oldcomputerguy » Wed Aug 28, 2019 3:46 pm

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Re: Friend has cancer. What should be the next steps?

Post by Mlm » Wed Aug 28, 2019 3:49 pm

I''m sorry to hear about your friends diagnosis. My sister went through this many years ago. When she was no longer able to work she applied for Social Security disability. With a terminal diagnosis she was approved very, very quickly.

She also ticked things off her bucket list while she was still able. Those are some of my most fun and memorable times.

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haranoth
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Re: Friend has cancer. What should be the next steps?

Post by haranoth » Wed Aug 28, 2019 4:05 pm

deikel wrote:
Wed Aug 28, 2019 3:28 pm
Tough one

Check with HR how his employment will do after the short term disability is consumed - it is very possible that he will actually be terminated from employment after these three months. If so, he should consider going back to work at some point and delay these three months as far into the future as possible.

After termination, he will loose health care AND life insurance through employment, but the long term disability will kick in. Health care can be done by Obama care or COBRA (18 months plus possibly another 18 months depending on state - where is he located?), but life insurance at this point will be moot - which sucks, since some life insurance have options to get some money prior to death and can be used for treatment/hospice care at terminal stage - so that's out.

The other obvious financial steps are wife needs to find a job asap, both for the next 18 months and thinking beyond.

He should probably cash in his crypto and brokerage this year (take the losses and offset wins, otherwise drag the losses over to tax offsets in the next two years) and likely his 401k next year (when lower income level) - other then he plans to leave that to his wife after death.

As long as his wife stays at home I fail to see why they need two cars, sell one of them and pay the loan off. Depending how his cancer goes, he might not be able to drive sometime soon/should not drive sometime soon anyway.

Since wife has no income, move to an area where she can find a job (and he still has reasonable treatment options) - but get out from HCOL area.

Not sure where in the process he is right now, but your friend is a software developer and by training a rather scientific and logic person, hopefully he can find a new project to focus on, the project being to help transition his wife to a life without him. Yes, that sucks, but hopefully the purpose will help.

Its another story of cancer being random and hitting anyone - health conscious or not plays little role in most cancers.
Thank you for a detailed breakdown. They live in Massachusetts.
the LTD stuff and termination of employment is kind of the sticking point. We aren't really getting an exact answer. Only troves of documentation and emails from HR. Guess we need to sit down with them, to understand what will be their response. It felt like HR, doesn't wanna talk about termination, until and unless it comes down to it.

deikel
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Re: Friend has cancer. What should be the next steps?

Post by deikel » Wed Aug 28, 2019 4:06 pm

California88 wrote:
Wed Aug 28, 2019 3:45 pm
I'm so sorry - devastating news. Being that the prognosis is so bad he might consider reading up on places like The Gerson Institute in San Diego.
Please...don't waste your last minutes in life with such rubbish...if it helps you psychologically, great, but please don't consider this treatment of the cancer in any way, form or shape. Staying within financial discussions, this is a waste of time and money
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deikel
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Re: Friend has cancer. What should be the next steps?

Post by deikel » Wed Aug 28, 2019 4:08 pm

haranoth wrote:
Wed Aug 28, 2019 4:05 pm
deikel wrote:
Wed Aug 28, 2019 3:28 pm
Tough one

Check with HR how his employment will do after the short term disability is consumed - it is very possible that he will actually be terminated from employment after these three months. If so, he should consider going back to work at some point and delay these three months as far into the future as possible.

After termination, he will loose health care AND life insurance through employment, but the long term disability will kick in. Health care can be done by Obama care or COBRA (18 months plus possibly another 18 months depending on state - where is he located?), but life insurance at this point will be moot - which sucks, since some life insurance have options to get some money prior to death and can be used for treatment/hospice care at terminal stage - so that's out.

The other obvious financial steps are wife needs to find a job asap, both for the next 18 months and thinking beyond.

He should probably cash in his crypto and brokerage this year (take the losses and offset wins, otherwise drag the losses over to tax offsets in the next two years) and likely his 401k next year (when lower income level) - other then he plans to leave that to his wife after death.

