People like me who represent disability claimants may think that we're the only ones interested in how the Social Security Administration handles appeals of disability claims but that's not right. Some non-profits are interested but so are insurance companies handling long term disability (LTD) benefits. LTD is generally reduced because of Social Security disability benefits received giving the LTD insurers a huge interest in the adjudication of Social Security disability claims. The more claims get approved, the less their liability.
Allison Bell has written an article summarizing what took place at this week's hearing before the Social Security Subcommittee, apparently for people in the LTD industry.
3 comments:
Most LTDs require recipients to file for SSDI even if the condition is known to not meet requirements. They helped build the backlog and fuel some of the larger firms. If they acted more responsible it would be easier to take what they are saying, but they are a part of the problem.
@9:23
Medically, I do not see a distinction between the LTD and SSA standards. Vocationally, LTD companies may contribute to the backlog, but I disagree they are knowingly advancing worthless claims. Most LTD policies require the recipient immediately apply for SSDI, but limit their vocational analysis to the claimant's last worked occupation (for the first few years; it varies by policy), as that is the general structure of eligibility in private LTD claims. Their analysis ends prior to determining whether the claimant can work in any occupation, the standard in SSDI. This arrangement means the LTD company is not knowingly advancing worthless claims.
Also, LTD benefits allow for medical treatment, meaning the record can be developed early, and potentially lead to an early award, and at the very least a file developed more than a claimant would receive by relying on the state agency.
There are tons of complaints which could be levied at LTD companies, particularly once the any occupation is reached and they jettison any relevance of an SSDI award (the one the used to offset the claimant's benefits with), but I do not see advancing worthless claims (particularly given the discretion SSA has in awarding claims) as legitimate.
You must not have ever processed UNUM or Aflac or MetLife where we do tons and tons of shattered ankles and feet that will heal in under 12 months and not cause a permanent loss of work. Many many claims like that. Or back injuries that are healed after surgery, shoulders, you name it. All have to be filed, take up space being denied. It is stupid.
Funny you point out the similarities to SSDI, always thought LTD claims adjudicators do the same thing as SSDI at DDS and even OHO, why do we need ALJs and Senior Attys when we can do it cheaper like the LTDs with adjudicators.
Post a Comment