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  1. #1
    Join Date
    Dec 2008
    Posts
    38

    Default Long Term Disability and Pension Benefits

    My workers compensation claim was made in the State of: Florida. I have been receiving workers compensation since sept 05. I retired from my employment and began receiving retirement pension benefits since Aug 07also receive LTD benefits since feb 2008 which cleared me as disabled until I reach 62. I received a letter today stating I had been overpaid by LTD because of my pension payments and they wanted a refund within 15 days. I am upset because I paid LTD premiums for 30 years. I am not receiving social security but is on 3rd appeal before ADJ. I need to know if the LTD company can demand what they see as an overpayment, and I see as a benefit. I was never provided a copy of my LTD benefits from Aetna after many request. Please help.

  2. #2
    Join Date
    Aug 2007
    Posts
    504

    Default Re: Help

    With my curent employer our LTD benefits are only in effect until one starts taking SS at retirement. Our policy states that once you take retirement SS your LTD ends. It sounds like your companies policy maybe similar.

    Just because they never gave you a copy of the policy that doesn't change the policy. If I were you I'd get a copy to see what it says. Your only recourse might be to go after your former empolyer for not giving you a copy of the policy. That will probably not get you anywhere, but you can certainly look into it.

    This is the way I see this. I pay for medical insurance through my employer. If I never saw the policy and its limitations and I went ahead and had a proceedure done that was not covered I wouldn't expect the insurance company to pay for the proceedure just because I had not been given a copy of the policy.

    Bottom line is you most likley will have to repay the LTD that you recieved while getting SS retirement benefits if the policy states they end when one receives retirement benefits. Many companies offer benefits like LTD and put all the responsibility of knowing what the employee is paying for and what the benefits are on the employee. Some don't offer you an outline of what the policy provides and then the employee needs to hound the HR department or contact the actual ploicy holder to get the details. I know it stinks to have to do that, but some times it is the only way to know what the benefits are from any policy, be it medical or STD/LTD.

    Best of Luck to you.

    beachgirl

  3. #3
    Join Date
    Dec 2008
    Posts
    38

    Default Re: Help

    In my situation, I worked 33 years paying LTD premiums monthly. I worked for my company 33 years of svc and decided to take an early retirement pension because my company filed bankrupcty. I was also out on workers comp due to an injury on the job with poor prognosis. I feel all these benefits are due to me. My Ltd is stating they are cutting my benefits because of my pension payments

  4. #4
    Join Date
    Aug 2007
    Posts
    504

    Default Re: Help

    Quote Quoting downlow View Post
    In my situation, I worked 33 years paying LTD premiums monthly. I worked for my company 33 years of svc and decided to take an early retirement pension because my company filed bankrupcty. I was also out on workers comp due to an injury on the job with poor prognosis. I feel all these benefits are due to me. My Ltd is stating they are cutting my benefits because of my pension payments
    Find out what the policy states regarding this. If it says they do not pay LTD once you take your pension then you will most likely have to repay them for the time you received both LTD and pension. It matters not that you didn't know what the policy says nor that you feel you are owed the LTD because of length of time paid into the policy. All that matters is what the policy states, when it comes to having to pay them back.

    beachgirl

  5. #5
    Join Date
    Jul 2008
    Location
    California
    Posts
    1,863

    Default Re: Help

    downlow,

    Your employer also should have a copy of your LTD policy. I would send a formal request, certified mail return request to your LTD company (your claims adjusters supervisor) asking for a copy of your policy, and state that you will send in a formal complaint to your state department of insurance if they do not reply.

    There are usually limits to the amount of income that the LTD allows you to recieve. If you recieve ANY other type of income like social security, or work comp payments...they will deduct that amount from what they are paying you. Every policy is different, I am writeing from my own personal experience, and your policy may be different.

    This is how my policy worked...when I recieved WC payments and SSDI payments those were deducted from the amount the LTD carrier would pay me. For example if I recieved $2,000 a month in LTD payments, and then I was approved SSDI in the amount for $1,000. per month...my LTD carrier would drop my paymentd to $1,000....so I was still getting the same amount as before I recieved SSDI. It was also the same with my WC payments.

    Also, if you are paid back pay from SSDI or WC...the LTD will back rate it, and ask you for a check. Every policy has certain guidlines as to the % max that you are allowed to recieve, and what is considered income.

    You can call your state department of insurance to ask for help.

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