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Please read below the account of one insured’s experience with Student Loan forgiveness for total disability. It seems to me the “deal” isn’t what it’s cracked up to be.

Submitted by a blog reader and supporter. Thank you.

“I just have to vent about how disturbing the whole student loan disability process and how unorganized and  untimely it really is.

Forgiveness of student loans by reason of total permanent disability is handled by a company called Nelnet. They claim they are the exclusive provider of this service for the US Department of Education. When your loan is forgiven, you have to make less than the US poverty level for 3 years, otherwise your student loan is reinstated.

Three years ago when my loan was forgiven eveything went fine. But then, as you warn on your website, I claimed too much income (wife’s job) and my loan was reinstated. 

I do not believe Nelnet has any access to tax records. They just ask you to sign a statement that you didn’t work, or if you did, how much. I regret so much we answered that truthfully.

If you make too much, then you have to pay the loan again, and Nelnet gets the money. See the conflict of interest? Nelnet gets the money if your loan is reinstated, and they are also the one to decide if you are too disabled to work. They don’t do medical reviews, just doctor signature on the form or SSDI with a 5 or 7 year medical review (we are 3 year). So their only weapon is a delay.

It took them a few months, but many months ago, they claimed to be starting the reinstatement of the loan, with them as the collectors. I completed a new disability forgiveness paperwork and had the doctor sign it. Submitted it quickly. On the new applications, they have a 4 month timeline, but on these reinstated applications, they make clear on the phone they have no requirement for when they will review them. They will hold off requiring payment on the loan for 4 months, but after that, they want payment.

It’s been more than that. They STILL haven’t processed the disability application. They claim their Information Technology Department is still working on it. But the loan servicing part says a payment is due just a few weeks from now. I tried calling and asking for a forbearance for reason of disability. She granted a one month reprieve on the loan payment, with longer available after they review documentation. Nelnet insisted they needed the original SSDI approval, not a current statement (printable of the SSA website). The next day, they rejected it as too old. More significantly, the loan payment date changed, from in a few weeks to now PAST DUE of $50 with another payment due in a few weeks.

It makes me so mad that they can take forever to process this disability application claiming their Information Technology Department is working on it, but require payments from the loan which clearly the Information Technology department already worked on. And then make due dates earlier and claim something is past due days after saying it was due in a few weeks.”

(I think in cases like this I would give my Congressional Senator a call for assistance. Technically, these untimely decisions could result in Nelnet compensating you for interest on all of the payments you’ve made since requalifying for loan forgiveness. Give your Senator a good swift kick in the butt to do some work for a change and help you resolve this mess!)

 

If you are interested in keeping up with the Unum – UK connections please see the article by Mo Stewart, a well-known researcher and writer in Great Britain.

 

Preventable Harm and the Work Capability Assessment

https://www.researchgate.net/publication/324587956_Preventable_harm_and_the_Work_Capability_Assessment

In the last few months I’ve received many calls from insureds/claimants who are attempting to manage their claims on their own. During the course of our conversations it becomes evident that, due to lack of information, they may have set themselves up for denied claims. Hence their calls to me when the bell begins to drop from the tower.

Insureds describe how they’ve been having verbal conversations with their reps, asking insurers for advice on what to do, writing long letters to the claims handlers, trusting information given to them, have not read their Plans or policies, and in general, describe how well their claims have gone, until they are about to be denied.

I also know that those who read my posts sometimes tell me how fearful my articles cause them to be. At the same time, I am contacted by many insureds for advice, (even when they have attorneys), because they know I provide accurate information and won’t just tell them what I think they want to hear.

“Information” is the most valuable tool insureds have to protect themselves from a complex, deceptive, adverse private disability system that provides no long-term financial security when they need it.

Please think about this! Before you even open the cover of your policies, these documents are adverse to you. You don’t have to file a claim, you don’t have to do anything, and yet, most people are totally unaware that benefits provided are subject to “conditions” that must be met, and insurers are permitted to use their discretion whether or not to pay you. You don’t have to DO anything and yet your policies are already working against you.

Imagine what could happen when you DO actually file a claim and attempt to move through the process. Today more than ever, insureds/claimants need to know how the process works and what to do, and not do, when filing claims and moving through the process.

There are over 1,300 articles on this blog containing valuable information insureds need to know. It occurred to me recently, after another very painful call from an insured, how limited in scope Lindanee’s Blog really is.

Therefore, I’m asking the 800 or so people who read this blog everyday to share Lindanee’s Blog with others particularly those who may have need to file claims in the future. This is not an attempt on my part to solicit more business, but rather to “get the information out there” to those who need it, before they begin working against themselves and handing insurers their claims on a silver platter.

I have no stake in the ground as people do on YouTube videos. This blog isn’t monetized, and I don’t have to compete with “Subscriptions, Likes” or “thumb’s up” to get higher ratings. My only concern is getting information out to the public to prevent them from making mistake upon mistake that won’t get them a successful claim.

Therefore, I’m asking my readers to let others know where the resources are and how important information and knowledge is with managing a disability claim before it’s too late. I know my posts are uploaded to CFS/ME and FMS chat groups and websites. Please help if you have a resource my information can be referenced on.

The information contained here on Lindanee’s Blog is free and available to everyone.

A word of caution to DCS clients who sign confidentiality statements with me. DCS, Inc’s proprietary information cannot be posted or shared without my permission, but you certainly can direct others to this blog.

Thank you.

 

 

 

 

Recently I was contacted by a reporter from the Baltimore Sun and gave an interview about Unum. Although I spent some time with the reporter, I knew that information I gave him would never make the paper. Unum’s long-reaching arms of protectionism usually prevent editors from exposing Unum to any great extent.

