|Standard Insurance terminated my disability benefits
Sep 23, 2002
I've been on disability through Standard Insurance for about a year and a half. With a lot of hard work, my health has improved substantially. I was in the process of arranging to return to my job half-time, with the understanding that Standard would continue to provide partial benefits. Then Standard suddenly terminated my benefits altogether. This has left me in very bad position financially. I appealed the decision and both my internist and my psychiatrist wrote letters to Standard advising them it was inadvisable to force me to return to work full-time right now. They denied the appeal, but at my request are now doing a "fairness evaluation" of their decision. But they're dragging their feet about it and my employer is now suddenly being very uncooperative about letting me return to work. Meanwhile I'm getting deeper and deeper into a hole and I can't seem to find any agency that can provide with advice or legal help about this situation. Can you explain what my rights are with regard to timelines, etc., and suggest somewhere I might be able to get any help? I live in Portland, Oregon. Thank you.
| Response from Ms. Franzoi
If you don't have a copy of the summary plan description (SPD) for your LTD plan with Standard Insurance, you should get a copy and review the appeals process, the time periods by which they must respond, what information they must give you regarding the reason for denial and what your options are if the "fairness evaluation" upholds their original decision. The insurer does have a right to re-evaluate whether or not a participant receiving benefits is still disabled. This appears to be what they are doing. It should be helpful in the appeals process that your doctors are able to provide substantiating letters regarding why you cannot return to a full-time position.
Have you contacted the HR Department or the Employee Benefits Department for assistance with Standard? If not, I suggest that you try that. Another suggestion is to contact the insurance commissioner's office in Oregon, explain the situation and see what they might be able to do to assist you with your appeal. I find in situations like this you often need some legal representation which I am sure is difficult to get if you are not receivng any income. You should contact a legal aid organization in Portland to see if they could assit you.
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