I have been on LTD for a few months. It was initially approved for only 3 months till end of Feb. I provided multiple updates before the end of last month for my case manager to review my case as I needed to know if I would be receiving further payments. However, my case manager was not getting back to me with an update on whether they were extending my benefits, even though I had asked them if they needed more information and they said they didn’t. It has been nerve wracking to say the least as I have bills to pay but my case manager finally got back to me a couple of days ago that they are extending my benefits for 2 more months. I am currently housebound and not able to function properly and my doctor has said that a RTW date is unknown. I have multiple sleep disorders (currently being assessed), a diagnosed rare disorder that I have just started treatment for (but usually takes at least a few months for significant improvement), and also a suspected case of a debilitating chronic condition. I am waiting to see multiple specialists but some of the wait times are over 6 months.
My questions are:
Why is my insurer so late in getting back to me (other than genuinely being busy is there something else going on?) and only approving a couple months at a time when my doctor has said RTW date is unknown? Is this normal? Anything I can do?
My employer is also only extending my medical leave month by month and they check in on me every month even though I have submitted a doctor’s note that my RTW date is unknown. I have asked HR to extend it at least a few months as my condition has worsened and it turns out to be more complex than what my doctor initially thought but HR ignored my request. This is causing unnecessary stress. Anything I can do about it?
Insurance companies are swamped, they don’t pay well, and to be honest many times hire “low” quality candidates so those are some reasons for poor communication. I have a theory that stating that you’re approved for only a couple months at a time is likely a strategy to get people back to work faster as people hate the unknown. In reality ALL claimants are only approved for small windows that corresponds to giving updates to your insurance provider, they just don’t say “you’re approved” for 1 or 2 months at a time… Some people are requested to give weekly updates to maintain their LTD payments…crazy.
I’ve heard of some employers doing this. I suggest you resend the request to your employer saying you will notify them when your doctors authorize your return to work, and that their monthly questioning is causing stress
that is contributing to your worsening condition. Do it by email so there is written record in the event things go sideways with your employer and you sue them for wrongful dismissal.
Take solace in the fact that your doctors are saying your return to work is unknown, and they are supportive in providing info that your symptoms are preventing you from working indefinitely. It means the insurance will likely have to keep bumping you out. If you can put a small nest egg together to support you just in case they cut your LTD benefits that will bridge the gap between getting cut off and a legal settlement for wrongful termination of benefits…
Thanks Buckets365. I didn’t know that all claimants were only approved for short timeframes. Weekly updates??! That IS insane. Your theory makes sense and I think it’s probably the same with my employer. However, the pressure of having to get better by a certain date is not conducive to one’s health. I do have savings so I won’t end up on the street but with the current inflation and increase in interest rates etc, it is so stressful.
This was the same for us. Only approved a couple months at a time. Then once he got CPPD, they approved early for the “any occupation” and now they leave us alone.
Yeah my payment had to be approved manually every single month which meant it was almost always late with zero communication because my claims manager was overwhelmed. It is stressful and really sucks for sure.