LTD Definition help

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Babycakes

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Hi there, I'm a 37 yo gal with slowly progressing limb onset with second opinion dx 9/2018. I stopped working last year and had no problems with SSDI. I have an LTD policy through my last job. Their definition of disability changes after 2 years...so for me 11/2021. It changes from unable to work your position to unable to work any position. I just have this hunch that they are going to try to deny me....it might be fine, but I'm trying to understand the policy to be ready just in case. Here's the definition of any occupation:

Any Occupation means any occupation for which You are qualified by education, training or experience, and that has an earnings potential greater than the lesser of:
1) the product of Your Indexed Pre-disability Earnings and the Benefit Percentage; or
2) the Maximum Monthly Benefit.

This basically means an earning potential greater than inflation adjusted monthly benefit amount.....
I'm wondering if they take SSDI and dependent SSDI as earning potential. Also I moved states...from California to the midwest (where I'm originally from). I'm wondering how or if they will look at that?

Maybe I'm overthinking this, but I'm a little paranoid....I'd like to volunteer/walk the dog/help at my kids' school while I'm able...even if it's difficult physically, it's good for me mentally. I'm hesitant to do anything....ugh.

Anyone had issues with The Hartford? The claim managers are nice and helpful....but I'm a little on edge....and I hate----hate not working. Trying to stay in gratitude and positivity.
Kim
 

nona

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I think that with your prognosis and health records you should be fine. I had no trouble with Mutual of Omaha . SSDI works as an offset, so it is deducted from the max LTD earnings and you will receive both. I seem to recall other threads about the Hartford, so try a search of this site.
 

Babycakes

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Thank you nona :) They have been deducting SSDI from LTD so far, but I'm just nervous about their 2 year mark. I did search the forum yesterday and there were a few posts....one was about getting declined and having to fight it. I really hope there's no drama!
Kim
 

KimT

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Mine was the same way and I'm still collecting, after five years. Mine will stop at my normal retirement age of 66 and two months. They called me the first three years and I haven't heard from them since.
 

Nuts

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If you are worried, have your doctor prepare a letter making it clear that you are unable to work at all, and have it dated for the month that you hit that two year mark. I seem to remember having to do this for my husband. His doctor was very blunt in this second letter and made it clear that this would not, could not, change.
 

Babycakes

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I just get nervous when big decisions could drastically change finances 🤪 thank you both for your experience. Having my doc write a letter is a great idea. The 2 year mark is next November...so a fair bit of time.
 

Ed340hp

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You may need to read your LTD contract carefully to understand what the two year clause involves. Some LTD policies have a 24 month benefit termination clause for specific diseases (like ALS). They must list this disease exclusion in specific language in the contract that was valid at the time of your initial disability claim (not just exclude neurological diseases in vague terms, and not reference what it may state in the employer's current year contract).

The income clause you reference just means that the Insurer can offset or deduct any earnings from the benefit (the same as the offset for SSDI). Usually SSDI and dependent SSDI are both considered income and offset from the LTD benefit. Volunteer work does not generate taxable income, so there is no income to offset the LTD benefit (volunteer all you want). Gifts and tips are also not reported income, so a gift or tip in exchange for the volunteer effort is not offset.

Hartford has been way easier to deal with compared to AETNA. Once your LTD claim(s) are registered in the Hartford web portal, confirming continued benefits requires an annual form called an Attending Physicians Statement to be submitted by your Doctor. They may also ask for a work or income statement from you, although in my experience they have waved the written statement form letter over the phone after they read the Physicians statement indicating ALS and you tell them you have not been employed or earning income.

Some Doctors offices send the Physicians statements for their ALS patient's LTD claims on a schedule, while others only send the statements upon request (talk to your Doctor's office on how they address the statements for other patients).
 

EricInLA

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I agree that volunteer work is not a problem at all. If it is even a close question with work, I'd make sure everything is off the books. You don't want to give The Hartford anything they can use to base a denial on, because you know they will!
 
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