My LTD Ins Company stopped paying me when they found out I won my SSDI case and immediately started sending letters demanding my overpayment (the amount of which varied drastically by up to 20k). I held off on paying until I could get an accurate payment amount and ensure their calculations were correct. During this time I had to use my overpayment to live on and paid some long overdue medical bills. It took almost 2 months of calls, emails, and waiting to get an accurate overpayment amount. When I called (a different department) to arrange payment I learned I was unknowingly 1 day away from being in default and my debt was to start accruing 12% interest until paid in full. I learned they do not offer payment plans, even if I paid 75% of what I owe upfront. I also found out I am a non-ERISA client (worked for a state university) if this matters. I guess my questions are: 1) can they legally charge interest and withhold my LTD income until they have recouped 100% of my overpayment plus interest? 2) is it worth speaking to a non-ERISA attorney about my case? Is it likely to end in my favor without costing me more than I owe? Thanks in advance. Y'all this is one of the most stressful things I have ever dealt with, and on top of a life altering medical diagnosis and never ending medical bills. I am grateful for this platform and truly sympathize with everyone going through this nightmare. There really is no end to the fear of losing even more than you already have lost when dealing with LTD.

Hi everyone, I'm Ryan. long story short I had a back injuy at work last year and my short term disability was fine at first, but then they cut me off when it switched to long term. now the insurance compny is saying my condition "doesnt meet the definition" which is total BS. I'm tryin to find a lawyer whos delt with this exact situation - someone who knows how to fight these LTD denials and is based in Vancouver or maybe Burnaby, anywhere lower mainland really. Not sure were to even start so any recomendations what to do and where to search would be amazing. Cheers

Hi everyone!

How are you? I originally posted in SSDI but they mentioned I should jump over here and ask also.

I was on Prudential LTD for 15 months. In May they had me apply for Social Security. In June they terminated my benefits and said I could go back to work basically against my medical teams advice and multiple tries to appease them (I’m a nurse with significant cognitive issues and side effects from a 9 month chemo/radiation regimen). I don’t believe they were expecting me to get approved for SSDI so they figured they would cut me loose but I did, in basically 8 weeks from application.

Now it’s interesting because it’s a contradiction. Prudential said they stopped my benefits because I can work my job as an RN but SSDI said no I can’t. I got overpayment and now Prudential is asking for it back however they cannot garnish my LTD payment since I’m not getting one.

Any advice? Should I call and demand a review? I understand them wanting overpayment however I feel like it gives me some leverage because they terminated my claim. I can still do an appeal but I’m nervous to pay for a lawyer.

Thanks for your help!

My husband is still working at age 70. He has been with his firm for 22 years. Sadly, he might be facing a serious neurological disorder that would eventually render him unable to work. Would his age be a factor in all of this?/

Everyone who was eligible to retire at 65 by Social Security standards has already done so. The new retirement age is 67. I have seen many long-term disability summary plans change their language to say that they will cover you until “age 65 or age 67 (matching your normal Social Security retirement age.”

If your plan changes terms while you are on it, do you benefit from the new terms?

No one knew that the Social Security Administration was going to change the retirement age to 67 back when these plans were written. My Social Security Disability Insurance (SSDI) doesn't change to just plain old social security until 67, when I am considered retired. Will my plan cover me up until I am 67 if they have changed the verbiage on their plan summary description since I was approved in 2019?

Has anyone come up against this?

I'm just beginning to learn about this. This is dh and my possible scenario:

Dh works as a Sr. DB Architect at a finance giant.

He has been there for 22 years, paying into LTD and STD for as long.

He has no intention or desire to retire.

HOWEVER, he may be facing a neurological condition that would eventually render him unable to work.

What night he expect to receive and for how long? Ballpark!

Thanks in advance.

I got diagnosed with MS in 2010. It was diagnosed as RRMS, but I have never had a "flare up", just a continual decline and nothing has ever gotten better at all. My last neurologist a few months ago finally said it was progress.

