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PDtax
PDtax, CPA firm owner
Category: Social Security
Satisfied Customers: 1892
Experience:  32 years tax and professional advice in all matters money
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I am in a very tricky situation, it involves 3 players private

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I am in a very tricky situation, it involves 3 players private insurance, SSD in addition to NYS unemployment.
I was downsized from my company in August 2010 after 10 years employment with them, I collected unemployment for the max of 99 weeks which ended August 2012.
I got injured November 2011 and applied for the private policy and started collecting it Jan of 2012 after the 30 day elimination.
For simplicity I got both for 8 months, which was confusing as to whether I could work in ANY job
I was told by my SSD attorney that I will most likely have to pay back the private policy amount in its entirety, now my hearing is scheduled in the next few months and I can get no answers from my attorney on the private policy because "its a conflict of interest from the grievance dept" I was advised to contact my system adminstator.
The private policy is now requesting a whole new documentation of the continuation forms since the 2 year mark denotes that I need to be "totally disabled from ANY occupation" they have requested my 2012 tax return which shows that I recieved unemployment.
My questions are:
1) Is the private policy going to dismiss the policy payout per month based on the fact that I was collecting unemployment? Do they care? Will they send notification to the state? I DID ask my tax attorney if I needed to put the income from that on my return and he said "no because it was after tax dollars and no end of year report came to me".
2) Am I going to have to "pay back" the private policy all the monies received? I looked at the policy and it is too hard to discern & Im not sure I want to talk with the reps and put any monkey wrenchs in the case.
3) Is this going to complicate the whole Social Security Hearing?
Submitted: 8 months ago.
Category: Social Security
Expert:  PDtax replied 8 months ago.

PDtax :

Welcome to the site. I'm PDtax, and was prompted to assist.

PDtax :

I will be back to your question shortly.

PDtax :

If I can restate a few facts:

PDtax :

You were collecting unemployment, then put in a claim for private disability insurance after injury in 2011. You did not mention if you sustained an eligible injury, just that you claimed under the policy.

PDtax :

You want an opinion about what the insurance company will do if you submit information that would give them grounds to dismiss your benefits and seek refund.

PDtax :

I guess I would ask first what your status is now, going forward. If you are disabled, you might be better off repaying the state for benefits paid while you collected from the private disability policy.

PDtax :

It also sounds like you were not eligible to collect from the disability policy if you had to be disabled for two years before collecting. If that's true, they will want repayment of all benefits paid.

PDtax :

Since you are currently collecting SSD and private disability coverage, you will have to insure that you remain eligible for one or both payouts going forward.

PDtax :

I would:

PDtax :

insure I was eligible for the private disability insurance, and that they were aware of the SSD payments you were receiving in combination.

PDtax :

Not respond directly to any insurance or government agent yourself. Your attorney must make the decisions about how best to maintain your benefits and keep the repayment to a minimum.

PDtax :

consult with my attorney about the best way to approach all agencies.

PDtax :

If you could confirm your employment/claim status now, it might influence how to proceed.

Customer:

I did indeed sustain an injury that was eligible WITH MY PRIVATE policy that had nothing to do with pre existing condition that ultimately is basis of my application of SSD benefits, my doctor put me out as "temporarily disabled" so we can take it month to month, the claim I made needed the documentation to be "to the tee" or believe me the insurance would not pay, however I was in a grey area not knowing if I could possibly return to some sort of job (sedentary), as time went on it became clear that I could not -- with the underlying history of depression & anxiety as well as a host of other problems made me eligible to apply for SSD. So, to answer your question, yes I am permanently totally disabled but not until the past year has the doctor fully come to that conclusion with a host of tests & meds etc

Customer:

I also did consult with my attorney and they can not answer any of these questions since it is a conflict of interest, what are my options for getting some answers?

Customer:

I am NOT collecting SSD just the private in the interim-- I have a hearing coming up, I think I may have to pay all the money back to the private policy since I cant collect both of those at the same time (which I have no problem with) I cant really get my questions answered thats why I am on this site

Customer:

Thanks

PDtax :

I suspect that you will have to repay your unemployment first. Most states claim you have to be willing and able to return to work for benefits. Start with that.

PDtax :

Then as I alluded to, you may be able to claim on both your private policy and SSD. Policies I am familiar with will reduce the payments made by the SSD, or often require that you sign over your SSD to them to offset their costs.

PDtax :

Since you are eligible for disability and need it, I suspect repayment of the unemployment from the date you received disability benefits is the easiest, cheapest way top go. Those benefits are expired, you will be able to work out repayment with them over time if ever, and you can retain your injury benefits.

PDtax :

I would review my policy to see about the SSD/private benefit interplay, and review that for benefits not only received (if you received both, you will likely have to repay some to your private policy company, as your attorney recommended) but going forward (you may be able to keep your private benefits and SSD, but likely a netting of the payments will happen, since you likely can't get both.

PDtax :

Thanks for adding the few facts needed, and thanks from Just Answer. I'm PDtax.

Customer:

Thank you for all of your help I will take the right steps to rectify this

PDtax, CPA firm owner
Category: Social Security
Satisfied Customers: 1892
Experience: 32 years tax and professional advice in all matters money
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