Ive been on disability for over 7 years. Ive worked for short periods and then had to go off again.
I recently return to work just a few hours a week. Id like to be able to return to work when i can and then go off when i need to.
Last time it was no problem. Well this time they have assigned someone to my case to monitor my return to work. In a week we’ve had 2 calls. Ive only been back a month and they are already pushing me to increase my hours, pushing me to try different meds, asking me what other types of employment i would like to work at if my return to work with my employer isn’t sucessful.
I feel like im being penalized for going back. It sounds like my benefits are now in jeopardy.
I told them that i might be taking a month off work. I thought my father had died in front of me and it’s all been overwhelming. Their response was that im not allowed to take time off work because it defeats the purpose of a gradual return to work and you can’t take any vacation.
Im not doing a gradual return to work. I don’t know how to convey this to them. I feel like i can work a few hours a week so that’s what im doing. They think this is going to be long term but i can’t honestly see myself being able to do this for more than a few months.
I want to stay in the workforce in some capacity even just causual which would work much better for my health.
This has gotten me so angry and caused health issues. I would think this would be encouraged but it feels like the exact opposite.
Has anyone navigated this before and can provide some advice on how to address this with them so they don’t twist things?
I would tell them that based on the state of my health I don’t anticipate being able to increase the hours nor sustain the part time work for more than a few months at best and it appears that this is as good as it’s going to get. Then let their calls go to voicemail and reply to them by email.
Unfortunately, my answer is going to be blunt. If you are on LTD, then you can’t work casual in the manner in which you are trying to do. The system is simply not set up for it. It is VERY unfortunate and damaging. I too, feel like I could work occassionally. Maybe 4 hours one week, maybe 10 hours the next week, maybe 0 hours the next week… it totally depends on my health. But the system is not set up for that. Once you go back to work, you risk everything. It makes no sense because you would think they would want to keep you working to improve mental health but that is not the case. My advice to you would be to immediately stop working and stay on disability, or you will risk losing your benefits. If you are anxious to remain involved in the community, volunteer work may be a way to do it. It’s what I have done… I volunteer 4 hours a week and it keeps my mind and spirit active. I know some people here may have different advice, but this is my advice… based on my experience. 99% of the time, it is true. There might be 1% who has been able to pull off the casual work while on LTD, but it is the exception and not the rule. It’s too bad you are punished for trying to do something good.
I also agree with Adam. I would push the LTD against any RTW especially if your doctors are not on board, if you are compelled to try a RTW as they may threaten to cut off LTD benefits then one does need to try and be very honest with them. If you are suffering from too much aniexty then they really can’t expect you to go back to work.
You are getting great feedback on this. I really feel for you. I often encourage people to try to RTW for the exact reasons you express. But, unfortunately some insurance companies (or at least the claims reps) are a one trick pony. For them, any attempt to work must end in you working full time and being off LTD. If you can work 2 hours you can work 8, etc.
Most group LTD plans are NOT designed for a person to do some work and keep the LTD benefits. In fact, most newly designed LTD plan have clauses that designed to prevent just this situation. So, one key thing to know is how your group plan defines disability from “any” occupation? Does your plan have any restrictive clauses against working part time and getting some or all of the LTD benefits. You could reach out to us with a copy of your group benefits booklet and any correspondence you’ve gotten from the insurance company and we could let you know your situation.
If your doctors don’t support a full return to work, then this is something you can definitely push back on. You are doing the right thing and unless there are restrictive clauses in your group plan around RTW, then most judges are going to look favourably on your and badly on an insurance company in your situation.
David Brannen
Disability Lawyer with Resolute Legal
The response posted above is based on the limited factual information made available and is not intended as a full and complete response to the question. The only reliable manner to obtain complete and adequate legal advice is to consult with a lawyer, fully explain your situation, and allow the lawyer enough time to research the applicable law and facts required to give an adequate opinion. The basic information provided above is intended as a public service only, a full one-on-one discussion with a lawyer should be done before taking any any action. The information posted on this forum is available to the viewing public and is not intended to create a lawyer client relationship with any person. If you want one-on-one advice, please click here to request a free consultation or call toll free 1-877-917-7050 to speak with a member with our disability claim support team.
If your insurance tries to force a return to work, and your doctor disagrees with it, are your benefits cut off? I tried a return to work while still on short term disability and it failed. So I don’t see that a forced return to work will be successful (I wish it could be) but my health has deteriorated significantly since dealing with my insurance company! With the type of work I do, it’s hard to do a gradual return as it involves travel and many meetings to attend. I suffer from chronic pain which flares significantly with any stress.
Yes. Agreed. I would think it would be a huge liability for my employer if I am sent back to work in my condition and I get hurt further somehow on the job.
I had a meeting with my insurance RTW specialist today. It took me days of preparing for this phone meeting. She was friendly but said it wasn’t her job to discuss anything in my claim with me, just to tell me I am being cut off regardless and my RTW date is set for July 22/24. Starting with 3 days a week @ 4 hours a day and in just over a month it will be back to full time. I’m very nervous but feel I will give it a go in good faith and the stress of my job ( it’s stressful) may be less stress than dealing with the insurance company’s heartless case managers. They didn’t even ask for any modifications other than reduced hours for reintegration. I am unionized and can appeal however from what I have read, most appeals at union level are unsuccessful. Worst case scenario as I understand my collective agreement, if I can stay working for 30 days full time, I can go back on short term for 6 months.(And not deal with insurance). That will bring me closer to my retirement date. Any feedback appreciated.
I see you are unionized, but a ltd lawyer can quickly review your collective agreement to see if they can still represent you if a RTW doesnt’ make any sense and your doctor doesn’t support a RTW.
I have spoken to disability lawyers a few times but didn’t know at that point that this was definitely happening. And fast! I have a dr appointment a few days prior to my expected RTW. I plan to ask to see an occupational therapist and have him ask for ergonomic assessment as well.
I saw my doctor who indicated I needed an occupational assessment, ergonomic assessment and a trial of EMDR prior to an attempted return to work. I presented this to my employer at my RTW meeting yesterday. She wasn’t sure what to do with it or how to proceed and is seeking further clarification. I am scheduled to return Monday. This whole process has me mentally end emotionally exhausted. I also don’t know what insurance intends to do. I sent the letters to them with no response yet.
Firstly, I suggest that you follow your doctor’s recommended treatment as that is what is best for your well being.
Almost all insurance master policies say you must follow resonable medical treatment to maintain your LTD benefits. If your insurer insists you RTW before this treatment is completed against your doctor’s opinion and ends your LTD benefits then they have breached the LTD policy and you should proceed with a lawyer.
Because there is a reasonable chance you’ll be able to return to work your employer will need to wait for you to finish your treatment, and will be required to hold a position for you unless they are willing to face discrimination “charges” along with a large severance package owed to you.