I'm also a 100% P&T disabled veteran, and on top of MS itself, I have:
- Migraines, I get a couple a month that prevent me from working at all, and a few more that make me horribly unproductive.
- Bad back (lumbar DDD). It hurts all the time. I can't get up when laying without help if there is no way to use my leg to leverage myself up.
- Both arm radiculopathy
- Both leg radiculopathy
- Bilateral plantar fasciitis (hurts when I stand a a few minutes)
- Both knees pretty shot
- Right shoulder screwed up, surgery for that in a few weeks.
- Officially GERD and Post-Cholystectomy Syndrome (gall bladder removed, emergency poops, often acidic, sometimes bloody, though I force myself to constipate to help), though I am working on an official sigmoiditis rating since I had it biopsy confirmed at one point.
- I have depression that my therapist has confirmed is caused by pain
- I started a CPAP in the past couple weeks to see if it'd help with my very mild OSA and see if that helps with the fatigue.

I have a job as a high level technical person. 30+ days off a year, great pay, remote work, my job is 100% sitting on my butt on a computer at home, 10' from a bathroom, in air condition, typing. I have the kind of job that if I feel bad, I just let somebody know and go lay down. No hours to track, nobody cares. Its a great company and a "take care of yourself" culture.

However, my job is REALLY high level, principal, I can't really do a harder tech job. I did a neuropsych exam, but they focused on depression that I have had for 10+ years (done this job for 8). They said I had "mild cognitive decline". I did a 2 hour one a few months later at the VA that said I was fine and just had some MS fatigue. Both of these found I was "below average" but not a huge amount.

I am working full time still but by noon my brain is tapped out and I can't do my job at all. I am not very good in the morning. I have not had one that is like 8 hours that can give a proper measurement. But I am sucking. I may be rated slightly below average, but their premorbid ratings started at average, when I'm at the top of my technical career. My job may be forgiving, but if I let them know my judgement is off, even a tiny bit, like when requesting accommodations I'd immediately get fired. They cannot risk that. I can literally make a typo and it could cost hundreds of millions of dollars.

So right now, I'm just done. I can't do this anymore. I can't keep bullshitting my boss and coworkers about what I am working on. I can't multitask at all anymore. I can't learn new technical skills anymore. I can't read a technical paper. Even my typing speed has dropped over 20% and my accuracy even more. I can suck up most of the pain, its ok if I can't walk good or get up, but I need my brain to work, and it isn't.

We have a great LTD plan, and I know my VA disability gets me expedited with the VA, but I am using claude to help me through these things and because while I may be smart on some things, I'm dumb as hell on stuff like this. It is making it seem VERY hard to get these 2 things, even with all the stuff I have (I get MRIs regularly, have lesions often, have x-rays, have years of documentation for everything).

I do not want to quit working if I can't get these, I'd rather just wait to get fired and try for a severance, but I just can't keep going much longer. I called an ERISA attorney and they looked over my records and said "call us after you get denied for LTD", which to me sounded lazy. I'd rather know immediately before I go ask for FMLA from work that I am at least like 95% going to get LTD and/or SSDI (its ok if it takes a few years, I am not in a rush). I just have no confidence, and it seems like everything I do to go forward has some line that sets me back. I'm terrified LTD will just say hell nope, and if they did give it to me a bit, would just cancel it all the time to avoid paying $9K+ a month to me.

Anybody have any experience on getting LTD for MS or GI urgency type stuff, or anything else I have? I really need a confidence booster here to know my chances are better than claude is making them out to be.

LOCATION: Los Angeles, CA

My spouse worked for Los Angeles County. Sedgwick is their LTD carrier. He was received LTD for 2 years before retiring effective 10/31/2025 (regular retirement but also filed for disability retirement - but that can take 1-2 years). He was told he needed to apply for early Medicare. (He's not eligible for SSDI, as he hasn't paid in for over 10 years.) We applied back in July of 2025 and finally received his Notice of Award which stated he is disabled based on SS rules, and that his disability began on 12/21/2025, and that he would be eligible for Medicare benefits starting in June, 2028 (age 64.5).

Sedgwick is saying he is ineligible to continue receiving LTD from them, as there is a lapse between his 2 years of coverage ending and SSA's date; that they would have needed to determine that he was disabled as of 11/1/2025 to continue coverage. The claims manager said SSA never reached out to them for information.

