What the heck did I do?
In February DCS received a call from an insured who told me he was “scared to death.” He said that he had been “clean” from over taking his Percocet for a day, and that Unum was currently harassing him to payback nearly $35,000 in retroactive SSDI. Specifically he wanted to know if Unum could take everything he owned since he no longer had all of the money to pay the company back.
While this is a very tragic position to be in, it also should never happen. This same insured also confided that he had not read his LTD policy, did not know which Payment Option Form he signed, and if Unum took all of his remaining money he’d be out in the street. He had no idea why he had to pay back the money and wondered if he could convince Unum “to just be satisfied with the offset.”
“Good grief”, I thought. To begin, anyone taking prescribed medication like Percocet, Oxycodone, morphine, or other opiates should not: 1) speak with insurance representatives on the phone, and 2) not sign any documents, particularly if they are abusing the drugs.
Unum’s newest POF form (if signed) gives the company voluntary liens on property when lump sums are not paid back, therefore “yes” Unum could take this insured’s property.Where this insured got the idea that Unum would be satisfied only with the offset for SSDI is beyond me, but obviously this insured didn’t have a clue as to what happened to him, or what could happen.
DCS has been recommending to insureds and claimants that the obtain copies of their Plans or policies, read and understand them, prior to going out on disability. We’ve also been recommending to insureds that they NOT speak with insurance representatives on the phone and insist on all communications in writing. Most people who phone in are still talking to insurance companies and are creating fires that will eventually be very difficult to put out.
Any insured who is taking pain medications should abide by the above and protect themselves from saying and signing things they do not understand. I asked the above insured to pull out a copy of the POF he signed, but he didn’t have one. This situation, although tragic, should never happen.
Binder and “take a hike….”
Another caller described a situation when he hired Binder and Binder to assist him with his SSDI award. Although SSDI benefits were approved, a year later he received an update from SSA and noticed information about his disability that was incorrect.
Afraid to change the information himself, he went back to Binder and requested assistance in filling out the update review forms. Binder refused to assist him claiming it had “thrown out” most of his paperwork other than a short electronic file. Mr. X then began calling many other attorneys in his area asking for assistance with correcting information and filling out his SSA review forms.
No attorney wanted the job. This situation doesn’t surprise me at all. SSDI attorneys get 25% of retroactive awards up to $6,000 to assist applicants with SSDI applications. Why should attorneys waste their time writing a fee agreement to help someone fill out review update forms? One attorney told this insured to “just muddle through the paperwork himself.”
By regulating fees that can be charged for SSDI assistance, SSA really isn’t helping matters when applicants need assistance for other SSA matters. Attorneys aren’t going to be inclined to spend their time with menial issues for small flat fees.
In the end this insured searched the Internet and listened to unknowing friends who told him not to ask SSA for help since it will just deny his benefits. In my opinion, national chains like Binder and Binder are no more than SSDI mills and although they boast of high approval rates provide very little service if needed in the future.
Applicants for SSDI should ALWAYS find their own local SSDI attorneys who are accustomed to working with county Administrative Law Judges. Claimants should stay away from insurance industry connected services such as Advocator Group, GENEX, or Allsup. National firms such as Binder and Binder are impersonal and an arms length away from personal claims and unique situations.
This insured will likely listen to friends and neighbors hammering him with inaccurate information. This is a situation should never happen. SSA should make sure that any attorney who is paid a fee to assist with an SSDI award should also assist with any subsequent issues in the future.
Are you beginning to see a trend here? Many situations described to me contain similar threads involving misinformation (or no information), inaccurate information, not obtaining policy copies and reading them, and finally, allowing fear to dictate action.
Fear will do strange things to people, but the fear that occurs when receiving disability benefits rests in the realization that if benefits are denied, there are no other options and there will be no money coming in to pay bills. Suddenly, “living on the streets” becomes a real possibility and claimants will often do anything, say anything and sign anything to obtain the money needed for self-support.
Insurance companies are well aware of the financial urgency and play the system and emotions as far as they can. Unfortunately, many insureds and claimants walk right into the insurance ambush and later regret that they “just didn’t listen.”
There is a great deal of information on Lindanee’s Blog as to what is appropriate and what isn’t. I strongly recommend to new readers that they take a moment and read some of the posts relative to their own situations and make an effort to thoroughly understand private disability insurance and how it works.
Most Americans can’t afford to manage these claims “in the blind.”