Hi Cheryl,
Are you saying that you've never had to go through any trouble with your LTD carrier this whole time?? That is awesome if so.? I've had TM for 10?yrs and fortunatly have LTD for the extra salary.? However, I've had quite a ride with it.? They were great to work with originally during the STD and first couple of years of LTD phase.? They even totally handled my SSDI paperwork, and quickly requested payback of their share of my retro payment once I was approved first time around.? They have since denied me several times, and I have had gruelling appeals.? There is a great deal of abuse in the disability insurance industry, many people fake it, and that makes it so hard for those of us who are seriously disabled and entitled to the insurance payment.? They also take advantage of people not having the strength to fight back and just giving up and not appealing the denial. For me, this last appeal was brutal.? I had to appeal 2 times on my own.? If I needed a third appeal, it then would be with an attorney.? That is what the "Plan" called for.? It was very hard to get together a worthy appeal against the insurance company while taking a good deal of medication.? I requested a copy of the medical records they had on file and were using to deny my claim.? I needed to go through my?records, and they weren't that easy to read.? There were 2 reams of paper, and so many sheets were duplicates.? It took so long, but I finally got it done the second time around.? It was about 3 years ago, and they haven't bothered me since.? I'm 58 and I hope they don't bother me again, but I wouldn't count on it. I am so much better prepared to?fight now than I was then though.? I'll give them HELL this next time. If faced with this, get support from any direction you can.? You'll?need it! Hugs, Barbara A? -----Original Message----- From: [email protected] <[email protected]> To: CANDIS KALLEY <[email protected]> Cc: [email protected] Sent: Wed, Aug 19, 2009 1:37 pm Subject: Re: [TMIC] OT? - Anyone who has employee STD/LTD benefits. Hi, ?? Wow! So many people on the list have insurance horror stories.?I am really lucky.I got my LTD less than 1 year before getting tm on 8/13/95. The physiatrist in rehab filed the LTD paperwork promptly. Also,I was told years later that using the "right words" in the filing was crucial. ?? Keep EVERY bit of paper sent by the company. If you speak to someone on the phone,tell them you want the discussion and resolution backed up by a letter. Give them 10 days,and follow up with them if you don't get a letter. DON'T GIVE UP! Some companies try to "wear youi down". ?? I applied for SSD on the phone while still in rehab,and was approved right away. I started getting benefits 5 months from onset of tm.? ?? ?LTD got screwed up by the benefits manager at the hospital I worked at. She told me everything was all set,and I would get a check in December retroactive to August. She then left to have surgery. Apparently her mind wasn't on my claim;when I hadn't heard anything from my LTD carrier,I called and was told they would not send anything "yet". I cried because I had a mortgage and overdue?bills to pay. I got a certified check in the mail overnight! ?? When I got the SSD retroactive payment in January,I had to give back all of it to LTD,since they had been giving me the total amount. ?My policy coverage was for a total of 60% from SSD and LTD combined. ?? I was very fortunate. At the beginning I had to keep proving disability every 6 months,then every year,then every 18 months. I also had a thorough exam by their neurologist a few years ago.Last year they offered me a lump sum that I turned down;it would have?meant losing thousands of dollars.?My LTD ends 6/17/2011 on my 65th birthday. Then I start my pension from work.? ?? My LTD insurer The Hartford has been very good. Still,whenever I get something in the mail,I worry. I know?a friend at work (a unit secretary) had Uno LTD insurance and she's had problems since day 1. She had loads of paperwork,and she said at the time "they're trying to wear me down so I'll give up,and it's not going to happen". It's been years and they still give her a hard time. ?? Cheryl in Easthampton,MA.?? --- On Wed, 8/19/09, CANDIS KALLEY <[email protected]> wrote: From: CANDIS KALLEY <[email protected]> Subject: [TMIC] OT? - Anyone who has employee STD/LTD benefits. To: "tmic-list" <[email protected]> Date: Wednesday, August 19, 2009, 12:55 PM 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. ? *She needs to have a knowledgeable doctor fill out the paperwork. If it isn't worded properly,there will be a delay in getting benefits. 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.