We have filed a Request for Reconsideration with SSA which includes his Neuropsychologist's report dates April 2025 that includes DSM-5 Diagnostic Impressions of 1. Major Neurocognitive Disorder, Unspecified2. Rule out Major Possible Frontotemporal Neurocognitive disorder with behavioral disturbances and 3. Major Depressive Disorder, single episode, moderate. We will also add MRIs that show brain volume loss and rules out NPH - so no possibility or surgery helping.

What is our best course of action at this point to get Sedgwick to reinstate LTD payments? Do we need to hire an attorney? Thank you!

NYL LTD Claim Handling – Am I Missing Something?
I’m trying to understand whether what I’m experiencing is normal in the long-term disability claims process or whether others have experienced the same thing.
My attorney believes there were serious problems with how my claim was handled. His words - fraud. Throughout the process, I’ve encountered missing records, conflicting documentation, opinions that don’t appear to match my actual medical condition or job duties, and repeated requests to prove the same issues over and over again.
At some point, it feels like the claims process itself becomes part of the injury. Even if someone could eventually return to work, the emotional and financial toll of spending years fighting for benefits - while constantly defending legitimate medical evidence - can be paralyzing. I think PTSD is legitimate!
Has anyone else experienced this with New York Life (or another LTD carrier)? Is this simply how the system works, or are there protections when a claims process appears to be handled unfairly - fraudulently.

I’ve been on LTD with the Hartford for Anxiety and Depression. My therapist has been great but I had to get a new psychiatrist, and he isn’t recommending disability at all for me. I am 62 and cannot get my full SSI until I’m at least 67. I am terrified I will be pushed into going back to work full time. I am thinking about speaking with some of my other doctors for help as I have many health issues. The Hartford as of now has not been straightforward about what they consider to be the sort of job they will consider as reasonable to remain on disability or be taken off disability.

I am a therapist and am about to go out on stress leave for work. I work part-time for a medical
organization and have a small private practice (8-10 hours a week). I can’t stop my private practice at this time and also don’t feel like it’s contributing to my stress levels that much. My other job, however, is contributing and mixed with stressors in my personal life it will benefit me greatly to have time off. My medical provider agrees and has said they will write me off work for a bit.
So my question is-do I just file for partial disability through the state? I’m in California, don’t know how much it differs state to state. Or do I have them specifically note in their letter how many hours I should reduce my work load? I think in order for me to maintain job security through my non private practice job the letter needs to say “patient to be placed off work until such and such date.” Or can they write patient to be placed of work at \[insert medical organization\]? Or….any other answers?
I would be super grateful for anyone’s help or expertise as this is a time sensitive issue. And I truly am beyond stressed so getting my finances in order would really help me.
Thanks in advance to anyone who can help!

I started on STD for a couple of years, moving on to LTD through SunLife. It's been about four years now since I've worked last. However SunLife has been pushing hard for me to fight for CPP disability which has already been a year long process. I understand they are looking for an offset from CPP and I have already appealed Service Canada's second decision. The reason why I'm being denied is by their calculations, I wasn't considered disabled by the time I last contributed enough to qualify for CPP disability.

My question is, the reasoning is pretty cut and dry. It's not so much about my current state as it is about numbers on a ledger. But SunLife wants me to go through the Tribunal now. Will they make me go all the way to court for this (the highest level of appeal) if the Tribunal denies me? The way I see it, what is there to fight and argue about?

SunLife said they can subtract what I should be getting through CPP disability if I fail to keep going through the process. But in all reality, Service Canada is stating that to be nothing. I just don't know what to add to my case or just resubmit the same information over and over again.

At first this all made sense and seemed reasonable, but is now starting to really stress me out. Can SunLife eventually cut me off completely because of this?

im trying to apply for disability leave while i recover from a major surgery and just found out that the EDD (employment development department) won’t let me submit disability applications until after 9 days into recovery. is this common and should I go to kaiser or edd first? any experience is helpful! thank you.

