NeedFacts

Got some good news today. Benefit Plans from my former work company called me. A very nice person after talking to me is going to send me the Plan Document on LTD that I need. He even asked me what my question was and tried to look up an answer for me in it. However, he was unable to find anything that addressed it. He offered to call MetLife and see what they say. I told him that my caseworker said that MetLife would not be removing the offset and increasing my monthly benefit by the offset. But he was going to call them and see what he could do especially when I told him that I found cases against Metlife where the advice was that they were obligated to pay the offset. Hopefully I won't have to get my lawyer involved. I will update here when I hear back from him.

Thank you for your response. It is a separate interest. It is continuing on a monthly basis. I appreciate your taking the time to respond to my question.

Mr. Bailey, I feel like I'm between a rock and a hard place so to speak. I decided to call MetLife yesterday. My company sent everything but what I asked for specifically. MetLife called me back/my caseworker specifically today. She said that they would not pay when my daughter turned 18 with no further explanation. Yet, I am seeing case after case being answered on the internet by lawyers where especially with MetLife or any LTD company that offsets for that, when the dependent turns 18, the offset is added back into the monthly benefit. I think I will ask again in another certified letter for it and quote noncompliance will result in fines per ERISA and see what happens. And tell them that they sent everything but what I requested. Something is just not right here. A gut feeling I guess. Maybe I'm in over my head and it is time to involve the lawyer since I can't get what I am requesting from them.

Agreed. I'm not getting anywhere very fast in my situation. I'm very frustrated since my certified letters especially to MetLife are being ignored. The only SPD I've seen is the one online that is posted on the company's website. But it has nothing that addresses when the dependent turns 18 and what they do about the Social Security Dependent offset. I've been doing research and lawyers on the internet are answering the same question that I have with the statement that they are entitled to the back benefit once their child turned 18. Another one states that my employer is responsible for providing me with a copy of the policy per Section 1332 of ERISA and that failure to provide same could result in civil penalties. Maybe I should state that in a certified letter to my employer requesting it again. Another one states that I needed to request in writing from MetLife an explanation of my monthly disability benefits. I do like that option. It's possible that the company requested the SPD/Plan Document from Metlife and it is having to come from there. I may need to be just a little more patient a while longer before I do anything else. I need to make some decisions here for sure. If I don't get an SPD or Plan Document soon, I think i will contact my lawyer. It's time. What is a disability advocate BTW?

Well I sent two certified letters. One to my employer's benefit plans requesting the plan documents and SPD. They responded back with the Plan Document but it has nothing in it about the Long Term Disability policy. To be blunt, it is ran by MetLife. I did send MetLife a certified letter also with the official documentation from Social Security that shows where my daughter's family benefit ceased to be payable and I requested that my monthly LTD benefit not be offset by it from the cessation date forward. I have heard nothing. Should I have requested the Plan Document from MetLife in my certified letter since they are over the LTD and go from there, should I call Metlife and just ask my caseworker to explain how they handle the offset once the dependent turns 18 or should I get my lawyer involved at this point?

Well I'm back with some not so great news/update. I'm sorry to report that my ex-husband I have been told by a mutual friend has recently passed away. But I have to think of myself at this point and ask will this affect me continuing to get my benefit as a result of the QDRO that is in place now since I have a separate interest? Or will his widow begin receiving his pension only at this point? Just thinking out loud here and wondering what the rules are when this major life event happens.

Mr. Bailey, questions for you. I'm alittle confused on the document plan wording: Is the SPD that the the company has online for viewing the same as the policy/plan that I would need to request a copy of or is there a more in depth official type of document that I need to get a copy of? What is the name of the document that I would need to request a copy of that would possibly have more detailed information relevant to my situation? And if there is, do I need to request the copy from the company that I worked for or the actual LTD company that is handling my disability claim through the company? Thank you in advance for your answers.

I have checked and the copy of the plan that I am referencing/reviewing says that it is the official SPD. With the disability company ignoring my certified letter, I agree that it is time to get my lawyer involved. Thank you for your advice.

Thank you for your response. I do appreciate you taking the time to do so. I have reread the policy many times now and there is absolutely nothing that addresses this issue. I actually have issues with the Family Supplemental Benefit being taken against my monthly benefit in the first place as it has very strict guidelines under Social Security rules as to how it can be spent only on that child and not anyone else in the family so why and how it is used against my benefit I don't agree with. Plus, we filed taxes on our daughter only for those benefits and not me at tax time so why those benefits were taken out against me seems to me to be wrong but that's another fight for another day. The only thing that the plan does address/show is how they arrive at the initial calculation in your monthly benefit by simply subtracting your Social Security benefits which include yours and any Family Supplemental Benefits. It is a simple subtraction from your monthly benefit from them. However, it is mandatory that you apply for Social Security Disability. But nowhere does it address what they do when the child(ren) turn 18 and you are still on LTD. The certified letter that I sent to them asked for an official explanation by them in how they handle this situation/issue first off and I noted to them that the issue does not seem to be addressed in their policy/plan. I gave them a reasonable time frame to respond back and it has expired with no form of contact back from them. That tells me that they don't like what I found. This situation occurred starting in 6/18 and it is now up to over $10,000 that they have potentially shorted me now. I talked with my lawyer initially and we agreed to start with a certified letter from me to see what they would do first. I was hoping it would give me some answers at least but evidently the insurance company has decided not to respond for whatever reason. Looks like I will be hiring my lawyer to contact them next as you suggest. I will keep you posted as to what happens next. Would it be a good idea to reach out to other LTD people who may be in the same situation at my company and see what they have to say?

