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Marsha411JD
Marsha411JD, Lawyer
Category: Employment Law
Satisfied Customers: 19778
Experience:  Licensed Attorney with 29 yrs. exp in Employment Law
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I was working international as a pilot in kabul afghanistan.

Customer Question

I was working for dyncorp international as a pilot in kabul afghanistan. I injured my back on the job in feb of 2014. I also had an additional diagnosis for PTSD in November or 2013. I left afghanistan the 26th of Feb. I saw my FAA flight surgeon on the 7th of March and he grounded me meaning I could no longer fly. I saw an addition specialist on 12 march and he made the condition permanent and a dissability. Hartford was the dissability insurance carrier and I should have started receiving short and long term from them at the max rate of 10,000 per month. When I attemped to file I was informed that Dyncorp had changed the policy effective 01 March and any injury on the job or job related in the war zone would not be covered. Dyncorp never informed me of this change in policy even though I was injured before the policy change and since the medical assesment I had in march was the first thing saying i was disabled they are telling me i dont qualify for anything. I am almost bankrupt now since I have been almost 2 years without a job and am wondering if I have a case against dyn since they did not inform me of the changes that would leave me with no compensation if i waited past 1 march to see a dr
Submitted: 1 year ago.
Category: Employment Law
Expert:  Marsha411JD replied 1 year ago.

Hello,

Thank you for the information and your question and I am sorry to read about your situation. Whether or not you have a claim against the STD/LTD carrier depends entirely on the exact language of the policy before and after the change. In other words, if the policy were to say, for example, coverage is established when the injury or illness is said to have occurred (or similar words), then you would have a good case against the carrier since the change in policy happened after your injury illness. On the other hand if it says a person becomes eligible under the policy for any qualifying illness or accident once it is diagnosed, then you would not likely have a claim since you were diagnosed after the change in the policy.

That said, it is true that the carrier has a duty to notify their policyholders of the change. However, whether or not a court in that situation would hold that since they didn't notify you, they couldn't apply the change against you, is not certain. Courts have gone both ways.

So, hopefully, your situation fits the first description. You will need to take all of your policy paperwork to a local attorney (ERISA specialist if this is an employer provided policy or a litigator if not) and have them review the facts and your policy information in depth to determine whether or not you will prevail in your appeal or suit. You do have a right to appeal the denial through the Company and then go from there.

Please feel free to ask for clarification if needed. If none is needed, then if you could take a moment to leave a positive rating in the box above, I will receive credit for assisting you today. Thank you.

Expert:  Marsha411JD replied 12 months ago.

Hello again,

I wanted to touch base with you and make sure that you did not have any follow up questions for me from the answer I provided to you on the 10th. For some reason, the Experts are not always getting replies or ratings (at the top of the question/answer page you are viewing or in the pop up box for this question), which is how we get credit (paid by the Site) for our work, that the customer thinks have gone through. In your case I received neither. If you are having technical difficulties with reading, replying or rating, please let me know so that I can inform the Site administrator. Please note that Site use works best while using a computer and using either Google Chrome or Firefox.

In any event, it was a pleasure assisting you and I would be glad to attempt to assist you further on this issue, or a new legal issue, if needed. You can bookmark my page at: http://www.justanswer.com/law/expert-marsha411jd/

Thank you and Happy Holidays!