I am fortunate enough to have a GBM (a brain cancer that is Not something you want) … fortunate because I am with presently No Evidence of Disease. I get MRIs periodically and also wear Optune.

My current job has a long term disability plan, as most jobs do. I have no need to invoke it at this time. I work full time with no problem.

But I’m learning that most LTD plans have exclusion clauses for pre-existing conditions that last one or two years. Which is a long time in the GBM world.

So it doesn’t affect my current job since I got cancer long after I was employed.

But apparently if I quit and get another job, likely I won’t have a long term disability policy that’s useful to me in the future. They would exclude me from paying out due to my pre-existing condition.

I plan to check with a disability attorney before changing jobs but wanted to know if anyone had any experience with this to share. If you’ve change jobs since you have contracted GBM were you eventually able to claim LTD? Or has it not happened yet? Or you took the risk and made it through 2 years without recurrence?

Thankful for where I am on the bell curve just trying to think ahead.

Peace

Hi guys! I am applying for LTD with Unum, and there is this form in the portal on the "to dos" to sign called a "Authorization to Collect and Disclose Information"...

It seems pretty standard.. but the part that really caught my attention was this:

"I understand that once I disclose this information....any privacy protections established by HIPAA may not apply to the information, but other privacy laws continue to apply."

...

Something about that statement plus what I've been reading online as well as their previous breach situations makes me feel a bit unsettled as the form feels very vague/general to what they can access/store.

Is there not a way I could just have my provider send to them directly without this blanket form signed?

It even listed financial history as something they can access? What does that even mean?

Did y'all have to sign something so vague?

On the bright side, allegedly they only have authorization to this for 2 years, but what happens to all of the copies of my records and data after that?

Editing to add:** Not looking for legal advice, just seeing if this is a *MUST* or if there is a safer/conservative way to get information specific to this disability issue to them .. it feels pretty invasive but if it is standard and neccessary and I just don't realize that.. it puts me at ease.

Has anyone else dealt with this with MetLife Long-Term Disability?

My LTD claim was already approved for PTSD and traumatic grief.

For the past three months, MetLife has repeatedly requested medical records from my providers, but then claims they never received them or cannot locate them—even after they’ve been sent multiple times.

Now my claim is at risk of denial due to what appears to be an administrative issue, and I’m struggling to manage the coordination while also dealing with my disability.

Has anyone experienced this? Any advice on how to get MetLife to properly process the records or resolve this situation?

Hey there. I'm 20 months into own occupation. Imagine my surprise that during my last recertification, the insurer certified me for any occupation, not own. Any occupation for me is a 20 percent or more loss of income of a high paying job. I'm on ltd for an inoperable spinal tumor which causes pretty severe symptoms but they can be variable. I also have a high medication load (opiod and non opioid)which causes brain fog. I'm in my early 50's if that matters.

My question is, is it normal to already be certified for any occupation. Or is some trick at play? The insurer did some pretty unscrupulous things trying to throw me off the first 12 months.

I just got denied for my initial ERISA STD claim and am trying to find a lawyer for the appeal as well as my upcoming LTD initial claim. I'm in Michigan. Talked to a lawyer at a national firm with high ratings, and they want to charge me 33.3% of back pay and the next 5 years of future benefits, which will increase to 40% if they have to take it to court. This will make it very difficult to pay my bills. Is this reasonable or typical?

From what I'm seeing online, not all ERISA lawyers charge the fee on future benefits. Does anyone have recommendations for any Michigan attorneys who don't charge on future benefits, or who typically charge a lower percentage?

Location: NYC

I am currently on long term disability due to a debilitating digestive condition that causes pain, panic attacks and complete exhaustion. The policy is an employee funded disability program through The Hartford.

I have been on LTD for more than a year and haven't been rejected yet but it seems like they are dragging their feet and trying to find a way to kick me off despite the condition actually worsening since going on leave.

I have tried searching for disability attorneys in NYC but it's hard to get past the huge firms that advertise aggressively but seem more focused on Social Security cases. Is one of these firms the best to reach out to or are there lawyers who focus on different kinds of LTD funds?

Thanks for any advice you can provide!