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Conference 7.286::digital

Title:The Digital way of working
Moderator:QUARK::LIONELON
Created:Fri Feb 14 1986
Last Modified:Fri Jun 06 1997
Last Successful Update:Fri Jun 06 1997
Number of topics:5321
Total number of notes:139771

317.0. "Limitations in LTD benefits" by VIDEO::GOODRICH (Gerry Goodrich) Fri May 29 1987 17:22

    The following is a memo I recently wrote after investigating
    DEC's Long Term Disability (optional) insurance.  I was somewhat
    suprised at what I discovered.
    
    - gerry




SUBJECT: Long Term Disability Benefits

I appears to me that there is a set of circumstances that can severely
reduce LTD benefits in a way that is probably not understood by
purchasers of this insurance and also, in some situations, increases
the costs to the insurer by discouraging a disabled employee's return
to work.

Example 1:

    An employee returns to work after a disability and due to valid
    and permanent physical limitations he/she can not work full
    time.  After 2 years, the employee's LTD benefits terminate.
    If, for example, the employee can only work 20 hours a week,
    that employees after tax income is approximately cut in half.
    
Example 2:               
    
    An employee returns to work after a disability and due to a
    valid permanent physical limitation can not perform the job
    he/she previously held and is reclassified to a lower level.
    After 2 years, the employee's LTD benefits terminate. If, for
    example, the employee was a senior manager and now can only
    perform the tasks of a clerk, that individual's income is reduced
    to reflect his/her assignment as a clerk.

If I understood the explanation given to me and these situations
are real, the individual would most likely be financially devastated.
This appears to present a no-win situation to the individual, DEC
and the insurance carrier.
                                                   
In example 1 an additional hardship is incurred.  Since the employee is
reclassified as part time, benefits such as heath and life insurance
terminate and the individual is most likely not insurable through
a private policy.

The individual in these examples has a valid severe handicap or he/she
would not qualify for any of these benefits.  That person will need
strong drive to return to any level of productivity. The person who
fails and can not work will remain financially secure, the individual
who is able to partially succeed will suffer severe hardship.

                                                    
This situation appears to be very de-motivating to the employee,
discourages a return to work, seems inconsistent with DEC's stated
policy on regarding the handicapped, and the insurance carrier is more
likely to incur total, permanent disability benefit expenses.  This is
not a situation where the "company takes care of the employee". If
the individual can not earn his/her wages, he/she should be considered
totally disabled.  Rather, it is a loophole in the insurance coverage
that fails to protect the employee in some long term situations.
                                                                
The information provided in the 86 Employee Benefits book does
not disclose the limitations in the above situations. This omission
leaves a sense of security where, in reality, it does not exist. 

An employee purchases this optional coverage under the belief that it
provides long term financial security.  The 86 benefits book clearly
presents LTD with questions similar to "can you afford loss of your
income should you become disabled".  The clear theme is one of income
protection.  The benefits book lists some exceptions to LTD benefits,
mental illness, act of war outside of the US, disability due to
service in the armed forces and injuries resulting from attempted
suicide.  I found no reference to loss of income protection due to
situations such as the ones discussed above, nor did I find any
statement that other restrictions apply. What other exceptions exist
but are not presented to the employee? 
                                       
The consumer (DEC employee in this case) purchases a product based
upon the data presented to him/her.  Should he/she later be in a
unfortunate situation, he/she may find that the product purchased does
not provide the service as represented.  I feel that correction of
this misleading oversight is ethically needed. 

On issues as serious as an employees income, there is little room
for anything but complete clarity.  I also believe that a pro-work
policy would benefit the employee, DEC and the insurance carrier.
There are many handicapped individuals that want to work and want
to contribute to the greatest extent they are able to, policies
that discourage this make no sense to me.

The intent of this memo is to be constructive, to improve communication
of benefits to employees and to improve actual benefits for all
concerned where possible. 

					- gerry
    
T.RTitleUserPersonal
Name
DateLines
317.1 SSD reduces LTD HARPO::CACCIAThu Jun 04 1987 17:0527
    
    
    Another limit on the benefits paid by your LTD are your social security
    disabilty benefits.
    