As long as his wife stays at home I fail to see why they need two cars, sell one of them and pay the loan off. Depending how his cancer goes, he might not be able to drive sometime soon/should not drive sometime soon anyway.

Since wife has no income, move to an area where she can find a job (and he still has reasonable treatment options) - but get out from HCOL area.

Not sure where in the process he is right now, but your friend is a software developer and by training a rather scientific and logic person, hopefully he can find a new project to focus on, the project being to help transition his wife to a life without him. Yes, that sucks, but hopefully the purpose will help.

Its another story of cancer being random and hitting anyone - health conscious or not plays little role in most cancers.
Thank you for a detailed breakdown. They live in Massachusetts.
the LTD stuff and termination of employment is kind of the sticking point. We aren't really getting an exact answer. Only troves of documentation and emails from HR. Guess we need to sit down with them, to understand what will be their response. It felt like HR, doesn't wanna talk about termination, until and unless it comes down to it.
Its great that you are helping your friend navigating this...this is the kind of stuff no one wants to deal with when time becomes really precious ..kudos to you !
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Afty
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Re: Friend has cancer. What should be the next steps?

Post by Afty » Wed Aug 28, 2019 4:23 pm

I'm so sorry to hear this. A few stray thoughts and suggestions.

Consider setting up a Gofundme. As people find out about the diagnosis, they will want to help in whatever way they can. A friend was recently diagnosed with stage 4 cancer and was able to fund her entire treatment through Gofundme. I donated a significant amount even though I haven't seen her in years.

https://thedrlc.org/cancer/ is a nonprofit that provides legal advice to cancer patients. They could probably answer your questions about your friend's employment rights. https://thedrlc.org/cancer/publications ... lications/ looks very relevant.

Is his wife able to work? Does she have employable skills? One way to deal with a potential job loss and loss of insurance is for the wife to find a job that provides family medical benefits.

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Re: Friend has cancer. What should be the next steps?

Post by Northern Flicker » Wed Aug 28, 2019 4:34 pm

If your friend lives in a state that expanded Medicaid under ACA that will be available if income falls below the level of qualifying for a premium tax credit, and your friend will be able to get insurance. If income exceeds the level needed for a premium tax credit but not by a lot, cost sharing subsidies will lower deductibles and out of pocket maxima.

It may not be cost effective to switch insurance mid-year due to resetting deductibles and out of pocket caps, so a common strategy is to use COBRA until year end and an individual exchange-based plan starting 1/1 with regular open enrollment.

Wishing all the best for your friend.
Index fund investor since 1987.

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Re: Friend has cancer. What should be the next steps?

Post by HelloT » Wed Aug 28, 2019 4:40 pm

Normally, there are coversion rights assoicated with Group Life insurance without evidence of insurability within 31 days of termination. He should be get it.

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Re: Friend has cancer. What should be the next steps?

Post by JoeRetire » Wed Aug 28, 2019 5:00 pm

haranoth wrote:
Wed Aug 28, 2019 2:44 pm
Asking inputs for a friend's situation.
We found out about a month ago that he has brain cancer and went for surgery 3 weeks ago. Now he will be starting his chemo this week.
The thing is, he has pretty aggressive cancer and the prognosis is 1-to-5 years , with the median being on the lower side of 1.5 years.
How sad.
He works in a decent mid-range company as a software developer.
Wife stays at home.
Why doesn't she work? She should try to make sure she has the skills to get a job down the road. If she doesn't, she should attain them now.
Life insurance 1xSalary
That gives her about 1 year to get a job on which she can survive. Hopefully, that is sufficient.
He is going on short time disability through work( 100% pay) for 3 months.
after that long term disability (60% pay) for 6 42 months.
Ugh, that's tough. Maybe she can start working part time soon?
Parents can help out somewhat with money, if needs be. Although, we are not sure how much cancer treatment costs, if he looses his job/insurance?
Even if he loses his job, the ACA means they can purchase health insurance without regard to existing conditions. Hopefully, it will still be around.
Should we talk to someone?
Your friend should be talking to folks. Certainly with HR. And they should be thoroughly reading and understanding all of their benefits.

