LTD benefits

[brokenbrain]

What is the name of your state (only U.S. law)? Ohio currently, Michigan at the time of employment

In January of 2004, I sustained a traumatic brain injury (TBI) as the result of a fall. At the time, I was employed full-time as a marketing director for a publishing company. I had the standard benefits package, including short term and long term disability. My employer was actually pretty fantastic about the whole thing, and I received full salary (occasionally through STD) over the next 18 months as I rehabbed and tried (unsuccessfully) to return to full-time, full workload employment. In fact, my employer won a national award as "Best Christian Workplace" in large part because of how they treated me--my story was 1/3 of the article. You can bet they used that big time in their HR publications!

I still couldn't multi-task, so instead of handling 50-75 titles, I was working on maybe 5. And even those, not very well. I didn't travel, talk to my authors or do anything "public." In fact, for the most part, I was paid to stare at my cubicle walls and create Myspace pages for my authors.

In May of 2006, I smacked my head again and lost most of the skills I had regained. The recession was just kicking in, and I really can't blame them for pushing me out. At the same time, that whole period is pretty fuzzy to me and I'm not sure exactly how I ended up not "working" anymore. (I still have memory and processing issues). It probably went something like this: "You know we can't keep you on, right?" and I responded, "Huh?" And then I signed my termination papers, which said I was leaving for "other job opportunities" (always code for dismissal) and "health issues." All the boxes were checked with "poor" job performance and that they wouldn't hire me again due to my brain injury. I have a copy of my dismissal papers.

Fast forward a few years. I'm newly married and my dad and hubs are going to through a mountain of paperwork to apply for SSA. They come across my benefits packet from my employer that showed I had Long Term Disability, and that if I were to become disabled so that I couldn't work in my current or equal position, that I would receive 60% of my salary (with $ amount) until age 65. Dad and hubs say, "Why aren't you getting LTD?" and I probably responded with something like, "huh?"

So, when we met with my SSA lawyer, we brought it up and asked him to find out why I'm not getting LTD. I've been working with this lawyer for over 3 years, and am not very impressed with him. But he has not been great with followup for SSA or LTD. When I asked him to look into LTD, I gave him about 50 sheets of employment documentation. At the time, it seemed he said that I'd have to get approval for SSA first, so let's focus on that first. I figured he know what he was saying, but still paid him $500 to do the preliminary work on it because I didn't want to run into a statute of limitations with the LTD.

For $500, he called my employer and got the exact same stack of papers I had given him. That's IT. I asked him WHY I don't have LTD and he didn't give an answer. Then I paid him another $500 to dig some more. Keep in mind, I was hiring him to find out WHY I don't have it, and if it's not a valid reason, I wanted him to be my advocate to get it going. So, MONTHS later, I get a letter saying that my LTD case was closed on some month in 2001. First of all, what does closed mean? Second of all, I didn't even START at that employer until 2003. When I follow up with these thoughts, he has the gall to send me a letter saying that for another $500 he'll keep looking. I am furious, but my SSA hearing is coming up, so I say I want an itemization of what I've paid for before making a decision about continuing with him. He says he'll send it in a week. He told me he sent it. I said I didn't receive it, please send another. That was about 6 months ago. Still waiting. Now I think he's incompetent and a liar.

I received my approved for SSA this week and would like to revisit the LTD stuff again, but clearly, not with this lawyer (who did nothing but show up for the hearing. I/my hubs filled out all the forms and collected the medical records).

I don't have any problem with my former employer pushing me out the door. I couldn't/can't do the job anymore, and now, almost four years later SSA agrees with me. However, it seems that I should have been receiving LTD from my employer all this time, or at least am entitled to a backpay and activation of benefits now. Or, have I been screwed my both my employer and lawyer?

Where do I go from here? Thank you very much!What is the name of your state (only U.S. law)?

 

[cbg]

I received full salary (occasionally through STD) over the next 18 months
In 30+ years of administering employer-sponsored benefits, I have yet to see an STD plan that pays beyond 6 months, and some don't pay that long. Are you sure that some of the payments you received during that 18 months were not LTD?

 

[brokenbrain]

Thanks for the quick response.

