Here at Kantor & Kantor we constantly find ourselves working closely with SSDI attorneys on behalf of our clients. Even more often, the evidence we secure on behalf of our clients during their LTD disputes can be utilized by your clients to support their SSDI claim as well. Here are some thoughts on our clients’ intersection between LTD and SSDI.
If we have a mutual client, use us as a resource to fight the substantive disability claim.
We can promptly provide copies of critical case documents, including testing or expert reports we have acquired in support of our client’s LTD fight. Our evidence saying a claimant is completely unable to work in any occupation on even a part time basis should be similarly useful for your SSDI case.
Fair warning: Good enough for our purposes may be adverse for yours. If we only have to prove a client can’t work in a job which earns more than $100,000 per year, a finding that the claimant can only work 10 hours per week is a slam dunk for our purposes, while an instant defeat for yours.
Admittedly, we LTD lawyers often get the better end of this mutual exchange. While evidence supportive of SSDI is usually supportive of LTD, evidence supportive of LTD is not always enough to support SSDI.
We are generally great referral sources.
Our disability clients all have to apply for SSDI.
Many ERISA LTD lawyers do not handle SSDI claims.
Many clients who are looking for you accidentally stumble onto our doorstep. We give out SSDI referrals dozens of times a day–we are sure other ERISA LTD lawyers have similar experiences.
If your client has an LTD claim, be mindful of the LTD limitations in the policy and the basis for your client’s LTD claim.
Most policies limit payment of benefits to two years (or fewer) based on mental health issues and drug abuse.
Many policies are starting to limit claims based on chronic fatigue syndrome as well as “musculoskeletal conditions” such as fibromyalgia.
If your client doesn’t have an LTD lawyer, suggest he or she find one who is willing to advance costs for disability-related medical testing. This will give your client (and you) access to otherwise unavailable resources which could make the difference in both claims.
If you are trying to sell yourself to a potential client, and the client is considering using the “free” service offered by their LTD company, explain why they want to use you, instead.
It is “Free” to utilize YOUR services if they are receiving LTD, as the insurer cannot deduct amounts paid to SSDI attorneys. As most only consider using this service because it is free, this is the easiest way to persuade a client to hire you instead.
Further, hiring these “free” services usually gives them the right to pull money directly out of your bank account to repay the insurer, where you’d have a plethora of financial repayment options if you received the entire SSDI payment directly.
See #2- you will be mindful of these things, while the insurance company’s hired service will not. In fact, that may steer the client toward a more “insurance-friendly” direction by focusing on conditions which limit the claimant under the terms of the LTD policy.
Did you win? Nicely done. Your client will likely owe reimbursement to the LTD insurer based on the terms of the LTD policy, and they will receive a reduced benefit going forward.
They have legal rights which may protect them from having to repay any such over-payment directly. See Biyleu v. Morgan Stanley Long Term Disability Plan, Montanille v. Board of Trustees of the National Elevator Industry Health Benefit Plan
Practically, insurers are aware of the possibility of not recovering over-payments; as such, they are often willing to agree to a reasonable payment plan to increase their chances of recover.
Be warned- if they refuse, they can recoup the over-payment from future monthly LTD benefits. Regardless, this is often preferable to having to repay the entire amount in one lump sum payment.
If your clients all happen to be safe from the evil clutches of insurance companies, feel free to reach out anyway—if just to discuss the possibility of sharing opportunities in the future, should they arise. Feel free to call 800-446-7529 and ask for Andrew Kantor or Beth Davis.