Many companies offer an EAP (Employee Assistance Program - https://en.wikipedia.org/wiki/Employee_ ... ce_program) that can help them deal with tough life issues. They should check into this as his workplace.
Last edited by JoeRetire on Wed Aug 28, 2019 5:08 pm, edited 2 times in total.
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delamer
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Re: Friend has cancer. What should be the next steps?

Post by delamer » Wed Aug 28, 2019 5:03 pm

haranoth wrote:
Wed Aug 28, 2019 3:43 pm
deikel wrote:
Wed Aug 28, 2019 3:37 pm
delamer wrote:
Wed Aug 28, 2019 2:59 pm
In the longer run, he may become eligible for Social Security disability if he can’t return to work.
Getting SSDI approved will likely take longer then he has left to live, its worth checking if he is eligible to receive SSDI (how many points has he collected so far?), but I think this is a slim chance in this case.

However, its worthwhile checking if his wife can get survivors benefits under SS (again depending if he is eligible at all)
He has worked 7 years out of college, all in same company, so 28 credits.
Seems like there is a chance for him to be eligible.
https://www.investopedia.com/ask/answer ... e-disabled
thanks
Note that Mlm above indicated that her sister was approved quickly with a terminal diagnosis.

Whether eligibility is affected by the receipt of disability benefits through his employer, I don’t know. But worth the time to check into.

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Re: Friend has cancer. What should be the next steps?

Post by Stinky » Wed Aug 28, 2019 5:10 pm

delamer wrote:
Wed Aug 28, 2019 5:03 pm


Note that Mlm above indicated that her sister was approved quickly with a terminal diagnosis.

Whether eligibility is affected by the receipt of disability benefits through his employer, I don’t know. But worth the time to check into.
If there's any interaction between SSDI and employer disability benefits, it is more likely that the employer benefits could be affected (that is, reduced) by SSDI. Rather than SSDI being affected by employer benefits.
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delamer
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Re: Friend has cancer. What should be the next steps?

Post by delamer » Wed Aug 28, 2019 5:18 pm

Stinky wrote:
Wed Aug 28, 2019 5:10 pm
delamer wrote:
Wed Aug 28, 2019 5:03 pm


Note that Mlm above indicated that her sister was approved quickly with a terminal diagnosis.

Whether eligibility is affected by the receipt of disability benefits through his employer, I don’t know. But worth the time to check into.
If there's any interaction between SSDI and employer disability benefits, it is more likely that the employer benefits could be affected (that is, reduced) by SSDI. Rather than SSDI being affected by employer benefits.
I can see that. In which case I would expect the LTD provider to require the friend to apply for SSDI when/if appropriate to reduce the company’s costs.

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Re: Friend has cancer. What should be the next steps?

Post by fru-gal » Wed Aug 28, 2019 5:38 pm

deikel wrote:
Wed Aug 28, 2019 3:37 pm
delamer wrote:
Wed Aug 28, 2019 2:59 pm
In the longer run, he may become eligible for Social Security disability if he can’t return to work.
Getting SSDI approved will likely take longer then he has left to live, its worth checking if he is eligible to receive SSDI (how many points has he collected so far?), but I think this is a slim chance in this case.

However, its worthwhile checking if his wife can get survivors benefits under SS (again depending if he is eligible at all)
I think you are being unduly pessimistic about SSDI. I have a friend with congestive heart failure and he got approved in the blink of an eye. Nobody with this diagnosis is going to be seen as faking it.

Will, trust, beneficiaries of accounts, all financial accounts and such documented clearly, go over that with the wife.

HR has to have someone who understands the health and life insurance implications or if not they can give him copies of the policies.

As to the wife working, she should start preparing for this in terms of training, but I am not sure finding a job is the right thing to do now. She would probably miss a lot of work and get fired. also moving etc. while he is still with her, probably not the right thing to add that chaos and take time away from being together. Although I wonder if moving in with the parents for emotional support and help would be an option. They don;t have to sell the house now to do that.

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Re: Friend has cancer. What should be the next steps?

