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I have question. My son is 34 and has worked for same company

for 17+ years. Due to...
I have question. My son is 34 and has worked for same company for 17+ years. Due to issues surrounding ADA violations he was forced to file and EEOC complaint which is still pending. He has a disability of Autism/Asbergers since childhood. It became apparent the store was trying to let him go due to a department change he requested, moved into and was never trained and/or provided "accommodations". I have attorney working on that for us. My question is that he was paid for one month through MetLife but denied any future SSDI benefits because MetLife and/or the company do not pay for anxiety issues, which is not my son's diagnosis. So I did what I thought was best and applied for SSDI for him while we weave out way through the system. I applied for him on March 17th, 2013, his last day worked. I just now learned that his application for SSDI has been approved. I was shocked only because everyone had told me SSDI would not approve him on his first go around. My question is, can I go back to MetLife and his employer seeking to reverse their decision that he was denied disability benefits. Currently he is on an "unpaid" leave and can remain at this status for up to 18 months. Basically the company is bound by a Union Contract to hold his job in spite of receiving no benefits, including medical insurance (I believe). HELP!
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Answered in 22 minutes by:
9/3/2013
John
John, Employment Lawyer
Category: Employment Law
Satisfied Customers: 5,879
Experience: Exclusively practice labor and employment law.
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Hi, thanks for submitting your question today. I will refer to the employer's disability policy as "DI" and Social Security Disability as "SSDI" for the remainder of this answer to avoid confusion.

You can go back and contest the denial of DI depending on the terms of the policy and how long you have to appeal an administrative denial. If you have surpassed the time to appeal, you may be precluded from appealing. Also, if you appeal and are denied again, then the only remedy is to file a lawsuit against the plan in federal court, for which I'd suggest you get an attorney. Be aware that you are precluded from offering evidence in federal court if you do not present it at the administrative appeal.

You should be aware also that most DI providers these days have a provision in their policy that requires that their disability payments coordinate with SSDI. What that means is that the amount that DI pays or owes you is reduced by the amount SSDI is found to owe you. Lastly, most DI policies these days have a claw-back provision that states whatever benefits DI paid out while awaiting for a SSDI decision or retroactive payment may be owed back to the DI insurer. I mention this just to inform you that, it may not even be worth it to pursue the DI past an administrative appeal because of this required coordination of benefits.

I believe this answers your question. However, if you need clarification or have follow-up questions regarding this matter, I will be happy to continue our conversation – select the Reply to Expert or Continue Conversation button. If you are otherwise satisfied with my response, please leave a positive rating as it is the only way I am able to get credit for my answers. Thank you, XXXXX XXXXX wish you all the best with this matter.

John
John, Employment Lawyer
Category: Employment Law
Satisfied Customers: 5,879
Experience: Exclusively practice labor and employment law.
Verified
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