Friday Q & A
I’ve already written a post about Unum’s “Aspire” program that sends carefully selected, top-claims deniers to Disneyland for yet more indoctrination and brainwashing. Management gets a great deal of control mileage by using the “Aspire Program” to push claims handlers to be “experts” at meeting the company’s termination agenda.
I’ve never understood why adult employees who, in my opinion, are already working for Ali Baba and the Forty Thieves, would want to go to Disneyland for a week to be indoctrinated. I’m hearing a lot about this lately so it must be time for Unum management to make their picks.
The topic of resigning from work before, during, and after disability is by far the most frequent question I receive. There is an excellent post on this blog called, “Resignations – A Disability Claim No-No.” I strongly suggest that you search this topic and read the post.
In short, no one should “resign” from a job when leaving work for disability reasons. NO ONE. Basically, employees should notify HR that “my doctor is recommending a period of total disability as of a specific date.” There is a big difference between notification of impairment and “I quit.” Please read the above mentioned post.
Why would Unum want to look at my SSDI file?
Whenever Unum asks for additional information it usually means it is looking for something and SSDI files are no different in motive. To begin, the Multi-State Settlement Agreement stipulates that Unum should “consider” SSDI information before making their own liability determination. So, Unum requests SSDI files to cover their behind. Not that it actually “considers” the information, but at least if they have it, Unum can say they did.
Today, Unum is asking for SSDI files for the intended purpose of chasing down nickels and dimes of offset errors, mostly from those who have been on claim for some time. The longer you’ve had SSDI approved, the more likely there are to be errors in calculation which presumably Lucens is helping them with. Unum’s calculations are bizarre and m most people can’t even figure out where the overpayment came from.
In addition, Unum is looking to get a copy of SSA Form 831 in order to determine if mental health listings were used to award benefits. If so, Unum alleges they “agree” with SSA and will limit benefits to 24 months.
Unum’s letters that encourage signing of the SSA Authorization claiming, “we want to make sure we give your claim every consideration” is fabricated untruth. Once Unum obtains SSDI files, it still denies claim benefits saying, “we have evidence that SSA didn’t have at time benefits were awarded and therefore we disagree with the decision SSA made.” What a racket! Why give up your SSDI files when your Plans and policies do not require you to do so?
How do I show 20% of disability earnings?
This question really illustrates a huge misconception. In order to be eligible for continued benefits while working, insureds are required to have at least a 20% earnings loss based on pre-disability earnings, sometimes “indexed” pre-disability earnings. Sometimes it’s helpful to look at this issue from the opposite direction.
Part-time workers cannot exceed 80% of pre-disability earnings and still keep their benefits. Therefore, claimants who are working part-time really need to keep track of their earnings and make sure they do not exceed 80% of pre-disability earnings. Therefore, claimants will have also met the 20% earnings loss requirement by not earning in excess of 80% of pre-disability earnings.
How long will I receive my benefits?
Technically, you are entitled to receive benefits as long as you meet the definition of disability as written in your policy or Plan. However, we all know that insurance companies determine who does, and who does not meet, that definition and benefits can be denied at any time.
Because of the certain “conflict of interest” in that insurers are both payor and reviewers of claims, benefits from private disability are uncertain at best.
ERISA Plans pay until age 65 (or normal retirement age), but IDI policies either pay to age 65 or provide for Lifetime benefits.