Post by abuss368 » Wed Aug 28, 2019 6:24 pm

I am so sorry to hear this horrible news. Having a caring friend like yourself is very helpful. I would consider working with the employer and health insurance company to better understand options. In addition, I would clean up the finances such as selling crypto, the small brokerage, and perhaps the saving and simply put it in checking (or keep in savings). I would advise that even if there were no health issues.

God bless.
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Re: Friend has cancer. What should be the next steps?

Post by JAZZISCOOL » Wed Aug 28, 2019 6:29 pm

deikel wrote:
Wed Aug 28, 2019 3:37 pm
delamer wrote:
Wed Aug 28, 2019 2:59 pm
In the longer run, he may become eligible for Social Security disability if he can’t return to work.
Getting SSDI approved will likely take longer then he has left to live, its worth checking if he is eligible to receive SSDI (how many points has he collected so far?), but I think this is a slim chance in this case.

However, its worthwhile checking if his wife can get survivors benefits under SS (again depending if he is eligible at all)
I am very sorry for your friend and his family.

There seem to be many complexities here but it's really important to read the terms of the STD and LTD policies that others have commented on. The company may offer some health insurance subsidies through this period of disability but any specifics will be in the documents. Regarding SSDI (and the potential approval of Medicare), it might make sense for them to consult with a good disability attorney in their area (who handles both private STD/LTD and SSDI (government)). They know the laws and would be unbiased (vs HR, perhaps). As noted above, the SSDI process can take a long time so, when things settle down a little for your friend and his family, it might be worth talking to an attorney to talk through options. A good disability attorney may be able to help to navigate these complex policies and SSDI depending on how things progress. As someone else posted, there may be ways to hasten the process in his situation. Also, some attorneys may offer a free consultation.

Here is an article that discusses SSDI (and SSI) and faster approval with a terminal illness (including brain cancer):

https://www.disabilitysecrets.com/resou ... terminal-i

You are so kind to assist him with everything. I am sure it is difficult for everyone.

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Re: Friend has cancer. What should be the next steps?

Post by ResearchMed » Wed Aug 28, 2019 6:36 pm

You might want to ask your friend and his wife if you can be of any help now - or especially in the future - with respect to actual medical treatments, by being an advocate for your friend.
That means, someone who is right there, listening to what is being said/planned, making sure it makes sense, that no one is suddenly mentioned some different procedure, etc.

Or perhaps after surgery, spend the night at your friend's side (arranged in advance) so that his wife can get a decent night's sleep... or whatever else like that would be helpful.

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Re: Friend has cancer. What should be the next steps?

Post by KESP » Wed Aug 28, 2019 6:47 pm

Really tough, I’m so sorry. Would his company really fire a terminally ill person?! I worked in private industry years ago and had a couple people diagnosed with dire illnesses. They were not fired although they did eventually pass from these illnesses. I work in a school now and there was a teacher who was diagnosed with what was thought to be a terminal illness after just 3 months on the job. They renewed her contract and despite several setbacks over a number of years, she miraculously overcame her illness. Hopefully he works for a compassionate company. I agree this isn’t the time for the wife to work. They have a rough road ahead and starting a new job now would be extremely difficult.

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Re: Friend has cancer. What should be the next steps?

Post by Typ997S » Wed Aug 28, 2019 6:55 pm

I realize that this thread is mostly focused on the financial aspect of your friend's situation, but I would also stress the importance of having your friend examined at a Major/Specialty Cancer Hospital, if they have not been already. Often times, in my experience with loved ones, the cancer specialty centers may have newer/better treatment options and/or a higher standard of care. My personal experience is with Roswell Park in Buffalo and Moffitt in Tampa. If your friend lives in Massachusetts, then I would think Dana Farber in Boston or Memorial Sloan Kettering in New York would be some obvious options, and there may well be others I'm not familiar with.

Best wishes to all.

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Re: Friend has cancer. What should be the next steps?

