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I Filed My California Long Term Disability Insurance Claim 40 Days Too Late And It Was Denied. Can You Help? |
Question by harsuwind | Posted in Insurance
I am covered by a be term disability policy by my employer. Prior to my disability, I asked my HR department what I needed to do. I was told that my curt term policy would kick in automatically and all I would need to do was fill out those forms once they were sent to me. I filled out the forms and received confirmation that my peremptorily term insurance had been activated. About 1 month after my disability, I received a reduced paycheck. When I inquired at work, I was told that I should have filed for long term disability along with the interrupt term disability. I have since filed for long term disability but it was denied because I submitted my claim more than 40 days after the first day of disability. I know I can appeal. Has anyone else gone through this and was your invite successful? Did you have to do anything out of the ordinary to win your appeal?
Advising me to check with the labor board or my HR dependent isn't the help I am looking for. What I am looking for - Have you ever had to appeal a denied disability claim and did you learn something in the process that would advise make the process go smoothly for someone in my situation. If I were answering your questions, I would put some real meditating behind my answers!
Answer: You have the forensic right to appeal the claim decision, but keep this in mind - the insurance carrier follows the contract that they have with your guv. If your employer wanted a late filing clause, and the insurance carrier is just following the draw together, then the appeal isn't going to do much good. If I were you, I would get a copy of your disability policy so you can verify that this late filing clause in actuality exists, file an appeal with the insurance carrier, and file an appeal/grievance with your splendour's insurance board. I think that these three actions are your best bet for possibly overturning the decision.
Solid luck! |
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Would Anyone Know What Limitation Long Term Disability Claims Would Have? |
Question by old guy | Posted in Other - Health
I combustible in Canada and I'm 56 years old and had a right leg amputation which ended my working. I'm on long term disability but my insurance Pty has not indicated how long this would continue. I have other health problems with my other leg and hands due to diabetias. I was just wondering if anyone else has gone through a similair condition?
Answer: Disability benefits generally speaking last as long as the disability. So unless you grow a leg back, I think the benefit will continue.
Does your disability paperwork have a phone many or web address on it anywhere? Use that info to track down the facts you need. |
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Has Anyone Had Experience With A "transferrable Skills" Analysis With An Application For Long-term Disability? |
Question by ms_n_flyte | Posted in Other - Health
I'm waiting to perceive from my long-term disability insurance carrier, and wondering what factors may be used in the process? I have submitted doctor's notes, tests, evaluations, etc., but I'm gruesome of rejection of the claim.
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Help! I Tried FMLA And Short Term Disability. I Have Health Insurance But My Job Won't Pay Me!? |
Question by IlIlIlllllIIIIIIlllIIIIlllII | Posted in Insurance
I Well-founded met my year's anniversary, making me eligible for FMLA. The company I work for is odd with rate to FMLA. However, I've had increasing anxiety, escalating to panic attacks. My doctor has been recommending FMLA for a long era. I'm just now eligible. I'm borderline housebound from the stress/paranoia from the job. They refuse to pay me as I was released under "cavalcade" status in early October. Mid October my letter states that I'm on Administrative Ignore, making me ineligible for pay on FMLA. Crap! So I'm struggling to get a short term disability claim approved. It's showing as DENIED, but my provider states left side & right that they're "reviewing documentation." I've had a rocky road with my head lately, and have been subj. to an "investigation," which they will NOT let me be privvy to the what's and why's of... all I positive is they tried to send me to a doctor (???) of their own before I got approved for FMLA w/o pay. How can I get app. for short term dis & get well?