    If you are termed permanently disabled after a review of your doctor's
    findings and you will be unable to return to work for a minimum
    of one year you may apply for Social Security Disability benefits.
    These payments are based on your average salary over the past years
    of employment. LTD will reduce your benifits to a minimum payment
    of $50 per month or an amount to maintain your monthly income at
    80% of your gross pay prior to your disability, whichever is greater.
    
    EXAMPLE
   gross pay      $1000
    SSD pays $0000  SSD pays $500  SSD pays $800   SSD pays $1000
    LTD pays  $800  LTD pays $300  LTD pays  $50   LTD pays   $50

    Bottom line is you will never get more than 80% of your pay from
    LTD but you will never get less than $50 per month.
    
    I had a car accident 10 years ago and was out of work for over 
    years and that is how it was working at that time. 
    
    BTW: my left leg qualifies me for handicap status but does not qualify
    for disability. Even though the leg is 1 1/2 inches short I do have
    almost 100% mobility and strength.
317.2More info , the new planVIDEO::GOODRICHGerry GoodrichMon Jun 08 1987 10:4023
    re: .1
    
    You are correct but at least the information you mention
    IS in the information given to employees.  I do believe that
    the current income level is 66.66% (tax free) instead of
    80% as you mentioned.
    
    I have been actively working these issues with corporate
    benefits folks and some clarifications are in order.
    
    1.  It seems that even though the words are unclear, the
    PSA manuals (not generally available to employees) state
    that benefits such as life insurance ARE maintained even
    if the individual works part time.
    
    2.  DEC has never reclassified to a lower job level, the
    practice has been to return the employee to total disability.
    
    3.  The new LTD package effective July 1st does NOT improve
    the part-time situation.  You still either stay on disability
    or take the income reduction.
    
    - gerry
317.3HYDRA::ECKERTJerry EckertMon Jun 08 1987 10:567
    Gerry,
    
    Where did you get the 66.66% figure?  I believe the 80% figure
    was included in information that was mailed to employees within
    the past month; I'll have to check to make sure.
    
    	- Jerry
317.4Source of infoVIDEO::GOODRICHGerry GoodrichMon Jun 08 1987 12:1916
re .3

>    Where did you get the 66.66% figure?  I believe the 80% figure
>    was included in information that was mailed to employees within
>    the past month; I'll have to check to make sure.

    Personnel Policies and Proceedures, section 4.09, page 2
    &
    86 benefits book, page 5.10

    
    I read the new package and didn't see any change. I am referring
    to LTD, perhaps you saw the Accident and Sickness plan for
    Wage class 1,2 & 3. It has a 6 month limit.
    
    - gerry
317.5recommendVIDEO::TEBAYNatural phenomena invented to orderTue Jun 16 1987 15:0810
    I highly recommend that everyone secure LTD from a private
    source.I spent 11 months on part time disability which meant
    I got $50.00 a month from the LTD plan while only receiving
    one half my pay. I had to sell assets in order to eat and pay my
    bills and the experience has left me behind in terms of financial
    security. The system does not provide any motivation to work
    part time. I did and now wish I hadn't. BTW my doctor recommended
    that I take full time disability.
    And the way the 66% was figured is also a ripoff.
    
317.6VCQUAL::THOMPSONNoter at LargeWed Jun 17 1987 10:144
    RE: .5 How many ways are there to figure 66% of current income?
    And which one is used for LTD?
    
    			Alfred
317.766%VIDEO::TEBAYNatural phenomena invented to orderWed Jun 17 1987 10:378
They take the number of days in the month and use this figure
    to base the gross on. Mine varied from 200-300 a month.
    Than they subtract gross pay if your are working part time.
    They go on a monthly (calendar) basis. What this means
    bottom line is that your all over gross that they take
    the 66% of is lowered. Working 20 hours a week will blow
    any benefits and you get the minimum payment.
    
317.8Can we do this in computer talk?VCQUAL::THOMPSONNoter at LargeWed Jun 17 1987 13:5130
    I'm trying to understand what you're saying but I'm
    getting lost somewhere along the line. Let me put it
    in computer talk and you can tell me where I'm lost.
    
