First to all "newbies" - WELCOME Anyone with TM who has been employed and has as a benefit Short/Long Term Disability (STD/LTD) PLEASE beware of these companies - you are not safe with/from them. They will do anything to get you off your deserved payments. You need to contact a good ERISA lawyer ASAP!
Here is a question from disinssues and a reply from a former insurance representative: "I may be able to shed some light on this, because, I hate to admit, I used to be one of those vocational experts who evaluated LTD and workers' comp claimants to determine their employability. Typically, when a LTD policy is getting ready to move from the own-occupation phase to the any-occupation phase, a vocational expert is called in to evaluate these cases and identify jobs. It was not unusual for the LTD claims person to refer the claimant for IMEs, which, of course, greatly underestimated the impact of the person's disability on potential work. Anything "vocational" that is offered to a claimant by an LTD carrier would almost have to be bad news. Their entire focus is to get that person off of benefits and reduce the exposure (claim reserves). People who manage LTD claims are given hefty incentives to get claims resolved; in other words, stop or deny payment of benefits to claimants. If you request rehab services, and then do not cooperate, that alone could be grounds for termination of benefits. First and foremost, get a copy of your Summary Plan Description and read it. Go through it with a fine tooth comb. There are numerous pitfalls to LTD, and you should familiarize yourself with the terms of the policy before you begin. Case in point: I recently was contacted by a frantic woman who said she had received notification that her LTD benefits were being terminated. She had been receiving LTD benefits for five years. Three years ago, she filed a Social Security disability claim at the request of the LTD. Her claim was denied and she did not appeal. She thought that she fulfilled her responsibility and continued receiving LTD. Recently, someone at the LTD wised up and checked to see the status of her Social Security claim and found that she had never appealed the denial three years earlier. Now she is told she has been overpaid LTD in the amount of $30,000 and they are withholding benefits until the overpayment is paid back. Simply put, they got her on a technicality. Suddenly, she has no LTD and no SSD. No income at all. And since she has not worked in five years, her Date Last Insured for Social Security disability is very soon. She will reapply asap, but the wait for approval, as we know, can be years. The LTD claims people won't tell you a thing and it is your responsibility to stay one step ahead of them. Question everything to reveal the hidden meanings in the claim language. What may seem to be straightforward English probably isn't! Find someone who understands the lingo and can explain things in layman's terms. Consider consulting a lawyer with experience representing claimants, particularly one who is experienced with ERISA if your policy is through your employer." I don't want to scare anyone but I'm now in my 2nd year fighting my LTD company and informed it could take years! When the LTD company dropped me (and the COBRA company doubled my insurance premiums), which cut my income in half! The LTD lawyer filed SSDI for me and I did get SSDI within 6 weeks of filing with the lawyer sending the paperwork in. ALWAYS HAVE THE LTD company hire a lawyer for you and have them file the SSDI because there is a Supreme Court case that rule in favor of the insured against the insurance company BUT there will be a fight in lower courts by the insurance companies to not pay which takes years! Life is short! Break the rules! Forgive quickly! Kiss slowly! Love truly, Laugh uncontrollably . And never regret anything that made you smile. Prayers and thoughts for you and yours, Candy K.
