r/LongTermDisability

I sent an application for my husband's LTD 5 year extension with Reliance Standard for a claim that ends 10/27/2026. The extension got denied not because of his medical condition but because of the criteria of being in a medical facility, receiving hospice or receiving home health. I used the reasoning that me being his caregiver 24/7 was far better than any of their 3 choices. Also, his medical condition won't get better with rehab which is the category for those 3 options. Anyway, it got denied but because it's ERISA an attorney has to take it without anything up front. I got only one acceptance out of about 6 law firms, all the others said they just couldn't give the time needed. I guess that's all you need is one. The firm that said they'd take it is in TX, that's all the info I'm giving. This is what they offered:

Contigency Administrative Appeal
• No upfront fees
• We finance all the expenses; if we don’t win there is no money owed
• There are no limitations to the number of appeals
• We will handle federal appeals
• 33 1/3 of fee from any back pay owed and future 60 months

Benefit Protection Services (Monthly Maintenance Agreement LTD Benefit Protection Services™
Premise - “It’s not once disabled, always disabled. It is a running battle.”
• Full Legal Representation at Semi-Annual Review by Insurance Carrier
• Review Insurance Carriers evidentiary requests against what is allowed in the
Code of Federal Regulations
• Analyze Insurance Carrier’s Possible Denial Strategy
• Develop Strategies to Maintain Client’s Disability Status
• Review of Shifting Disability Definitions and Limitations
• Proactive Development of Evidence before Shifting of Definitions and Limitations
• Communicating with client’s doctors to develop best evidence of Disability
• Attorney review and submission of the latest medical & vocational evidence
• Attorney completion and submission of all forms
• Attorney communication with Insurance Carrier
• Attorney monitoring of all deadlines
• Monitoring of Shifting Offsets and Overpayments
• Overpayment Negotiation if necessary

I'm beating myself up for not getting weekly home health. I just felt that someone coming to take his vitals once a week was stupid and abusive of his insurance. Would I be stupid to do this? Does anyone see anything fishy here? It's kinda like this offer or nothing.

Thanks for your opinions

How does this impact my claim?

Should I get a new therapist?

I meet with my physical in a week and then will request them to extend my leave because I genuinely don't feel ready and want to escalate my care via psychiatrist care.

NYL is my provider and I'm transitioning from STDI to LTDI.

51 y/o F was medically retired from the fire service after a failed shoulder surgery (times 2), ulnar entrapment, and hip impingement that I’ve been told needs a total replacement. I still have shoulder instability, but surgeons are reluctant to try a third time. Also was told I have CRPS in my foot/ankle after reconstruction surgery. I was given a letter that says I’m considered disabled under ANY occupation…do I even need a lawyer at this point? What if I do all the steps to get SSDI but am told no? Do I have to appeal - then what? I thought all SSDI monies offset the amount the LTD company pays. I’m so lost -and appreciate any advice.
BTW - the shoulder injury happened on my way home from work-not on the job, yet I had to go back to work the next day because there were no people available for overtime.

Without getting deeply into it, would you, or do you know of anyone who'd pay an independent consultant to review their denied STD/LTD claims?

Essentially, I've spent +10yrs adjudicating disability claims from the insurers side, and now id like to use that knowledge to help claimants UNDERSTAND & RESPOND to denied or terminated disability claims.

Im not a lawyer, so "legal advice" cannot be provided. My services would consist of- interpreting the denial to the claimant, reviewing policies, reviewing the denial against medical documentation, and putting a plan together for the claimant to appeal the decision.

This idea literally was just a thought in the back of my mind for many years but I haven't put any of it in play so I wouldnt even know what this type of service would charge...definitely not lawyer rates considering these claimants haven't been paid by the insurer.

Do you think there's a market for this and if its profitable?

Thanks for reading!

Has anyone had a wc case then they stopped paying you. Then your employer ling them disability plan starts paying monthly benefits. The when its over at the 2 year medical review. The try to but a lien on your WC settlement?

Can owning a car be used against you?

I'm currently on LTD from Guardian. I have applied for SSDI. On one of the paper work packets it asked if I could drive a car.

I have a good day once or twice a month were I can drive a car for 30-45 minutes tops before becoming exhausted. I have an adrenal disorder, and the moment you start driving (at least for me) the timer starts. it's like holding your breath and seeing how far you can go. Then you are exhausted and have to recharge to be able to drive again.

I want to keep my car to be able to go out if I need or want to. My wife is gone at different times of day so being a one car household won't work because of the constant barrage of doctors appointments.

Hi everyone! This is a post from one of your local friendly mods.

1. We have created sub rules. Please take a gander. Let us know if you have any feedback or suggestions.

2. We are considering additional rules to regulate attorney participation in the subreddit. I am an attorney, and there are several others who have participated in this sub for years in a way that perfectly encapsulates the positive spirit of Reddit. As the sub has gained popularity, concerns have been raised about the proper parameters of attorney involvement, with a focus on keeping the subreddit a safe space for claimants to share their thoughts and experiences openly and safely.

If you have thoughts or suggestions on what such rules should look like, please feel free to share them.

3. I am going to try to create more informational content to answer commonly asked questions. Again, if anybody has specifics they'd like addressed in a post, feel free to let me know.

4. Our moderator team consists of an LTD attorney, (me) and two wonderful individuals who have experienced the LTD process themselves. We all do this for the good of the community. We are always open to suggestions or feedback.

But please keep in mind that we are only human, and we are doing our best with the resources we have. So please remember to be nice - especially via modmail!

5. Thank you all for your active participation. This sub has grown from 185 weekly visitors to 1.3k in the span of just a few years. This is almost entirely due to the vast number of "helpers" who frequent this sub. I am genuinely proud of what this little sub has become, and I thank you all for helping it grow.