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Return To Work: Group Long Term Disability (LTD)

How Do I Confirm My Interpretation of Provisions of a Long Term Disability Income Policy?

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Many of the provisions affecting benefits when you return to work are only briefly outlined in a Summary Plan Description, so you will need to speak to the insurance company to clarify how the company will interpret provisions that seems relevant, preferably in a phone call.

It may seem like the easiest way would be to send a letter asking for a written response. However, the drawback to a letter in this circumstance is that the human contact is lost. Also, it is difficult to communicate in writing that you are not yet ready to return to work, but that you are simply exploring possibilities, and that you have concerns about not being ready to go back to work and are afraid to try it too early. Without the personal contact, the insurance company would be more inclined to take questions as a trigger to undertake a disability review to see if you're healthy enough to stop receiving benefits -- and possibly discontinue your income well before you have a new job.

Hopefully, you will have been assigned a particular claims representative and there will already be a relationship with that person.

When you get the answer(s), it  is advisable to ask for written confirmation. Rather than say somet hing like, "I'd like t his in writing in case there are problemsin the fu ture" consider saying something like "It's just because my memory is so bad, and this is very important."

If the claims representative is hesitant to commit the statement to writing, ask if it is all right for you to write to him or her, and confirm your understanding of what the person said. The person can  then easily confirm or revise what  was said in a return e mail or letter.

If you are not comfortable making the call, ask a friend or family member to do it for you -- or ask a social worker, or hire a professional such as an attorney or a health finance counselor.

Regardless of who does the calling:

  • Make sure the person with whom you speak understands that your inquiry is theoretical -- that you aren't ready to return to work yet even though you would like to. For example: "Say, I was just wondering. I have some good days, but they don't happen enough to work regularly. But, in case they did start happening frequently enough that I felt good enough to try to go back to work, what would happen?"
  • Ask your specific questions, always reminding the person with whom you speak the situation is still theoretical. For instance, "If I couldn't stay at the job would my benefits start up again? I see something in my policy called Recurring Disabilities. If I had to go back on disability before six months is up would this cause my benefits to start up again, even if I had tried to work at a different employer? Oh really?"
  • Ask for the company's interpretation in writing. Companies do not always stand behind what one of their employees may have told you over the phone - even if you could prove what was said. "Would you send me a letter explaining that; I don't quite understand it fully."
  • Assume that the conversation is being recorded. Even if it's not, the assumption will keep you on your toes and from saying anything you shouldn't.
  • Read Making a Friend for tips on how to handle a phone call to the insurance company.

CAUTION: Proceed very carefully. Understand how taking a new job will impact your current benefits, and the possible new ones. Returning to work is a major step if a substantial portion of your disability income is due to Long Term Disability benefits. If you just jump back into the workforce, lose your current coverage and find you can't continue to work, you may end up collecting only Social Security Disability Insurance (SSDI) during the second disability period.

Before you go back to work, see Preparing to Return to Work.

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