Post by ResearchMed » Wed Aug 28, 2019 7:01 pm

Typ997S wrote:
Wed Aug 28, 2019 6:55 pm
I realize that this thread is mostly focused on the financial aspect of your friend's situation, but I would also stress the importance of having your friend examined at a Major/Specialty Cancer Hospital, if they have not been already. Often times, in my experience with loved ones, the cancer specialty centers may have newer/better treatment options and/or a higher standard of care. My personal experience is with Roswell Park in Buffalo and Moffitt in Tampa. If your friend lives in Massachusetts, then I would think Dana Farber in Boston or Memorial Sloan Kettering in New York would be some obvious options, and there may well be others I'm not familiar with.

Best wishes to all.
Very good point, at least for a consult, or a few for starters.
And maybe again later, for a sanity check to see if things are going the way 'they' (the "experts") would expect. Keep in mind, no one will "know" what "THE" right answer is, in most cases, especially complicated ones. But there may be choices/decisions, etc.

If you don't know of the closest major academic cancer center, if you give us the approximate locations, some of us could give some suggestions.

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Re: Friend has cancer. What should be the next steps?

Post by delamer » Wed Aug 28, 2019 7:07 pm

JAZZISCOOL wrote:
Wed Aug 28, 2019 6:29 pm
deikel wrote:
Wed Aug 28, 2019 3:37 pm
delamer wrote:
Wed Aug 28, 2019 2:59 pm
In the longer run, he may become eligible for Social Security disability if he can’t return to work.
Getting SSDI approved will likely take longer then he has left to live, its worth checking if he is eligible to receive SSDI (how many points has he collected so far?), but I think this is a slim chance in this case.

However, its worthwhile checking if his wife can get survivors benefits under SS (again depending if he is eligible at all)
I am very sorry for your friend and his family.

There seem to be many complexities here but it's really important to read the terms of the STD and LTD policies that others have commented on. The company may offer some health insurance subsidies through this period of disability but any specifics will be in the documents. Regarding SSDI (and the potential approval of Medicare), it might make sense for them to consult with a good disability attorney in their area (who handles both private STD/LTD and SSDI (government)). They know the laws and would be unbiased (vs HR, perhaps). As noted above, the SSDI process can take a long time so, when things settle down a little for your friend and his family, it might be worth talking to an attorney to talk through options. A good disability attorney may be able to help to navigate these complex policies and SSDI depending on how things progress. As someone else posted, there may be ways to hasten the process in his situation. Also, some attorneys may offer a free consultation.

Here is an article that discusses SSDI (and SSI) and faster approval with a terminal illness (including brain cancer):

https://www.disabilitysecrets.com/resou ... terminal-i

You are so kind to assist him with everything. I am sure it is difficult for everyone.
My husband was on STD for about 6 weeks earlier this year. Once his company’s HR department filed the initial paperwork, all of his contact was with the 3rd party insurer not his HR department.

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Re: Friend has cancer. What should be the next steps?

Post by Vernn » Wed Aug 28, 2019 7:24 pm

I'm sorry to hear about your friend but here are some important steps.

1 Request a copy of the ST and LT disability polices from HR not the summary they usually hand out.

2 Apply for SSDI NOW and a properly completed application can be approved within weeks. Just don't assume that the hospital/doctors office will send in the medical records. He should get the records himself and provide them to SSA. Also check to see if his diagnosis is on the Compassionate Allowances List. https://www.ssa.gov/compassionateallowa ... itions.htm

3 Familiarize himself with ERISA (Employee Retirement Income Security Act (ERISA) this is what governs the companies long term disability policy. If there is any issue you will need an attorney that practices in this area. It is federal law and is not at all intuitive and there are strict deadlines. State insurance laws are not applicable nor is it something a disability lawyer can help with.

4 Apply for an state disability that is offered.

5 As long as his retirement is left in his 401k it will not be counted as an asset for medical services or getting low cost insurance in case of a termination.

Learned this all the hard way!

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Re: Friend has cancer. What should be the next steps?

Post by StoopieHippo » Wed Aug 28, 2019 7:44 pm

For what it's worth, if he's in a well-known cancer treatment facility (MD Anderson for example, or Seattle Cancer Care Alliance), most places will have Patient Financial Services and charity care so they don't have to turn away people who need financial help to cover their treatment. There's some strict guidelines on these services - all prescriptions must be for cancer treatment/written by a provider from their facility, there's a max amount of money the patient can make (not sure if net worth/assets are taken into consideration) but usually it's ~2x federal poverty level, etc. Additionally, there's a some patient financial networks and he can apply for financial assistance through them, too. https://panfoundation.org/index.php/en/ <---- is where I'd start. He should qualify for a lot of those foundation assistant ones since he's not a Medicare/Medicaid recipient, too.