    Gross pay = (annual pay/365) * # days in the month
    
    Is this right? this is pretty much how real paychecks work
    except they run  gross pay = (annual pay/52) * a week
    
    benefit paid = (gross pay*.66) - part time pay

    This way you subtract the part time pay from the benefit. Unless
    the part time pay is greater then 66% of your regular pay you get
    some benefit. Either way you get at least 66% of what you were
    getting working full time.
        
    	or is it
    
    benefit paid = (gross pay - part time pay) * .66

    This way you subtract the part time pay from your normal gross
    pay and get a benefit of 66% of the remainder. Your part time
    pay would have to be at least what your full time pay was to
    zero out the benefit. If your part time pay was half your normal
    pay you'd wind up with about 83% of your normal pay.

    In either case I can't understand how you'd wind up with less then 
    66% of what you'd get in full time pay.

    			Alfred
317.9nit from ex-personnel personVORTEX::JOVANliving on the edgeWed Jun 17 1987 17:0514
   
>    Is this right? this is pretty much how real paychecks work
>    except they run  gross pay = (annual pay/52) * a week
    
I know this is a nit, but having worked in personnel, I know that gross
pay is figured as follows:

gross pay = hourly rate X 2080

2080 is the hours in a year ( and no, I don't know what the number is for a 
leap year! ).


Angeline
317.10have to find docVIDEO::TEBAYNatural phenomena invented to orderThu Jun 18 1987 11:465
    I will have to find the worksheet to verify the math but
    I ended up with less than 50% pay. According to personnel
    the 66% was only if full time disability than 66% of gross
    would be paid tax free.
    
317.11Pushing for plain EnglishVIDEO::GOODRICHGerry GoodrichThu Jun 18 1987 12:08119
    It seems that I am not the only one confused, it turns out
    that many things concerning LTD are unclear. I have sent
    the following memo to the corporate benefits folks, it contains
    some fiction but I am hoping that the response is explicit.
    
    ---------------------------------------------------------------
    
    -----------------
    | d i g i t a l |			INTEROFFICE MEMORANDUM
    -----------------




    
SUBJECT:  LTD Benefits - Plain English
                   
After reading the information in the employee benefits book (86), the
recently mailed information regarding the new policy, and DEC's
Personnel Policies and Procedures it appears that much information is
not clear or omitted. This is confusing to all involved and getting
accurate details is not a simple task. 

Creating a plain English document and including specific detail should
not be a difficult task, the following are examples of such wording.
The examples may not reflect reality since some of the information is
not available to me (or any employee) and some examples reflect what I
feel should occur as opposed to current policies. I would appreciate
your review of this and an explicate response as to what actually
would occur in these situations. 

                            
Thanks - Gerry


----------------------------------------------------------------------

Benefits if employee is fully disabled:
   
    Income - 66 & 2/3's percent of base salary coordinated with Social
    Security, tax free.  There are no cost of living increases except
    that Social Security increases will not decrease the LTD benefit. 
   
    The following benefits continue at the rate/value in effect at the
    time of disability and Digital waves the normal employee payroll
    deductions. These include dependent coverages. 
        
        Life insurance 
        Medical & Dental insurance (coordinated with Medicare) 
        Vacation continues to be accrued up to maximum 
        Pension accrual 
       
                                                                     
Benefits during rehabilitation employment:
   
    Income - 66 & 2/3's percent of base salary, tax free reduced
    by 50% of the the income earned. Salary increases due to merit
    raises will not decrease the LTD benefit.



Benefits during rehabilitation employment cont:

    The following benefits continue at the rate/value in effect at the
    time of disability and Digital pro-rates the normal employee
    payroll deductions. These include dependent coverages. 
        
        Life insurance 
        Medical & Dental insurance  
        Vacation continues to be accrued up to maximum 
        Pension accrual                                     
    
    Salary review periods will be extended to include the same
    number of hours worked as the original salary plan called for.
       

Benefits after rehabilitation employment time limit:
    
    Employment status - If after the rehabilitation time limit,
    the employee can not perform his/her original job his/her
    situation will be reviewed and one of several courses of action
    will be taken:
   
    1.  Employee returned to full time disability status.
        
    2.  Employee offered an alternate job consistent with his/her
        abilities, education and experience at a salary and benefits
        at least equal to his/her position prior to the disability.
        Should the employee decline this offer, LTD benefits
        terminate. 
    
