When you apply for group long term disability (“LTD”) at work you are supposed to get a decision in 45 days under a federal law known as ERISA. However, that is not usually the case, and almost invariably, the insurance company that typically acts as the claim administrator asks for additional time to make a decision. Nonetheless, I received an approval today from Prudential 45 days after filing an application for LTD benefits for a 53 year old woman who had worked for New York City.
Like many other LTD applications that I filed, I submitted supportive medical records and reports together with the LTD application forms. What made this application different? The answer appears to be that I submitted the claimant’s Notice of Award for Social Security Disability (“SSD”) benefits.
Most LTD plans deduct SSD and other disability benefits, such as workers compensation, from the LTD benefit. For some people that will completely offset the LTD benefit, and the entire amount of LTD benefits received will have to be repaid. My client’s SSD substantially reduced her monthly LTD benefits. Absent the SSD offset, it is likely that Prudential would have asked for additional time to review the application because its liability would have been significantly greater.
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