Those are some options if he loses his job and can't get insurance after COBRA expires...or even to just help cover the cost of his meds.

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Re: Friend has cancer. What should be the next steps?

Post by TexasPE » Wed Aug 28, 2019 8:10 pm

haranoth wrote:
Wed Aug 28, 2019 2:44 pm

Life insurance 1xSalary

He is going on short time disability through work( 100% pay) for 3 months.
after that long term disability (60% pay) for 6 42 months.
Regrets for the situation - you are to be commended for stepping up to help!

See if more life insurance is available without underwriting (my employer allowed 2xsalary w/o medical info). Sometimes this is made available when the updated annual insurance package is announced - October in my employer's case.

See if STD period 'resets' after the first of the year or after x weeks/ months back at work (again, practice at my employer)
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Re: Friend has cancer. What should be the next steps?

Post by drawpoker » Wed Aug 28, 2019 9:25 pm

deikel wrote:
Wed Aug 28, 2019 3:37 pm

However, its worthwhile checking if his wife can get survivors benefits under SS (again depending if he is eligible at all)
Sorry, but no, she can't. A widow (or widower) only qualifies for SS survivor benefit if she/he is caring for child (children)

A spouse with no children, as the OP posted, only is eligible for survivor's benefits upon reaching age 60.

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Re: Friend has cancer. What should be the next steps?

Post by Sandi_k » Wed Aug 28, 2019 10:54 pm

Several things I haven't seen mentioned yet:

- Your friend should execute HIPPA releases for his wife, his parents, or any other friends/relatives that will be assisting in care.

- He should figure out a PoA for healthcare and financial affairs.

- If he has retirement accounts, make sure that the beneficiaries are up-to-date. My now-deceased BFF changed her life insurance, and forgot her 401(k) account. Her beneficiary was already dead when she passed, so there was nothing we could do.

- His company could have a catastrophic leave-sharing program. This would be one good way to keep him on pay status without having to exercise disability just yet. It will eke out the FMLA period.

- He should file the FMLA paperwork ASAP. Note that the clock re-sets again on Jan. 1, 2020 - he gets another 12 weeks granted then, as long as the paperwork is filled out and signed again.

- If he has both STD and LTD, he may be able to eke this out for the time he needs without quitting or being medically separated. If he paid the premiums himself, those payments are tax-exempt, and many companies will continue to pay your medical premiums while you're on disability, since they have salary savings while you're on disability.

- If they own a house, he might be able to get mortgage payoff insurance without a physical. He won't be able to get more life insurance, but he might be able to get the mortgage paid off, which would be a boon to his wife.

In my company, we try REALLY hard to NOT medically separate people in these circumstances if we have another path. We understand the hardship of losing the life insurance, and the cost of COBRA on top of everything else. So approach this methodically, and ask for help. People really can surprise you.

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Re: Friend has cancer. What should be the next steps?

Post by Northern Flicker » Thu Aug 29, 2019 12:33 am

If there's any interaction between SSDI and employer disability benefits, it is more likely that the employer benefits could be affected (that is, reduced) by SSDI. Rather than SSDI being affected by employer benefits.
Yes, LTD generally guarantees the income level, not a fixed benefit amount. SSDI thus will not normally increase the income level if someone has LTD but it should qualify the recipient for Medicare even if younger than 65.
Last edited by Northern Flicker on Thu Aug 29, 2019 12:42 pm, edited 1 time in total.
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Re: Friend has cancer. What should be the next steps?

Post by JoeRetire » Thu Aug 29, 2019 6:30 am

TexasPE wrote:
Wed Aug 28, 2019 8:10 pm
See if more life insurance is available without underwriting (my employer allowed 2xsalary w/o medical info). Sometimes this is made available when the updated annual insurance package is announced - October in my employer's case.
Excellent suggestion!