    3.  Employee reclassified to permanent part-time, however the
        employee's benefits will remain not less than as during
        rehabilitation employment. Salary review periods become
        that of standard permanent part-time status.
       
    In situation 3, actual benefits are:
    
    Income - 66 & 2/3's percent of base salary, tax free reduced
    by 50% of the the income earned. Salary increases due to merit
    raises will not decrease the LTD benefit.

    The following benefits continue at the rate/value in effect at the
    time of disability except as noted. Digital pro-rates the normal
    employee payroll deductions. These include dependent coverages. 
        
        Life insurance - value increases based pro rata on actual merit
          raises  
        Medical & Dental insurance  
        Vacation - accrues based upon hours actually worked and total
          years employed. Maximum prorated based upon hours actually
          worked except that no previously accrued vacation will be
          lost. 
        Pension accrual - based upon pre-disability income and
          pro rata increased based upon actual merit raises.
        LTD benefits for new disability - pro rata adjusted to reflect
          actual merit raises.
						15-Jun-87 gog
    
317.12what happened on this?OG1BA1::WEIGLThu Mar 24 1988 11:515
    
    Long ago and far away, but...
    
    What ever happened with this issue?  Did you ever get a response
    from the Benefits folks?
317.13A follow upRETORT::GOODRICHTaking a long vacationTue Aug 09 1988 09:3323
   
    I can't afford to work!
    
    It has been a fair amount of time since I entered the base
    note. I have been on LTD for a year now.  I probably could
    be  productive to some extent part-time but would go broke
    if I tried.
    
    You see, Social Security cut you off if you work at all,
    LTD has a time limit for rehabilitation but then cut you
    off also.                   
    
    Even if LTD didn't, Social security considers you a dead-beat
    if you work part time and thus your retirement benefits are
    adjusted accordingly.
    
    DEC is pretty good about the whole thing, I couldn't expect
    much more from any company.
    
    So here I sit at home, if I wish to feed my kids and send
    them to college, it is my only choice.  
    
    - gerry
317.1488 ?REGENT::MERRILLGlyph it up!Wed Aug 24 1988 12:593
    Doesn't the new 1988 Benefits book answer this satisfactorily?
    
    
317.15???????????????????????EISNOW::GOLDROSENTue Apr 02 1991 23:3814
    	Yesterday, I talked with a the men from personal in Seattle. 
    After that meeting, I need to now about the follow items:
    
    		Can I get LTD and latter I get a part-time job?  The
    personal man told me that I can't have a part-time.
    
    		Will LTD, can I get health, dental, and life insurance? 
    The personal man told me that I can not have it.
    
    		Is the amount of pay is .66, or.666666666666666666666666666 
    of the salary.  The personal told me that the later figure is right. 
    If I get $1 before, the LTD is .66 with the first rate, or
    .66666666666666666666 with the second rate.

317.16Some dated info...EXPRES::SORRELLSLive Music Are BetterWed Apr 03 1991 09:2616
        re: -1
    
    Perhaps someone has a more recent benefits book handy, but my 1988
    version says:
    
    The definition of disability is (for the first 30 months) "unable to
    perform any and every part of your job" and (after 30 months) "unable
    to engage in any gainful occupation for which you are reasonably 
    qualified."  Some "rehabilitative work" is allowed.  Otherwise, you're
    not totally disabled.
    
    My book seems to say that medical and dental benefits continue on LTD,
    but this may have changed in the last 2-3 years.
    
    Good luck - hope you get some more current information.
            
317.17You get what you pay for...SCAACT::AINSLEYLess than 150 kts. is TOO slowWed Apr 03 1991 09:4811
re: .15, .16

Not being able to work on LTD...

That's one of the the reasons I pay for my own disability policy from a company
other than Digital.  My policy says that as long as I am unable to completely
perform the job I had when I was disabled, I'm considered disabled.  There are
no limitations on outside income.  BTW, this policy is considerably more
expensive than the standard Digital disability policy.

Bob
317.18CSSE32::VERGEWed Apr 03 1991 15:523
    Personnel Policies and Procedures Book is available
    On-Line through VTX.  Check out the latest version  . . 
    
