by Heavyduty053 » Wed Nov 10, 2010 10:15 pm
I have been with this company for 21 years and all the times that i have had surgeries which has been several, ge disability has paid benefits while out of work. This is the problem---since 1995 i have had 3 cervical fusions on my neck which has also caused arithritis top to bottom and i have lost alot of mobility. I have had both shoulder torn rotator culps fixed which has set up arithritis over the years, but i have managed to work even tho sometimes the pain was great.....This year i fell and have been diagnosed with 2 bulging disks in my lower back, i have pain in my tailbone and a pinched nerve in my left hip and some numbness down my left leg...i applied to the same disability and their started out paying me in June of this year, but when my surgeon said he didn't want to do surgery at this time, the benefits stopped..i am under the care of a pain doctor who says i can't return to work. Disability says they don't have enough to approve it . I filed an appeal, my doctor has talked to their doctors and has sent them xrays, mri results, ct scan, nerve induction results. They have all the proof they need, but yet this has been going on for several months. When i have talked to disability all they say is that they have 180 to make up their minds. I haven't had a pay check in 3 months, my savings is just about gone and still no word. What recource do i have
Posted: Thu Nov 11, 2010 06:02 am Post Subject:
You may not have any recourse if they are acting within the language of the insurance contract.
But that doesn't prevent you from filing a complaint with your state's Dept of Insurance alleging unfair claims practices.
It might speed things along to have the DOI in their face.
Posted: Thu Nov 11, 2010 01:45 pm Post Subject:
Individual long term disability insurance? Oh wait...nevermind that ship sailed.
The DOI is a possibility. Why didn't your Dr. want to operate? What was the stated reason for stopping benefits?
Posted: Thu Nov 11, 2010 05:38 pm Post Subject: GE disability
The reason my surgeon did not want to operate is because my spine has already had enough weakening by surgeries already. Arithritis is all up and down my spine and that coupled with everything else, it was better to put it off as long as possible, or until pain becaomes so great that it will have to be done.. My pain doctor has took me off work from now on because these systoms is not going to disappear, their only going to get worst.....and by the way, i didn't know a person has to have surgery nto qualify for benefits.
Posted: Sun Nov 14, 2010 02:39 am Post Subject:
They don't, generally.
Posted: Tue Apr 17, 2012 03:50 pm Post Subject: Need to file a claim
Please give me s phone number for your compat need claim form
Posted: Tue Apr 17, 2012 05:42 pm Post Subject:
This is not your insurance company's website. Please check your policy for the insurance company's contact information.
Posted: Wed Nov 26, 2014 10:27 pm Post Subject: disability insurance
Sorry this is 2 years overdue.
Unfortunately DOI can do nothing . LTD "insurance" is not insurance, it is a benefit, falling under ERISA laws enacted by Congress. Due to the unfortunately vague language of most SPDs and the plan using its own definitions, most genuinely disabled workers will not be able to collect for more than 24 months. The Plan will deny benefits - usually the reason being mental illness not being a covered disability. Everyone who becomes disabled for any medical reason, at some point becomes "depressed" - one mention of symptoms of depression in the medical records is the red flag the LTD company latches onto and uses to deny any further benefits, citing that mental illness is not a covered disabling condition. Even the best of the highly specialized LTD attorneys will at the most go through arbitration ( which you will pay dearly for in addition to his 40% take of the recovery) . No one ever gets their day in court. It is one of the worst laws no one knows about until it happens to him. The result is a fraction of what you thought you were going to have as replacement income necessitating your becoming a recipient of food stamps, and every other welfare program available . This is the apex of injustice! The " insurance " company rakes in the premiums, uses the money to fight YOU, and you lose while they keep getting more powerful with huge profits .
Disgusting. And Congress created this. Ask your Congressional representative ( guaranteed he never even heard of this since most employers no longer provide the benefit) to change the laws. Only congress can do it. It would put the responsibility on "insurance " companies instead of taxpayers , but lawyers won't like it. Easy money they don't want to lose.
Posted: Thu Jan 15, 2015 08:31 am Post Subject:
LTD "insurance" is not insurance, it is a benefit, falling under ERISA laws enacted by Congress.
This is 100% incorrect. Insurance is insurance, and LTD insurance is insurance.However, if the insurance is employer-sponsored, then it is not subject to state insurance laws which are in conflict with ERISA. Regardless, it is still subject to the provisions of contract law and to civil litigation in a federal forum, and if the insurance company has violated any terms or provisions of the contract, or there is a conflict of interest, then the matter can be resolved by the court.
There is a great deal of federal case law on disability claims under ERISA in which the insurance company, as "administrator" of the benefit plan, has a conflict of interest and cannot legitimately deny benefits.
LTD attorneys will at the most go through arbitration ( which you will pay dearly for in addition to his 40% take of the recovery)
This may only be true if there is an arbitration provision in the contract. And even then, some arbitration clauses are "unconscionable" and void under federal and/or state law.
Do not believe everything written above, as most of it is incomplete or inaccurate.
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