Today, when insurers attempt to “nickel and dime” claimants with repetitive calculations of SSDI and overpayments, it is possible your insurer may actually owe you. One of the figures I have always recommended verification for is the number called, “pre-disability monthly earnings”, or the number used against which the percentage of benefits from the Plan is applied.
If this number is inaccurate, then all benefits subsequently paid to claimants are also wrong. Although I check all new client claims via a calculation, I find that most claimants overlook the importance of “pre-disability earnings” unless its obvious the number reported by the employer is way too low.
Although there are many versions of definitions, Plan provisions are very specific about what is, and what isn’t included in the earnings figure. The calculation isn’t a matter of opinion, but is objectively figured based on the Plan definition and earnings patterns of employees. It is possible that employers under-report earnings that should actually have been included.
Therefore, it is important for claimants to take a careful look at this particular Plan provision most often called “Monthly Earnings” to ensure the figure is calculated perfectly. Letting an error such as this to continue long-term could be quite expensive.
One of the most devastating provisions and situations are for waitresses where the majority of their earnings are in the form of “tips” Employers are very smart and most often choose provisions that DO NOT include “tips” in the pre-disability monthly earnings. I’ve had clients who are taken aback when they discover the only “earnings” used are the minimum wage amounts paid by the employer. TIPS are never included.
As an expert Consultant, I make it a habit to check “Monthly Earnings” for all claims I have access to the right information for. Consider… those who have been on disability for a long time could actually be owed quite a bit of money if just this one provision is calculated incorrectly.
My recommendation is to make sure you take a look at the Plan definition for Monthly Earnings and make sure your insurance company is using the correct figure to calculate your monthly benefit. This should be done “earlier” in the claim because sometimes employers are no longer available in the future to provide additional information, if needed.
In reality, ALL figures contained within Plan provisions should be verified. Don’t allow insurers to allege, “you owe them”, when they actually “owe you.”
