Understanding Letter


#1

I just received a letter from my Insurance company LTD/Waiver of Premium. The letter states “The purpose of this letter is to advise you of the change in your group policy’s definition of disability, effective Aug 16, 2019. As outlined in our letter dated July 6, 2017 approving your LTD benefit claim, benefits are paid during the first during the first 24 months on the basis that your disability prevents you from performing the essential duties of your own occupation. After this time period, benefits continue if your disability prevents you from performing the essential duties of any occupation taking into consideration your training, education and past work experience. At this time, I am unable to determine whether or not you will continue to qualify for benefits at the end of this period, but your case manager will continue to assess your claim.”

I am participating in the gradual work return/rehab program. It’s starting Sept. 17 or Sept. 24. I’m assuming I am still being paid during the rehab program? It’s 6 to 8 weeks.


#2

I wouldn’t assume that.
You will definitely get paid by work for the work you do (unless you get paid through the Phoenix Pay System and then it’s a gamble :-)).


#3

You are paid while participating in a rehab plan–no worries there. It will be a good test to see if you can manage working. If it is a struggle see your Doctor and go from there.


#4

Thanks. I think it will be tough for awhile. Good to know though.


#5

The letter you received has NOTHING AT ALL to do with your current rehab program or return to work. It is simply a standard form letter sent out approximately 12 months in advance of the “change of definition” clause in your LTD contract. This type of letter is typically sent by all LTD insurers to all LTD claimants.

When you were approved for LTD back in July 2017 you were told about the 24 month “own occupation” clause and that your contract changes to any occupation in 24 months. This information is also contained in your LTD booklet. By the way, any occupation should not be taken literally… There is a minimum income level you must be able to earn and you must be suited by way of education, training, etc. - your union can provide more information if you are curious.

Your insurance company is simply covering its legal basis, and adding a little pressure, by reminding you of the upcoming change in definition in your contract in 12 months from now.

Laura - I encourage you not to be discouraged or distracted and dwell on the “what-if’s”. You have a great job and it sounds like you are supported by a wonderful employer and a union. Other than having suffered a devastating illness (which can’t be underestimated), you are in the best possible situation as far as return to work goes and any fallback plans necessary. The ball is completely in your court, and I know that you will be successful in whatever YOU choose because this time you are the one in control and you are on the road to recovery.


#6

Thanks Joanne. I’ve always been a bit nervous when I get these form letters. Must be a knee jerk reaction! I m feeling better about things & starting to think of this work return as part of my recovery from a life threatening disease.


#7

Thanks, I appreciate your support.


#8

I saw “Aug” and not the year so I thought the change in definition was soon, sorry.


#9

Oh that’s okay, the time just seems to be flying by. Thanks