317.19COMET::PERCIVALI'm the NRA, USPSA/IPSC, NROI-ROTue Apr 16 1991 15:4634
	The P&P is very little help in determining what happens
	when you go on LTD. Remember, LTD is a group insurance
	plan, not a benefit. If you have difficulties dealing with
	Prudential, you can expect little or no help from Personnel
	or Benefits folks.

	The payout is 66 2/3% (your .6666666 number), BUT you will
	be expected to file for Social Security disability payments
	(you are eligible 5 months after the start of your disability)
	IMMEDIATELY. If you do not file or do not pursue all avenues
	of appeal within the SS system, Prudential can reduce your
	payout to reflect what the SS benefit WOULD have been.
	When/If you recieve a SS disability award there will ususally
	be a "lump sum" payout of back benefits, you will be expected
	to pay this to Prudential. After you start receiving regular
	SS checks Prudential will reduce their payout to you to maintain
	the 66 2/3% number. SS increases after this will NOT affect the
	amount that Prudential pays (so to some degree you can try to
	keep up with the cost-of-living).
	
	The BEST advice is to get a lawyer that specializes in SS
	diability cases. Payments to the lawyer will be 25% of the 
	"lump sum" (plus reasonable expenses). This ammount is deducted
	BEFORE you get your first check and is deducted from the amount
	that you must pay back to Prudential.

	Between SS and Prudential be prepared to have one of the more
	frustrating times of your life (as if the disability itself 
`	were not enough). Actually, the Prudential people make the 
	folks at Social Security look extremely competent.

	
Jim	(Who's wife has gone through this process).
317.20what I heardLEDS::UYENOTue Jun 18 1991 13:486
    I, too, would recommend getting LTD from a private insurance company.  I
    had my insurance agent check into DEC's LTD offering.  As I understand
    it, you would be required to take on any job that you are qualified
    for.  That would mean that you may have to take on a job that would
    leave you financially unstable and that doesn't help out much when you
    are already partially disabled.    
317.21From U.S. LivewireNOTIME::SACKSGerald Sacks ZKO2-3/N30 DTN:381-2085Tue Jun 18 1991 15:0118
            Digital's Long-Term Disability premium rate increases

  On July 1, Digital's Long-Term Disability (LTD) premium rate will increase
  from $.34 to $.36 for each $100 of base weekly salary.  The new rate will 
  begin in employees' July 11 pay statements.  This adjustment is required as 
  part of the initial agreement between Digital and the Prudential Insurance 
  Company of America, the company's long-term disability insurance carrier.

  Employees who are not currently participating in the LTD Plan may apply for
  coverage at any time.  They must, however, complete a Long-Term Disability
  Evidence of Insurability form available from local Personnel offices.
  These forms should be submitted to Personnel, who then forwards the forms to 
  Prudential.  Prudential determines whether coverages are approved or denied.

  Employees will receive a letter through interoffice mail during the last
  week in June explaining the rate increase.  Those with further questions 
  about LTD benefits should refer to the recently updated "Your Benefits Book" 
  or contact local Personnel offices.
317.22I'm confused?!?1ROYALT::MAYWed Jul 07 1993 15:3329
    A question on my mind is:
    
    How come LTD(Prudential) "forces" you to apply for $$benefits, and if
    you don't they take 200. away from the 66% you get?? I pay into LTD AND 
    SS each and every week I work, then Prudential "BALES OUT" of paying
    once SSbenefits start..
    
    
    I'm confused....
    
    
    This did happen to my wife...We were told if you don't pay LTD weekly ,
    you CAN NOT apply for LTD if you become disabled. If you DO pay into
    LTD weekly, you can then "apply" for LTD benefits and somethimes be
    turned down. My thoughts when I signed up for this 20 years ago and my 
    wife 15 years ago, was the INSURANCE CO. would pay your LTD if you
    ever needed it. THEY then force you to apply for SS and bale out on you
    once you get other bennies..Ya my wife GETS 100./month from Prudential,
    but that sure isn't the 66% of her annual salary they promised...
    
    
    				How come???????
    
    
    
    				Boy did we get a piece of a rock...
    