In general, review all available employee benefits while still an employee. Many employers allow you to increase your life insurance significantly during the open enrollment period. Sometimes you can even purchase additional life insurance beyond the standard 2x without underwriting. They should ask.
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Re: Friend has cancer. What should be the next steps?

Post by deikel » Thu Aug 29, 2019 7:09 am

JoeRetire wrote:
Thu Aug 29, 2019 6:30 am
TexasPE wrote:
Wed Aug 28, 2019 8:10 pm
See if more life insurance is available without underwriting (my employer allowed 2xsalary w/o medical info). Sometimes this is made available when the updated annual insurance package is announced - October in my employer's case.
Excellent suggestion!

In general, review all available employee benefits while still an employee. Many employers allow you to increase your life insurance significantly during the open enrollment period. Sometimes you can even purchase additional life insurance beyond the standard 2x without underwriting. They should ask.
This only works/helps if the employment does not get terminated after the short term disability absence...otherwise you loose the coverage with end of employment
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Re: Friend has cancer. What should be the next steps?

Post by deikel » Thu Aug 29, 2019 7:10 am

drawpoker wrote:
Wed Aug 28, 2019 9:25 pm
deikel wrote:
Wed Aug 28, 2019 3:37 pm

However, its worthwhile checking if his wife can get survivors benefits under SS (again depending if he is eligible at all)
Sorry, but no, she can't. A widow (or widower) only qualifies for SS survivor benefit if she/he is caring for child (children)

A spouse with no children, as the OP posted, only is eligible for survivor's benefits upon reaching age 60.
That's true, I ignored no kids involved - however she might get death benefits - although those are small
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Re: Friend has cancer. What should be the next steps?

Post by user9532 » Thu Aug 29, 2019 7:52 am

Sorry to hear this.

Early last year, I underwent treatment for stage 2 bladder cancer. I had a surgery in January 2018, followed by six months of chemo and then another surgery and recovery. Then my cancer went into remission.

I used FMLA the entire time, didn't go on disability. My bosses were understanding and provided me a lot of flexibility (I don't work for the private sector). I didn't take leave the entire time, but worked from home whenever I could work, although I wasn't productive at all during that period. My colleagues also helped me with my work loads.

I had chemo a few days a week followed by a two-week break. I would work during that break. But I have to admit, most of the time "working" meant just logging on and showing my presence.

Is your friend able to do any work at all? Probably he should talk to the employer to see whether they can allow any flexibility, such as working from home or working reduced hours on selected days etc. Based on what I experienced, undergoing chemo doesn't mean you have to take the entire time off. When I was undergoing chemo, there was one person sitting on the next chemo chair with a laptop doing office work. But of course chemo is tough and I had many tough days.

FMLA allows you to take upto 12 weeks (480 hours) of leave. Your job will be protected during this time. You don't have to take the whole leave in one stretch, but you can take on an as needed basis. For example, if you need only three hours a day, you can just take that three hours. The employee has to formally submit an application (Form WH-380) to get FMLA approval. There is a section on the application the doctor has to certify. An FMLA application is only for one year. You need to renew if you want to continue for more than one year.

If he is able to do some work, he will be able to stretch the protected period for longer than three months. For FMLA, you can use sick leave, annual leave, or leave without pay. Try to stretch the FMLA beyond the finish line of chemo. Things might get better when all the chemo is done.

Just because the doctor gave a bad prognosis doesn't mean you have to lose all hopes. Fighting cancer is tough. There is a psychological aspect to it. If you start thinking about the negative consequences and the uncertainties, life can become miserable. For me, emotionally the worst day was the day I received my diagnosis. Different thoughts came through my mind, but finally I decided to take a completely positive approach. I stopped worrying and maintained 100% optimism throughout the ordeal. I am a man of faith, and faith played a major role during treatment and recovery. Faith has even a bigger role today in my life. This helped me to get through the tough days. Now I participate in a cancer support group at my church. I know a couple of people who survived stage 4 cancer.

You have to prepare for contingencies. That doesn't mean you have to lose all the hope.

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