LTD case manager is out to get me

Disability Insurance
1

Ive been on LTD for 2.5 years now. I was approved for CPPD in February.

My LTD case manager cut me off without warning while I was waiting for the CPPD decision. This cut-off happened right before the COD to Any Occupation.

I contacted her to ask what happened but she was so inconsistent in her communication that I ended up speaking with her manager for some clarity. Her manager was very apologetic and even approved a one-time payment to tide me over when she realized that my income was cut off without warning.

I found out that my case manager was supposed to keep me informed every step of the way, which she didn’t. I also found out that it’s very unusual to cut someone off LTD while they’re waiting for CPPD decision. And that COD to ‘Any occupation’ means not just any job but something that is within your expertise and would pay you close to what you were making before.

In order to be ‘approved’ for LTD again, I had to reapply and my doctor had to fill out a new medical questionnaire.

The case manager’s manager said that being approved for CPPD counts for a lot but I haven’t found that to be true since all this happened.

My case manager still calls me every couple of months. She asks the same questions, including my expected date of return to work. My disability is such that I may never be able to work again. It’s hard enough coming to terms with having this disability, but to have her breathing down my neck like this is causing me so much anxiety. I know other people with my disability have been able to focus on managing their health and hear from their LTD once a year. I, on the other hand, seem to be under constant scrutiny.

In addition, now she’s asking for information about my car accident and if I’ve received a settlement from the insurance company. She said it’s to avoid an overpayment on their end. It’s really nerve wracking having to deal with her so often especially after what she did to me earlier this year.

For reference, she was not my original case manager. She was placed on my case after the first one went on medical leave. The first case manager was amazing to deal with so I’m at a complete loss as to why this one seems to have honed in on me and won’t back off. She’s now asking for more doctor’s notes because the last ones she has are from March and she wants something more recent. Is this normal?

I read here that some people have email only contact with their LTD. Can I do that? How?

I’m also surprised that her manager let her continue working on my file after her intentional sabotage. Why do you think that is?

Also, is the LTD provider entitled to my settlement from the car insurance company?

2

A simple email to your case manager and the manager’s manager that because of the previous wrongful LTD termination you now require all communication be done through email so there is a written record. I would also ask because of the unprofessional way things were handled before you are also requesting a new claims manager.

I am very stern and quite difficult towards my LTD insurer, and they pretty much leave me alone. But do what’s in your comfort zone. Everynow and then I get a voicemail instead of an email, and I just send an email back asking for what they want.

With regards to the car accident settlement there is strong likelyhood they are entitled to some or all of it depending on how your master policy is worded. If the car accident caused the disability you are getting LTD for then I’d say the chances are very high they are legally entitled to it.

3

Forgot to add. Have the insurer request doctors info directly from the doctor instead of going through you.

Before my COD my LTD insurer would ask for medical updates directly from my doctor every 6 to 8 months. Most of the time he simply wrote “no change since last report” if they didn’t ask for anything specific.

4

Thank you so much for your detailed response. I will try your suggestions.

5

Just curious why you think there is a strong likelyhood they’d be entitled to some or all of it?

I am in a similar situation and I have read previously that it is something they typically cannot touch.

6

Hi, because many LTD insurance master policies usually state directly in them that any settlement from any auto accident that caused the disabilty or subsequent to your disability is an offset to your LTD payments. They are worded in various ways, but that the general jist of it.

I have read 15 different master LTD policies and 14 of them contained such a clause. The one that that didn’t reference any auto accident settlement entitlement did state any “loss of income benefits” from an automobile insurance plan will be offset from the LTD payments.

I personally know of two people who said their auto accident lawyer said that their LTD insurer can’t touch their settlement, and it turned the the auto accident lawyers were 100% wrong.

If your master policy doesn’t mention offsets or entitlements under any other insurance payments or settlements then you have nothing to be concerned about.

7

Thanks for your reply and info my accident was 6 years prior to me going on LTD and not for the same reason.

My master policy states under Offset Provision “Loss of income benefits under an
automobile insurance plan, to the extent
permitted by law.” It doesn’t mention anything else about automobile anywhere in the master policy.

  • to me that read as just loss of income part of my lumpsum payment from the accident. Which appears to be what the 1 of the 15 you have read states. Crossing my fingers it’s just that.

I also have a “maximum income provision” which allows me to collect 85% of my income before being clawed (I’m paid 70%). When I got my lumpsum from CPP-D they were only able to claw back the excess of that extra 15%.

Either way thanks for you information. I now know I’ll need to speak to a lawyer to decipher exactly what my plan states.