I have long term disability through my company as well as Social Security Disability. My daughter qualified through me as a Family Supplmental Benefit until she turned 18. We managed to get it extended until she graduated from high school. My company plan subtracted my Social Security and hers from their benefit that was payable to me as an offset. No where in the policy does it address what to do when the family benefit goes away. I notified the disability company when the family benefit ended. Several months later, I noticed on my monthly EOB that they 'quietly' reduced my total benefit by the amount that was paid to my daughter yet they did not increase my payout. So it is a numbers game at this point. I have found on the internet the same situation and the lawyer advised that person that they were entitled to that part of their benefit to be reinstated again. I sent a certified letter to the company recently asking for either an explanation or the back benefit and for it to be reinstated. It has been ignored. My questions are: Am I entitled to that benefit and the back wages? What should I do now if I am? Hire a lawyer? This is a big name insurance company and I worked for a large company. Should I contact others that I feel sure have been done the same way to initiate a class action suit for them also?

I would like to update my situation. I have very good news to report. Benefit Plans has paid my back benefits plus interest in full and has begun paying my monthly benefit according to my QDRO. And as you predicted, my disability plan has not come after it in any way so I'm good to go with it. I wanted to take the time to thank each and every one of you who gave me such good advice on this forum. I'm so grateful that I found this very informative source for QDRO's. I don't know what I would have done without your advice and guidance through it all. Thanks so very much. It was certainly a pleasure working with all of you. You all fill a great service in what you do. Sincerely, LAHartline

No the QDRO is not being paid to me because of my disability. It's flat out a result of a divorce settlement/time frame from way back before my disability time frame even started. I so hope you all are right. I hate to have to get a lawyer involved. I will wait and see what the LTD company decides first before engaging a lawyer. I have no problem using one if I have to though. I had to use one to fight them on an initial disability decision and we won the case against them. It was an odd situation. I won Social Security but my company LTD turned me down for coverage so I had to take them to court. I will keep you posted on what happens.

Well thank you Mr. Presson. That is so kind of you. I hope so too. I believe in being prepared when I go up against a situation/knowledge is power. Before I landed here, I had spent countless hours combing the internet trying to find the answers I needed before I found this board. And I could tell this was the place where I would find exactly that by the level of expertise here. I'm very impressed by what I saw posted in the answers given to people. You all definitely know your material, inside and out. Back to my situation, I have looked at the LTD plan document and its a little vague. It doesn't look good for me though. I think I may be in for a fight. It says they MAY offset with. I think they will have to analyze the QDRO and see exactly what it is: Your LTD benefits are reduced by other sources of income that are payable to you because of your total disability. Income that may reduce your LTD benefits includes, but not limited to: Workers’ Compensation benefits or benefits provided under a similar law, state disability benefits, and other statutory benefits for disability, retirement, or unemployment Benefits provided through Company benefit plans.Any Social Security benefits for which you are eligible, including any benefit received by a dependent on your behalf because of your entitlement (refer to the Social Security and “Long-Term Disability Benefits”).If any of these benefits are payable as a lump sum, your LTD benefit will be calculated as if these benefits are paid monthly. The insurance company may have the right to recover advanced benefits by direct payment or by offsetting against future LTD payments.Your LTD benefits will not be reduced by any private disability coverage that you have purchased

Very good advice. I think you are quite correct in your summation. I will take a look at the LTD plan document first and go from there. Thank you for your insight on this situation. I do appreciate it.

I went ahead and contacted Benefit Plans and just asked them some questions about it. They said that I would lose the back benefits i.e, the lump sum if I elected to defer my benefit until later in life rather than now. They said it would not increase my amount per month since my ex when he retired had hit the required 85 points so he got the full amount per month and so did I. My problem is now this: I actually worked for another company when I went out on LTD. They of course offset for Social Security and Family Supplemental Social Security in my monthly benefit. I never liked the Supplemental being taken out since it had to be spent on that family member only and not anyone else so I don't see why it had to affect my pay since it was so limited but that's another discussion. So now my question is will the LTD company have a right to offset with the back and future monthly benefits of the QDRO? On one hand, it's a money settlement from a marriage dated from 1979-1992 which is before my LTD. On another, the benefit will be collected for life from the time my ex retired which is within my LTD. I'm sure the LTD company will argue that the benefit will fall within their being able to collect it somehow. Just thinking out loud here. Then again, I might need to ask my lawyer about it?