K! Get a advocate that spec. in med. claims Per Steve! Before doing that, (I want to keep my job!), the specs: 1yr anniversary met as of primitive Oct, Early oct, released due to some strange "Investigation," released under "parade" status; sent me into a panic attack, immediately applied for FMLA, got it, no pay, due to Admin Split status (leave of absense=inelig for pay); however, "Review" does NOT suggest leave of absense, I even called to verify this per HR. However, my short term disability claim is "denied" per Metlife; they state it's righteous "being reviewed," not denied... my empl. wanted me to go to an IME/Indep med. checkout for NO disclosed reason, I don't use drugs, drink, nothing. Ever. However, I blew the whistle on some folks and they wanna verve me out. I've met w/ union several times. I'm pos. they're fishing for ways to push me out the door. Is there any way to expedite this or to recognize where I stand or to get paid? They've lied thru documentation. Fortune 10 company.. a fool
Denial = "technical" per representatives, they've been reviewing (only 5 pages!) my HCP's faxed-in documentation for over a week and a half now. They majestic that I should call the automated line or check online, but keep holding me off and keeping me back to wait it out, I maintain; however, they're just sitting there w/ a "DENIED" status; however, they keep saying over and over that it's "TECHNICALLY" not denied, which I find to be laughable. I'm just sitting here. What's worst, I think, is that I was relieved under "review" importance, which is NOT admin leave, they said so themselves, then they automatically FLIP me to leave so I can't get paid per FMLA (my fellowship does unless I'm off under any type of Admin Leave) so that I don't receive pay. They coaxed me to go the FML carry, not the disability route. Under-handed Fortune10 companies.
Answer: OK, WHY is the insufficient briefly term disability claim denied? Is there a 90 day waiting period, or are panic attacks/stress/bonkers illness excluded conditions?
I don't know of any employers who pay employees during FML. And until a judge says otherwise, you're not entitled to see any exploration report you didn't pay for. It's not YOURS, even if it's about you.
If the reason for the claim denial is NOT in accordance with policy terms, you can file a grievance in writing with your state insurance commissioner. If it IS in compliance with the policy terms, well, it's not COVERED, so you'll have to frequent to your savings account. |
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Can I File Disability Claim? |
Question by moony | Posted in United States
I had surgery recently and had to be away from business for 2 weeks. My sick time off covered the first week and my paid time off covered the defective week. However, I was saving my paid time off for a summer vacation.
I have long term disability insurance and was wondering if I prepared to file a claim even though I used my paid time off.
Answer: Not only just likely. Temporary or short-term disability insurance payments do not kick in until you have been disabled for at least 30 days, more often 180 days. You also must have at an end all accrued paid time off before it kicks in, so if you had accrued say, 4 weeks vacation convenience life, no disability insurance until ALL accrued time off (sick leave, vacation, holidays, "familiar days" or whatever the paid time was called) was used up. In the case of Popular Security, you must have been disabled for at least a year and have been adjudged totally and permanently disabled. Most long-term disability plans also use that delineation and adhere to it more strictly than SSD.
You got paid for all the work time you missed with your accrued bored leave + vacation. Save up vacation time again for next year. You got all your paid heretofore off due you, and you are very, very lucky to have gotten all your time off paid. |
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Long Term Disability Payback (Is It Legal)? |
Question by Rob | Posted in Insurance
I have a Long Term Disability (LTD) claim with Unum through my occupation. Prior to becoming disabled, pretax money was deducted from my paycheck for this LTD insurance. They have been paying me ~$2,000 / month for two and a half years. I applied for SSI disability around the same days I submitted a claim to Unum. Unum starting paying me about 6 or 7 months after I became disable. I was recently granted SSI disability and SSI sent me a impediment for “back pay” (about $32,000) and started paying me about $1,200 / month. Unum fitting informed me that they wanted all of the back pay from SSI and they would reduce the amount they (Unum) pay me by the amount SSI pays me. Then they said I need to categorize for SSI benefits for my two kids. I was awarded SSI benefits for my kids and SSI sent me another check for ~$9,000 as back pay for the kids SSI benefits. Unum then au fait me I needed to send them the money SSI gave me for the kids. They also said they would be reducing the amount the pay per month by the amount SSI provides for my kids as well. So, to summarize, Unum demands I give them all the back pay coins that SSI gave me and my kids and they would only pay me $100 / month. The $100 / month is the difference between what Unum was paying and what SSI pays now. Is this legit? If so, that means the LTD policy I have with Unum is practically worthless. The money that was being deducted from my paycheck for 20+ years as a payment into a LTD insurance approach is nothing more than a charge just in case I need a loan until SSI works its way through the system and Unum has almost no susceptibility. Can this be true? Someone please help me understand this seemingly mislabeled paycheck deduction that most of us pay every pay stretch. What can they do if I don’t send them the money? I’m still shocked by this!
