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John, Employment Lawyer
Category: Employment Law
Satisfied Customers: 5565
Experience:  Exclusively practice labor and employment law.
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I have a question regarding disability benefits. I am

Customer Question

I have a question regarding disability benefits. I am receiving long term disability benefits for a medical condition I am being treated for which will end in 17 months. I also have a private Short term disability policy for which this condition is a pre-existing condition. However I have had another new condition diagnosed in the last month which would be covered by the private Short term disability plan for up to 12 months. Can I legally claim and receive disability benefits from both the Long term policy and the Short term policy for separate conditions at the same time. Both policies only pay a portion of previous pay and only the LTD is taxable. I am out of work for total disability at this time. If you have some answers I would appreciate it. I do not want to do anything illegal. Thank You
Submitted: 1 year ago.
Category: Employment Law
Expert:  John replied 1 year ago.

There is a 99% chance that the plans coordinate with each other because virtually all plans now have coordination of benefit language within them. That is to say the LTD will reduce your benefits paid by the amount of any other plan or insurance proceeds you receive so that you never in total get more than the LTD payout, which is probably 60-70% of pay. So, your options are - 1) try to continue the LTD benefits with the new condition (i.e., call the adjuster and tell him/her of the new condition for a continuation of claim, or 2) when the LTD ends submit the STD claim and start over.

Customer: replied 1 year ago.
The LTD is with a different company and is from a previous employer. The original disability event started 19 months ago. I tried to return to a different kind of job to meet restrictions but the condition became worse. I was told to stop that job by MD. During the time I was trying to work I took out a private after tax STD policy with a high premium which I still pay and won't pay a benefit for original disabity. I have just recently been told I have nerve root compression in my back and am being treated for this as a second disability. So from your answer I take it I cannot claim or collect on the STD policy for the new disabity and continue to collect total benefits from the LTD which will not cover a new disability. I am trying to off set the cost of COBRA which is $1080 a month and all the medical bills. The premium for the STD is very high as well so I can't afford to pay it if I can't receive additional disability benefits from the STD plan. They do not waive premiums while collecting disability. What is my best course of action?
Customer: replied 1 year ago.
Please respond to my further questions regarding this matter as above. Thank you
Expert:  John replied 1 year ago.

STD plans usually only pay out for 6 months or so anyway, and your LTD plan pays out for 17 more months at least and until regular retirement age (65) if it lasts that long. So if you have the choice of one or the other, I think it's clear that keeping the LTD is the best plan.

Customer: replied 1 year ago.
Why do I have to choose one or the other? Why can I not draw from both since one is from an employer I am no longer with which I am taxed on and the other is privately paid by me and is not taxable and they are for different disability conditions?
Expert:  John replied 1 year ago.

The answer to why you have to choose one or the other is because they have coordination of benefits. Coordination of benefits means that the max you can collect from any and all sources of payment is the % of pay. It doesn't matter that they are different conditions or that they are from different sources, taxable or not etc.

Expert:  John replied 1 year ago.

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Expert:  John replied 11 months ago.

Sorry to bother you, but you haven't yet provided a positive rating for this answer. YOU MUST COMPLETE THE RATING FOR THE EXPERT TO RECEIVE ANY CREDIT, if not the site keeps your money on deposit and I get no credit for the work I put into the matter. Thanks.