In 2016 I had an Claim with Auto Insurance due to the accident. At that time Auto Insurance requested to apply to employer LTD plan. On their request, I had a LTD claim back in 2016 and it was denied in December 2016. Once employer LTD was denied, Car Insurance has paid me replacement benefits until April 2017 and set me to RTW upon passing two IME Exams. I have not appealed employer LTD and instead collected from Auto Insurance. I have returned to work after 7 month on a gradual return April 2017(Rehabilitation plan was established by Auto Insurance and my doctor). I did it in a good faith and tried my best to get into swing of it even I felt that I did not recover fully.
I worked sometime but I had to go again on LWOP for 3 months(2018)
Worked some more until September 2019.
I found myself unable to go back to work due to many functional limitations.
This time around due to financial constraints, I have applied second time to LTD.
For whatever reason Insurer wants to treat this Claim as continuation of 2016 Claim and indicating that this Claim can be treated as Appeal to the first one.
Is it even possible ? I have passed 2 year limitation period for Appeal.
Also my current condition might have been triggered by 2016 accident, but diagnosis is not the same.
Just as a side note when I have returned in 2017 to duties of my occupation and for most part worked full time hours with certain accommodations (work from home etc).
hi Vasilva, welcome to the Forum. The short answer is yes, it is possible that a situation like you describe could be a continuous claim. You are right to be concerned about missed appeal and limitation dates etc. I would strongly urge you to get a free consultation with a disability lawyer (either with us or with another firm) as soon as possible before you give more information to the LTD insurer. A situation like yours is very fact dependent. if it turns out that this is a continuous claim, you are going to want to know what you need to do to protect your rights. A lawyer will need to know a lot of specific information, including seeing a copy of your group benefits booklet that describes the LTD benefits.
Call the number below if you wanted to contact us for a free consultation.
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 1-877-282-5188 to speak with a member with our disability claim support team.