longterm want all of the money

[r272]

What is the name of your state? DE

I got hurt in 03 and i recieved shot/long term ins. through my job. I just went to court with an alj and was approved for all back pay. I was informed by my attorney that my entire back pay check including what ever i got for my children will go to the long term company. How is this possible when they did not give me anything for my children, I had to struggle to survive on what I received from them based on the 60% of my income from work.

If they were helping me with payments for my children I would not have a problem with paying them back, but the did not so how do they get the right to take the entire check?
And what about all of the copay's that I put out over the years?

Is this true? can they take what's due to my children?

any help would be greatly appriciated

 

[moburkes]

Tell me what ALJ is, and I can answer your question? Did you qualify for social security or medicaid back to the time of the accident? And, did you mean SHORT/LONG term disability?

 

[ksajb]

This is a very typical scenario. Most employers provide 'cheap' disability insurance policies. You probably don't remember signing over any SSDI overpayments to them in the event of an award. The insurance company then considers their benefit to you as a 'loan'. That's why they request that you apply for SSDI.

You only have to pay back the difference of what they paid to you and what SSDI is paying you. Unfortunately that does include the children's benefits. On a positive note, the LTD company isn't entitled to any COLA (cost of living adjustment) that SSDI has provided since the date the ALJ found you to be disabled.

If you refuse to send the LTD company their money they paid you, then they may get ugly and will probably take the difference out of any future earnings you are entitled to from them. I don't know about the legal actions the LTD company may take against you so you may want to speak with your attorney. BTW, doesn't he get paid first or did the LTD company provide legal representation for you?

You have the right to request an itemized statement from the LTD company of all benefits they paid you. Don't send them anything until you review the statement. Good luck!

 

[moburkes]

What the heck is a "cheap" disability policy? The OP could have been an informed consumer, researched the policy, and bought his own individual policy, which doesn't have that clause inserted.

 

[ksajb]

It doesn't sound like the OP is referring to a private policy, now does it, moburkes? Company based policies tend to offer cheaper coverage to employees at an affordable rate and the result is having to pay back the LTD company. If an individual purchases his own policy, then there is a bigger likelihood he won't have to pay any money back to the LTD company. The OP has to pay the money back. It isn't any type of reflection on his/her choice of coverage, so don't try to make it sound like I'm insulting anyone.

R272, you're best bet is to read over your policy and it will all be explained. If you don't have a copy of the policy, you may be able to obtain one from the HR dept where you were employed.

 

[moburkes]

It doesn't sound like the OP is referring to a private policy, now does it, moburkes? Company based policies tend to offer cheaper coverage to employees at an affordable rate and the result is having to pay back the LTD company. If an individual purchases his own policy, then there is a bigger likelihood he won't have to pay any money back to the LTD company. The OP has to pay the money back. It isn't any type of reflection on his/her choice of coverage, so don't try to make it sound like I'm insulting anyone.

R272, you're best bet is to read over your policy and it will all be explained. If you don't have a copy of the policy, you may be able to obtain one from the HR dept where you were employed.

I know that he's talking about a employer-sponsored plan - especially since it was mentioned in the original post, but especially since he mentioned it having to be payed back.

My question to you was what you meant when you called the employer-based policy cheap.

I also offered suggestion about individual insurance because I realize that he wouldn't have to pay back the money.

 

[r272]

thank you both for your response, by the way the alj is judge that I went before and was granted a fully favorable decision for my ssdi. I spoke to someone at the social security office and she informed me that there is a good amount of back pay, but the amount i'll get from them is a little less than what I currently get from my longterm company. I'm sure this means that the entire check will go to them.

this really sucks, and to make it worse, I have to recieve the check and then wait until I hear from the longterm company to contact me just to tell me to send them the check. I'd rather not see the check at all.

I just thougt of this, I also got short-term from the same company(UNUM) do they take the back pay for that as well? and do they calculate the amount owed to them from the date I signed the form?

I'm going to contact the company to get a copy of the policy.

 

[justme2007]

ltd and ssdi

Check your policy, work with the ltd co, they are not being mean or petty - just going by the policy. From my experience - the LTD will pay the diff between your SSDI (which is ALOT less that 60% of your pay at the time of disability - check your annual statement). As far as the kids' payment - the LTD typically want 50% of that. In short, a typical policy says that the LTD co will pay the 60% of your pay at the time of disability minus 100% of your SSDI minus 50% of what the children receive.

