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| *The Commerce Journal>>>Insurance |
SS finds you disabled, but work insurance did not. Can you re-open case? |
I was denied benefits for long term disability from my employer's insurance, despite paying into it for 10 years. I was, however, found disabled and approved by social security. Can I go back now to my employer's insurance claim and say that SS determined I was disabled, how can they deny me then? Any advise? There is no standard disability policy. You have to read the definition of disability in the policy. The better policies will say you are disabled if you can no longer do the work in your profession eventhough you could learn to do something else. The more restrictive policies will only pay if you can not do any work at all. Normally SS is the most restrictive of all. It actually says you are disabled if you can not capable of doing any job in the US economy. Fortunately they no longer enforce this that tightly. However it has no bearing on what the private disability policy rules. You have to read the contract.You should have the agent who sold the policy to your employer go to bat for you . -use the appeal paperwork that they sent with the denial notice. resend all medical records and proof, plus the award letter from social security. also get a second opinion from their doctor and one that you chose. good luck, it will be an uphill battle, you may have to get a lawyer that works on contengany to help. -Do what I suggested above, get the state insurance commissioner involved. You may have to get a lawyer. Who is your work disability carrier? UnumProvident is legendary in finding anyway to deny you; they even have a doctor that barely looks at your records turn you down. Well, the guidelines for the SS disability don't commit the insurance company. Many insurance companies have a specific definition of disability, that exclude some things that ARE covered under social security. So you can ALWAYS file another appeal, but it's not likely you'll win without an attorney. You also need to look at the denial reasons, and look at your policy - and if your disability type is specifically excluded under the disability policy, it's flat out not going to be covered. agent, 21+ years |
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