LTD - Denied - Options?

[xDazedx]

What is the name of your state? What is the name of your state? Texas & Colorado

First of all this is a great site. Thanks to those that are reading this message and a bigger thanks to those of you replying

My wife worked for a major insurance company for several years. She was diagnosed with Multiple Sclerosis while employed there. At the time she was so sick that she did not have the energy to fight for LTD after being denied a few times. She never returned to work.

Two years ago, she was finally approved for Social Security Disabilty benefits after being denied a few times. It took a letter to a US Senator to get her approved. The only reason I added that is for those of you getting denied it may help your case to write your Senator.

I feel the Insurance company operated in bad faith. They had nothing to lose by denying her LTD request since they are self insured. What are her options with this? Does having SSD negate any LTD possibilities? What are the statute of limitations on this if she can pursue legal action? Any assistance you can offer would be appreciated.

She was employed in Denver when this took place.

 

[Thomas234]

I cannot address your statute of limitations question, however fighting for the LTD at this point may no longer be worth it. You will need to first find out if the LTD policy has a “benefit offset” for disability payments received from another source… e.g., SSD, Workers’ Compensation, and such. Most do, and more than likely this one does as well. If you do not know what a benefit offset is, it simply means the LTD company will reduce what they pay your wife by what she receives from SSD.

Example, if approved for LTD and the monthly benefit would be, say, $2,000, and your wife is currently getting $1,500 from SSD, then all the LTD provider would pay is $500. In other words, they won’t let her collect both for a total of $3,500. If LTD is $2,000 a month and SSD is also $2,000 a month, then LTD pays nothing. They may have a “minimum” monthly benefit, but in most cases it’s only $50 to $100.

So before you fight a battle that may get little if any additional money, verify if there is a benefit offset, and what the minimum monthly payment would be from LTD.

Best wishes

 

[xDazedx]

Thanks for the reply Thomas.

Other than the offset, is there a good chance of getting this done if we decide to proceed?

 

[Bigfoot]

I'm sorry for your wife's state of health. I can't imagine the challenges that she faces daily.

Generally, disability benefits are always coordinated. So if she were to fight (and win) to receive benefits from the insurer, it's likely that they will be coordinated with Social Security. It's unfortunate that she had to be in the middle, but the good part is that she is receiving benefits.

Check too to see if she qualifies for Medicare health coverage. This benefit is available to some beneficiaries even without meeting the usual age of 55 or having a kidney problem.