I don't remember the exact dates and lengths, but I don't think so. I'm pretty sure it was all sick days, vacation days, personal days and short term disability. It went something like this:

* January 21, 2004 - date of injury
* two weeks of sick leave while I got evaluated
* about ten minutes in the office, realizing that I couldn't handle all the lights and sounds
* two months on short term disability as I started rehab
* full salary as we THOUGHT I could come back. my therapist came to work with me, met with my boss and HR and we "rehabbed at work" with shorter hours, lots of breaks and ridiculously low workload - about a month
* continued to do 1/2 days without the therapist at full salary - about 2 months
* off for 3 months (STD) after I crashed and had to recover
* back to work at full salary, starting at an hour a day up to 6 hours a day with a two hour lunch, all with a reduced load - about 8 months, up until the 2nd brain injury in May
* sick leave for a week while evaluated and resting, then sick leave/vacation/personal days until no longer working there.

There was no exit interview, I didn't sign anything other that the termination letter.

My benefits overview says that I had long term disability. It's dated, gives an overview of all my benefits, and says what I would make monthly up until age 65.

I never really thought about disability because I had always been healthy, and all that HR stuff is confusing anyway, even without a brain injury!

 

[cbg]

Is the LTD carrier the same as the STD carrier? Did you apply for either STD or LTD at the time of the second injury?

 

[brokenbrain]

I believe they are different companies, but I don't know for sure. I never saw anything for STD as our HR department took care of it.

I have the contact info for the LTD carrier. I was signed up when I started working and didn't sign anything else when I stopped working. (At least I don't remember). I was single and lived alone at the time, so I didn't have anyone to advocate for me. I was pretty much in a fog at the time. I just want to make sure that I wasn't taken advantage because of that. I'm unclear why I was not given a benefit I had.

 

[cbg]

Here's the thing.

Neither STD nor LTD is automatic. You have to fill out an application, part of which is completed by you, part of which by your doctor, and part of which by your employer. If the STD and LTD benefits are by the same carrier, and if you go directly from one to the other, sometimes they just flow one to the other. But if they are different carriers, or if there is a gap between, (both of which appear to be true) you need to apply for the LTD. If you didn't apply, there would be no benefit.

 

[brokenbrain]

That's kind of what I'm afraid of. Every other time I've left a job, I had an exit interview where I signed papers and turned in my key card, etc. I've always had another job lined up. In this case, I was not well, and certainly not able to make decisions, so I kind of wonder if I was taken advantage of. I wasn't thinking clearly enough to ask about LTD, my employer didn't say anything and I was left on my own until my dad and husband found the paperwork.

Do you think it's worth finding a lawyer who can advocate for me to say that I was wrongly denied LTD, or am I just out of luck? (Even with the SSA approval, the difference is almost an addition $1,000/month, plus backpay).

I'm a little peeved that I had this benefit and it wasn't explained to me when I lost my job.

 

[cbg]

I'm sure that at the time you were hired, the employer provided you with information about the benefits you were entitled to and when. That's pretty standard. With limited exceptions (FMLA, for example) it then becomes the responsibility of the employee to request benefits.

The employer is not required to go to you and say, btw, you should be applying for LTD benefits. In fact, if you had been back at work for 8 months, you might not have qualified for the benefit any longer. It's not as simple as, I have a disabilty therefore I am entitled to LTD benefits. It doesn't work that way. Being back at work for that long might have negated your eligibility. It's nice of them if they approach you, and some will do so. They're not required to. They are not legally obligated to do so. Exit interviews are not required by law.

If it would make you feel better to talk to a lawyer, do so. But you have posted nothing to suggest that the employer cheated you out of anything you are guaranteed entitled to.

 

[brokenbrain]

Not exactly the content I was hoping to hear, but the straight answer I wanted to hear. Thank you.

Officially, at least, according to SSA, the onset of my disability was when I got the second TBI. My medical records report that the first TBI impaired me, but the second TBI, while still recovering from the first, is what made it severe enough that I could no longer work.If that's the case, then the 8 months I had worked wouldn't apply toward eligibility, because it would actually be a second event, so to speak.

In an effort to save paper, as employees, all info about our benefits was kept online, other than the initial forms we completed. Not that that helps you when you no longer work there, since you can no longer access the info to determine eligibility for LTD. Fortunately, i was able to have a coworker print off the contact info for the LTD carrier, but even she couldn't see any limitations, only "If you are no longer able to work in a full-time capacity, you would receive 60% of your salary..."

You have been much more helpful than my SSA lawyer. If he would have come back and said, "due to the fact that you had come back, you were no longer eligible" or some such explanation, I would have felt he did something for the money I paid him.

Since dealing with this issue makes my headache worse and I don't do phones well anymore, I still may consult with a local lawyer. Would I look for someone who specializes in employment or disability?

Thank you very very much for your time.