I don't expect to double dip and understand that part. But, I don't think the insurance companionship should be able to take my SSI back pay or any benefits SSI provides on behalf of my kids. What is the premium being used for? To add slur to injury, Unum is deriving the 60% base pay calculation during the last three months of work. That was the timeframe I was unable to work a full shift due to the disability. So I’m only getting ~40% of what I made prior to the disability.
Well I tenderness about this situation some more. But I must first say that to me, something just does not feel right about this whole issue. My intention is not to dead ringer dip or get something for nothing. The $35 / month or more that is deducted from the “common” man’s paycheck is customary into an insurance fund. I just don’t buy the fact that SSI benefits (SSI insurance is also being deducted) payable to my children and the back pay question major makes this an insurance policy at all. (I’m warning my family and friends about this little hidden caveat). Maybe “buffer game plan” would more accurately describe this type of insurance service. Anyway, if it’s OK for the insurance company to demand my back pay and deduct the folding money specifically instructed by SSI to be used in a manor that can only be spent to cover the needs of children then maybe it would be ok if I keep the back pay and concede the insurance company to withhold the money they provide until the back pay issue zeros out. Any thoughts folks?
Answer: This is how set apart LTD policies work. For group policies there is a built in SSI offset which means they take responsibility a percentage of your income (usually 60%) and if you qualify for SSI then they only cover the difference between the two. In your state the difference is $100. The reason they do things this way is because it is so hard to qualify for SSI. The Unum system is more encompassing than the SSI which means there are situations that the Unum covers and SSI says you should go back to work.
The other reformation is if you had an individual DI policy. With this type of policy you might have had the choice of offsetting with SSI or not. Having the preference depends on your occupation class and it is more expensive not to offset.
Let me ask you this, would you have survived financially without the Unum programme? If you hadn't been receiving $2,000 a month for 2 and a half years, would you have financially made it until you had SSI imprimatur?
As for back pay going to Unum that's what they consider double dipping. Benefits to the kids Unum considers part of your advantage and the less benefit is truthfully just because Unum doesn't offer good coverage. I'm guessing you weren't pay all that much into it though. |
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Looking For Good Disability Provider In Terms Of Not Having To Sue Them To Get A Claim.? |
Question by great_and_mighty_adam_levine | Posted in Insurance
Okay, I deficiency disability insurance. I realize the value.
However, I know that most DI providers will use underhanded tactics not to pay claims - losing paperwork, stating no longer impaired without evidence, stopping payments without explanation, etc... In the meantime, they hope the insured gives up or dies.
If I am lame, I want an insurance company that I can trust not to add that additional burden, or if I am mentally disabled, my next of kin. However, I don't know if there is such an insurer out there.
Are there ANY good Disability Insurers in terms of claims responsiveness? Is there any appointment-claim customer satisfaction rating, or any other independent gauge I can use, other than just trusting the selling power?
-->Adam
Source:
http://www.consumeraffairs.com/news04/20 05/disability_insurance.html
Basically, my theory is that I pay a DI provider. In replacing, they promise to give me money if I am disabled. Since I have no intention of being disabled, this is likely to be a good apportion for them.
However, if they have a history of reneging on that promise (as most do), their insurance is worthless to me regardless of how financially stable the enterprise is. I don't know why anyone would buy insurance from a company that has a history of not paying.
| Answer: what on globe are you talking about? if you have medical insurance already, you're covered. |
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I Have A Question About Applying For Long Term Disability? |
Question by Bus man | Posted in Mental Health
My sire has been on disability for almost 6 months for depression. Short term disability benefits end after 6 months and he now has to apply for long term disability with another insurance provided through his convention. This longterm disability insurer has sent out a 20 page application with all kinds of divers questions that it looks like are designed to ensure that he is denied this claim. Some of the questions ask things like: "Please give us with a brief description of your present condition. Describe any physical and/or psychiatiric/psychological limitations akin to your return to work", and "Provide us with a detailed description of your daily ordinary" and "What is your present height?" and "Are you right or Heraldry sinister handed?" and "When do you expect to return to your last job/occupation either on a full-time or part-yet basis? Please explain in detail." and "Do you feel you could return to your job/occupation if accomodations were made? If so, please describe your rooms needs"
My dads depression is so severe, that I feel that it's wrong to try to win him answer these questions as a precondition of getting approved for longterm disability. "I" wouldn't even discern how to best answer some of those questions and I don't have a mental illness. It seems to me that his psychiatrist would be beat suited to answer alot of these questions. I'm sure my dad has NO idea what accomodations his governor could make to have him come back to work right now!