    								John
317.23GSFSYS::MACDONALDThu Jul 08 1993 11:5212
    The insurance that you get from LTD promises that when disabled your
    total income from all sources will equal 66% of your current pay.  What
    that means is that if and when SS benefits kick in, the insurance
    continues to pay that amount necessary to bring the SS payment and
    insurance payment together to equal 66% of your pay.  Otherwise if they
    paid you 66% of your pay AND you received SS benefits you would likely
    be getting more than 100% of the pay that you received working.  No
    insurance is going to provide that.  The obvious incentive to stay
    "disabled" would make the system a bigger mess than it already is.
    
    Steve
    
317.24doublecheck the policyWMOIS::JALBERT_CThu Jul 08 1993 12:295
    LTD is no longer 66%  of pay.  You should refer to BENEFIT policy 4.09,
    on VTX which speaks to disability coverage after 13 weeks.
    
    
    
317.25GSFSYS::MACDONALDThu Jul 08 1993 14:0514
    
    Re: .24
    
    > LTD is no longer 66% of pay.
    
    I recall that you could elect different levels of coverage of
    LTD depending on how much you were willing to pay for it.  In
    any event the point is that the amount guaranteed by the insurance
    is always indexed against anything you may be eligible for from
    SS.
    
    Steve
    
    
317.26They're still baling out..ROYALT::MAYThu Jul 08 1993 14:3816
    RE.23
    
    I understand that we can't collect from both LTD and SS. I'm confused
    that they(Prudential) can force us to apply for SS in the first place. 
    I pay LTD for long term disability and thought I paid SS weekly for
    when I retire...Aren't they two different things??
    
    Even as I write this , I understand SS hs more than just retirement
    bennies... ie .. disability payments..but how can the insurance co.
    "seem" to bale out so easily. If I were to take out Home
    insurance(which I have) and god forbid my house burns down, I wouldn't
    expect State Fram to force me to apply for SS benefits to pay for
    repairs..Boy Am I confused?!?!
    
    
    						john
317.27SS activation NOT Digital's rule....29563::REESE_KThree Fries Short of a Happy MealThu Jul 08 1993 15:2540
    I just returned to work 7 JUN 93 after disk surgery/fusion.  Unfor-
    tunately I was already in the 3rd month of STD when I had surgery;
    under the new disability program LTD commenced for me 9 MAR 93.  My
    26 week combination of STD/LTD were up 7 JUN 93, thus my return.
    
    The neurosurgeon was agreeable to my returning to work half days
    for 2 months - because of our new disability policy it was not an
    option (not an option if I cared to return to my existing job....my
    manager had held it open at his discretion for the 13 weeks of LTD,
    he couldn't hold it if I stayed out).  There is some permanent nerve
    damage that has affected my left arm; hopefully in time (at least 2
    years), additional functionality *should* return.  I made the decision
    to return to work rather than face the upcoming hassle.....our own
    health services people (corporate) acknowledged that someone having
    the procedure I did would not be expected back to work much before
    September <--- this was assuming there were no complications. Once
    I knew I could recover some use of the arm thru intensive physical
    therapy it was always my intention to return to work as soon as 
    possible.
    
    The SS requirement to remain out on LTD is not a rule of Prudential;
    my packet describing "how it would work" was mailed out by our new
    LTD carrier - The Travelers.  The packet contained a booklet entitled
    "Disability" <---- a publication of the U.S. Department of Health and
    Human Services.  I pay the LTD amount that covers 100% of my salary,
    so you can imagine my surprise when I saw the forms to be filled out
    for Social Security.  I did contact my case worker assigned by The
    Travelers, she assured me that utilizing SS at this point would 
    not reduce my benefits later (assuming I live long enough to collect
    them).  I still have not received a satisfactory explanation as to
    *why* SS would have been invoked, though.....and the govt booklet 
    was less than clear - ask me if I'm surprised :-)
    
    I have mixed feelings about utilizing SS (assuming I had not regained
    *any* use of my left arm and had been forced to remain out under the
    "next phase" of disability).  As I mentioned, I pay the LTD premium
    for 100% of salary.....does anyone know the answer to this?
    
    Karen
    
317.28GSFSYS::MACDONALDFri Jul 09 1993 12:1140
    
    Re: .26 and .27
    
    In a previous life I sold disability insurance so I'm at least
    familiar with the industry and its practices though not up to
    date.
    
