If you are disabled and can't work, you might have disability benefits provided through your job as part of your package of benefits. These benefits are generally referred to as ERISA short term disability (STD) or ERISA long term disability (LTD) plans. ERISA stands for the Federal Law that covers these type of disability benefits: the Employee Retirement Income Security Act of 1974. STD and LTD benefits are usually provided through a policy or a self funded plan administered by an insurance company. Some of the major players in the STD and LTD insurance business are: CIGNA, The Hartford, MetLife, Sun Life, Unum, Liberty Life, Prudential, the Standard and Aetna.
Besides representing claimants in Social Security Disability cases, our office also represents individuals who are seeking or have been denied ERISA STD or LTD benefits. Recently, a prospective client asked me whether it was a wise decision for an LTD claimant to allow his or her LTD insurance company to also handle their Social Security Disability case. Here are my views on the subject:
The vast majority of ERISA LTD plans have provisions that allow the insurance company to offset the money that they pay a beneficiary by the amount that the beneficiary receives in Social Security Disability benefits. Moreover, most plans also provide that a beneficiary is required to apply for Social Security Disability in order to be able to received LTD benefits. These provisions are completely legal. However, LTD beneficiaries are free to determine who handles their Social Security Disability claim. The insurance company does not get to choose who will act as the claimant's lawyer or representative. Unfortunately, it is clear that, in most cases, insurance companies do not respect a claimant right to choose his or her own lawyer or representative before Social Security. Instead, they steer or even strong arm beneficiaries into hiring companies like Allsup, Advantage 2000, Ocudanta and Disability Services, Inc. to handle their Social Security Disability claims. These companies are agents of the insurance company and do not owe a duty of loyalty to the claimants. Their goal is to help the insurance company, not to help you. For this reason, I urge all LTD claimants who are also applying for SSDI, to obtain their own lawyer. Social Security Disability Lawyers work on a contingency basis and will not charge you any money unless they are able to get benefits. In addition, the insurance company is required to give you credit for the contingency fee paid in the case and are not allowed to include that portion as part of the offset.
Ideally, you should hire a law firm like ours that handles Social Security Disability as well as ERISA STD and LTD claims. This way, the law firm can gather evidence and develop arguments that will help you in both cases. A competent disability lawyer that concentrates in disability law is also going to be able to counsel and advise you on issues that might affect the interest of the insurance company. (Remember that insurance companies make profits by denying benefits.) On the other hand, Allsup, Advantage 2000, Ocudanta and Disability Services, Inc., are required by the terms of their contract to be tight-lipped as to any information that might prejudice the economic interests of the insurance company.