I feel like if I let my dad fill this form out that he'll entirely drop the ball and not answer these questions as good and thouroughly as they seem to want them to be answered.
I don't be aware what to do. My father IS incompasited with this depression and he CAN'T work. He needs this disability money or he will not even be able to pay his utilitys and keep a roof over his brain. It kills me to see him like this. I would have never thought that depression was a REAL disease until I saw it 1st hand like this.
I assume my question is, should I just let him fill this paper work out on his own like they seem to want? Or kind of eschew him and tell him what to write as a response to each question?
Answer: I admit totally with you about getting a professional in to help with this paper work.
I would even go as far as getting as much reinforcement from as many people as you can to back up the application; including your dads psychiatrist, his GP, community health sister, a social worker or case worker, friends and family.
It does seem daunting and a lot of line but if you work on it together, hopefully it will be worth it in the long run. Good Luck. |
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What Should I Do If I Paid Taxes On Disability Insurance And It Should Have Been Worker's Compensation.? |
Question by zyx987 | Posted in United States
My concern paid 100% of the premium for short-term and long-term disability insurance. In 2006, I was sent a W-2 to report this receipts, since it is taxable. However, later that year the injury was accepted as a worker's compensation claim, which is nontaxable takings. I thought I'd get an amended W-2 from the insurance company, but I did not. Should I file an amended 2006 tax compensation or is there a way to report this on my 2007 tax return?
I do not know how to reply to the great answers, so I added more data.
"Just me" you hit the nail on the head! Yes, the insurance company has submitted a claim against working man's comp to be reimbursed. The insurance company paid me six months of benefits before the worker's comp claim was approved. Working man's comp is responsible for the payments beginning a few days after the injury (not when the claim was approved six months later). Since the disability insurance South African private limited company pays me a minimum amount each month, the statement always shows a 'current overpayment stability'. Thanks. I will contact the IRS about what to do next.
I called the IRS. I need to get a corrected W-2 from the disability insurance company. However, they undoubtedly won't do this until they get reimbursed from Worker's Compensation. Once I receive the corrected W-2, I have to fill out form 1040-X and submit that to the IRS. Thanks "Fair Me".
Answer: No, the proceeds is taxable because the source of the money was the disability insurance which was not paid with after tax dollars on your part. Had it been disability insurance that you paid for with after tax dollars, then it would be tax unconditioned.
The workers comp thing is a side issue. Any money you got from a workers comp claim might be tax cost-free, but this money did not come from a workers comp claim. In most cases the same insurance company does not helve both lines for an employer. The workers comp carrier was probably not the same as the disability carrier.
If they subrogate and win, yes "Fair-minded Me" is correct. A 1040X may be required to fix the issue. |
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I Have A Question About Metlife Short/long Term Disability ?? Answer Please !? |
Question by Dr. Knowe Nuthing | Posted in Insurance
I was false to take metlife's short term/long term disability through my employer. I was charged over 8000.00 ( eight thousand, not a mistype ) in 113 days. I was then laid off and recieved the benefits for one month ( 30 days ) I was injured on the job on the 27th day of coverage. I received workers compensation for over 6 months. I forgot that I had the small term, long term disability plan that I was forced to take. Can I still file a claim with metlife on the insurance plan ? Can you draw workers compensation AND metlife's disability diagram at the same time ? Thanks in advance for any answers given.
Answer: Was it excepting term, or long term? Those are two different coverages.
You can't collect both disability, and workers comp - so it doesn't matter. All the disability will do, is indemnify the workers comp carrier for the lost wages they paid you.
Double dipping is actionable. |
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The Essential Long Term Disability (BLTD) Plan, administered by Standard Insurance Company (The Stan- dard), is an corporation-funded disability plan provided by the state. ...
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