    When you sign up for 100% or 90% or whatever else, what that means is
    that the insurance company guarantees that you will receive the 
    percent of your salary that you sign up for.  What most people do not
    realize, however, is that this is not the same as saying that the
    insurance company guarantees to cut you a check for that amount each
    month.  They are just saying that they guarantee that that is the
    total amount that you will receive.
    
    All disability plans that I know of are intended to index their
    payments to whatever SS benefits you may be eligible for.  So what
    the insurance company is saying is that if you sign up for 100% of pay
    when disabled, the company will pay an amount that when coupled with
    any SS benefits for which you may eligible will produce an amount
    paid to you that equals 100% of your regular pay.
    
    So if you are not eligible for SS benefits, then the insurance must
    cut you a check each month for the percent that you signed up for.
    Because the plan is indexed to SS disability benefits, however, the
    company has the legal right under the terms of the policy to require
    you to apply for SS benefits.  If you refuse to apply, then the company
    has the right to assume that you are eligible and to reduce the amount
    they pay you by the amount you "should" be receiving from SS.
    
    Pulling it all together, perhaps the simplest way to look at it is
    that disability insurance is a really a supplement to what you are
    eligible for from SS.
    
    I'm not saying this is the right way to do it, but just that this is
    the way that it is.
    
    Steve
    
    
317.29UNderstandable...but is it right??ROYALT::MAYFri Jul 09 1993 12:3110
    re.28
    
    I guess that's the best explaination I'll ever get...so I'll except
    that...I do understabd that if an insurance company HAD to pay EACH LTD
    insurer their XXX% without another supplement(SS), they most likely
    would go out of business REAL soon. ....considering we only pay
    2-5.00/wk for LTD disability INS.
    
    
    						john
317.3029563::REESE_KThree Fries Short of a Happy MealFri Jul 09 1993 13:4322
    Thanks Steve, appreciate the info.  I knew I couldn't (through any
    means) exceed the equivalent of 100% of my salary; I just didn't
    realize SS would be used to supplement the LTD coverage I was
    paying for.  I guess I understand the rationale that SS might have
    to be invoked if it were to be determined that I would NEVER be able
    to work again; fortunately this isn't the case for me, but in reality
    I did need a little more time out than was available to me after
    the surgery in February.  The old STD/LTD program would probably have
    fit my personal scenario a little better.  Oh well, can't win them
    all.
    
    One thing I did notice reading the government booklet; even after
    you apply for SS and sign the release for your doctor to provide
    SS with info on illness/treatment etc.....SS *can* deny you benefits.
    According to the booklet, I might have had trouble even if I never
    regained use of my left arm.....per SS I would have had to lose use of
    BOTH arms, or one arm and one leg to be considered for the next
    phase of LTD!!  Ever try driving a 5 speed without power steering
    with just one good arm......I don't think so :-(
    
    Karen
    
317.31You're in good hands with ALLSOPROYALT::MAYFri Jul 09 1993 14:4018
    re.30
    
    	As you mentioned..You must apply for SS and can be denied..We
    were..
    
    My wife suffered a stroke due to a rare blood vessel disease(no
    cure,not sure of cause, 330 cases reported in country). The stroke came
    without warnings, was gone in 30 minutes but left herr left side
    parilyzed(sp), blind and brain damage. The paralisys(sp) went away,
    sight came back,etc but she damaged the left side of the brain
    (reading,writing,logic,math) due to lack of oxygen. SS denied us and a
    another company named ALLSOP(working for Pru) made us fill out ALL the
    forms a second time and said they'd fight for SS for us and PRU(NO
    CHARGE to US). They got them and my wife was on the old STD/LTD plan so
    her benefits are the same as before they rewrote the package.
    
    
    							john 
317.32CSOA1::LENNIGDave (N8JCX), MIG, CincinnatiFri Jul 09 1993 14:5812
    re: .30, .31
    
    My mom when through this, too, and the procedure was as indicated.
    You supply SS with all sorts of info, they evaluate it, they deny it,
    the insurance company appeals it (at their cost), then you get it.
    
    In fact, the lawyer they used in my mom's case (all that this lawyer 
    does is "work" the SS system) indicated that SS almost always denies 
    the initial filing, and that it usually requires the second or third
    appeal to get their approval. So be forwarned...
    
    	Dave