FAQ: My Long Term Disability carrier offered to hire a company to assist me in obtaining Social Security Disability Benefits . . . Should I accept?

This question comes up all the time, so we thought we’d discuss it.

Although it is a relatively straightforward question, the answer is not so straightforward. In short, it depends.

First, it is both to your benefit and to the benefit of the insurance company or employer paying your LTD claim that you receive SSDI Benefits. In every group policy I have ever seen, your LTD benefit will be reduced by the amount you originally receive from SSDI, so the insurance company is very happy to have Social Security pay what is often a high percentage of your claim. That is why it benefits the insurance carrier.

It also benefits you to obtain SSDI, in that after being receiving benefits for 24 months, you will be entitled to receive Medicare, which may be your only avenue to obtain health coverage. Also, the carriers will not offset any increases you receive from Social Security due to Cost of Living Allowances.

It is also to your benefit to have obtained SSDI, as the very recent U.S. Supreme Court decision in Glenn v. MetLife provides that insurance companies must consider the fact that Social Security has granted you benefits when they are considering whether or not to pay your claim.

So, getting SSDI is a good thing, but that doesn’t answer the question whether you should allow the insurance carrier to assist you.

First, having the insurance company obtain a representative for you, or hiring one yourself, will not save you money, or cost you money. Social Security lawyers can only charge you if they win, and if they do, the insurance companies almost universally offset only the amount you receive after the lawyer has been paid. So, the cost of the Social Security lawyer/representative is not relevant to your decision.

Second, you have to consider if the lawyer hired by the insurance company can help you get SSDI benefits, but at the same time harm your ability to continue to receive LTD benefits. The answer to this question may decide the issue for you. SSDI has no limitations on the time it will pay for disabling conditions, which is not the case with most group LTD Plans. The LTD Plans often have 24 month limitations for Mental & Nervous Conditions, and/or Substance Abuse. Suppose someone has Fibromyalgia with secondary depression. A representative hired by the insurance carrier may well push Social Security to award you benefits based on the depression, knowing that the insurance company will be able to turn around and use the award of SSDI benefits to limit your LTD claim to 24 months. Will the SSDI representative actually do that? No one knows for sure, but I have seen instances wherein I certainly believed it happened. Based on the foregoing, if there is any aspect to your disability which could be classified in such a way as to limit your ability to continue to receive LTD benefits, the safer approach is to retain your own representative who will be serving the interests of only one party, YOU!

In my opinion there is only one reason to even consider letting the insurance company retain someone to help you get SSDI. That reason is, if the insurance company is willing to hire someone to convince Social Security that you are totally disabled under the governments very strict standards, it will be more difficult for the same insurance company to turn around and deny your LTD claim. However, the mere offer by the insurance company to hire someone for you is probably strong enough evidence of your disability to outweigh the disadvantages of allowing the insurance company the ability to control your SSDI claim.

If you need assistance in getting your SSDI benefits, contact NOSSCR, which is the National Organization of Social Security Claimants Representatives. The organization, will, without charge, find someone in your geographic area qualified to help you.

Finally, if you think the advice offered in this blog is biased because I am looking for business, I am not a member of NOSSCR, and do not EVER represent claimants seeking to obtain SSDI benefits. However, I have seen scores of cases where the choice of a Social Security representative has impacted a client’s ongoing claim for LTD benefits. GK

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