Oh, the STD - no, they won't want that if it was 6 mo. Your SSDI starts 6 months after the beginning of the disability, STD was for that period and assuming your sole income was STD from UNUM, you won't have to pay that back.

After this initial frustration (I know what you're talking about and how you feel - been there), things will settle and get consistent.

 

[r272]

Thanks justme, well I did some checking and found out that ssdi will pay me less than what I get from unum even with my childrens payment, i'm so sure that the complete back payment will go directly to unum. Actually, it would appear that if they wanted all of the money they gave me, I would still come up short.

Anyone ever dealt with the ltd co. as far as maybe them taking a certain amount of money from the back payment check and then maybe offset the amount due to me from my existing payment over a certain amount of time? This would not make it so bad initially.

 

[justme2007]

work with unum

With mine, I paid most of what I got in back pay from ssdi, then worked on paying them the rest. Didn't recieve anymore from them until I'd paid everything back. Make sure they deduct the monthly payment they're withholding from the amount owed (they tend to miss that). I didn't have unum, but I would think it'd work the same. Call you're case worker (or case manager - or whatever they're called there) and let them know you can't pay all right now, but can pay X amount and work out a payment plan with them. Keep track of everything - and get as much in writing as you can - just incase you're sent to a new case worker.

Oh, they should want only what the ssdi back pay is. the diff between the ssdi (both yours and the kids) and their 60% should not be included in their repayment request.

 

[r272]

Justme, it must be god sent that you read and responded to my post as it seems you have been through what I am dealing with. For me it's just been really hard going through this problem as i'm only 36 and have been out of work since 1/03.

If I understand what your saying, when I get my backpay check from SSDI, I might be able to contact unum and work something out, like if my check was for 40,000 it might be possible to tell them I can pay lets say 30,000 now and since they will still pay me anyway they could deduct that amount or an amount we agree to out of future payments almost like an advance on future payments.

This would work, since even if they take the full amount monthly I would still be able to recieve my SSDI for myself and my children. I could get alot of bills out of the way.

thank you so much for your help

 

[justme2007]

best wishes

R272 - Happy to help, yes, went thru in in 2005 - not a fun thing.

 

[r272]

Made a call to my ltd co. this morning and got some good news, my caseworker told me that I could look forward to getting some cash because my case will go back to april of 04 so i'll get the cost of living. Also, I was able to confirm with her that when I do get the award letter from SS and foward it to them they will ofcourse calculate the overpayment and let me know how much it will be.

What really gave me some sort of joy was whe said if I can't pay the total overpayment amount in a lump some which is how they would prefer to get it, they will not have a problem taking some and either with hold my ongoing monthly benifit until the balance is paid or they could work it out that I will still get a partial payment.

I have to tell you I was shocked as I have been doing what I always tell myself I shouldn't which is looking online day and night for info. and most of the info. I found was that the LTD co. will not work with me and they would want the entire check no questions.

I appologize for being long winded but i'm so happy at this point. I'm just waiting for the award ltr.

 

[ksajb]

We've got a similar situation as your's. Two of our children also received benefits until one of them turned 18. When SSDI sent the backpay to dh, the LTD company received over 80% of his and the children's benefit. They had the right to take 100% of it but they paid less than SSDI. Our company went for 100% reimbursement. Now dh doesn't receive any benefit from the LTD company but is still in an active status in case dh loses his SSDI benefit.

I have never heard of Unum or any company being willing to negotiate the backpay unless a recipient forces their hand (spends the backpay before sending it to the insurance company).

Please don't forget to get an itemized statement from Unum before you pay them back.

 

[r272]

Did dh just send the money to the LTD when they requested the amount? From speaking to my rep., I understood that ofcourse they are not going to offer you the choice not to pay the full amount. But what you said about forcing their hand was right, becuase SSDI sends the check directly to you and not the LTD co. So the power is in your hand at that point, unless you don't attempt to work something out with them and they decide to SUE. Ofcourse i'm going to give them the majority of the overpayment so at least this way I can continue to get a partial payment until the balance is completely paid.