Sure enough when the article came out it contained one or two sentences about Unum’s tendency to deny claims, and that was all. But, the article did mention that Unum’s public relations department told the reporter that out of the 650,000 claims submitted to Unum each year, Unum paid 85% of them. What?

Reading such rubbish was like old home week reminding me of Unum’s ridiculous claim in 2002 when regulators were still conducting the conduct market examination that lead to the Multi-State Settlement Agreement. Back then, Unum alleged it paid 98% of claims, which was later debunked when regulators and attorneys asked for proof of the calculation.

Unum’s recent statement of paying 85% of claims should have been investigated by the Baltimore Sun reporter. Surely, he could have asked for “Proof” of how that statistic was calculated. In my opinion the allegation of paying 85% of claims is just as ridiculous as Unum’s prior statements that it paid 98%, and here’s why.

To my knowledge, nearly all disability insurers determine, and price premium based on a 60% liability payout rate (LAR). Premium for ERISA group plans and IDI polices are both underwritten assuming a 60% risk of payout. Therefore, if any insurer were to pay 85% of claims while costing out premium at 60%, doesn’t it make sense they would have lost their shirts by now?

I know this to be true since most claims managers and VPs go ballistic when unit LARs begin to exceed 60-70%. Unum’s claim VPs are well aware of the effects of pay out rates and opt to manage them at the 60% level by demanding claims handlers do their jobs better by denying more claims.

Of course, it all depends what blocks of claims are thrown into the calculation mix to distort the outcome. Years ago I was an expert in a qui tam case involving Unum and social security. It was discovered at that time that Unum included Short-Term and Maternity claims into the statistical mix – a huge distortion. STD doesn’t have any financial reserve and is usually paid for 26 weeks, and nearly all Maternity claims are paid.

Public relations offices presume most reports are deaf and dumb on the subject of disability insurance and would be more likely to accept nonsensical statements such as, “we pay 85% of claims.” In reality, garbage-in equals garbage-out and any statistics given by Unum should be validated with proof of how the figure was derived. I’m guessing everything including the cafeteria was thrown into the mix on this one.

Let me also point out that if I were a Unum investor, and the company publicized it paid 98% of claims, I’d immediately sell my stock and run for cover. Insurance companies who continuously pay claims in excess of premium costs won’t stay in business very long. The fact that Unum remains a going-concern tells me it’s not telling the truth about paying 85% of claims.

The truth is that no disability insurance company can make a profit using a 60% payout rate to cost out premium. If Unum were to actually pay those claims that should be paid, and deny those claims that should be denied, the company would not be profitable. Therefore, Unum, like all other insurers must “risk manage” claims – devising strategies to deny legitimately payable claims in order to make a profit. The denied, legitimate claims make up the difference, and remain the path to profitability.

Insurers can’t increase premium or LAR percentages because they would price themselves out of the private disability market. Insurance is a very competitive industry. Therefore, all insurers cost premium conservatively, and make up the profitability difference by denying legitimately payable claims.  Make sense?

Unum’s mantra is to put out figures of payouts that are exorbitant, and untrue. Whenever you hear of a statistic like this, you might want to request verification of how the figure was derived, particularly if you are a regulator.

In my opinion, Unum’s pants are on fire most of time, but particularly when they allege a 85% payout. That’s just crazy!

 

 

 

 

Sources inside Unum continue to report to me that company treatment of employees continues to harass those who either challenge claims practices, or have had to go out on STD themselves. This is another subject I’ve written about extensively, but because I am aware Unum employees read my blog I’m going to address it again.

After a recent discussion with a Unum LTD DBS it occurred to me that neither its claims practices nor treatment of its employees changed in 16 years. Apparently, Sandy Rosen from HR is still covering Unum’s behind, and management harassment is at an all time high.

A Customer Service rep who is expecting to be fired shared that Unum’s treatment of cancer insureds is unfair and dishonest. Although he was told to keep his mouth shut, he was eventually offered around $4,000 to quit the “remote” program and leave.

Another claims employee out of work and receiving STD is receiving daily calls from her manager harassing her to come back to work. I also understand that several other employees have been harassed by managers who contact those on STD on a daily basis.

Listening to Unum’s current employees talk is like “old home week” for me. Most who call DCS, Inc. describe a claims process focusing on denials and meeting financial targets.  Although I have said many times, “Whatever Unum does to its insureds, it can also do to YOU”, it doesn’t make things any easier when “the targeters become the targets!”

Unum employees should realize they need to protect themselves from Unum’s violations of human rights in the workplace. My first suggestion is to keep a journal at home documenting what goes on at work. Daily records of 1/1 meetings, unit team meetings, internal memos of interest from Unum’s “Intranet”, and other management directives that don’t seem quite right to you.

Use your conscience as a guide to figure out what’s right and what isn’t. Keep your journal up to date with records and other information that could prove wrongful termination and deceptive claims practices. Come on. If you’re working in claims, you know how the process works. Document it!

One of the problems I ran in to from the DOL and Human Rights Commission was, “We believe you, but prove it.” Document your employment, your activities and management’s directives – if a wrongful termination occurs, you will have documentation to back you up.

Unum’s managers begin to pad personnel files long before most employees are aware of it. Do not keep your Unum journal anywhere near your office or office computer.

Unum terminated me off campus when I was taking HIA tests in South Portland – then it raided my office drawers, computer, shelves and confiscated all of my files. Another employee in Chattanooga’s desk was raided and her personal belongings were thrown to the curb in front of the building for her to pick up at 5 o’clock. That’s got to be pretty humiliating.

More claims or work seems to be coming your way, you are set up in projects in which you will fail, 1/1 meetings begin to be more critical and negative, and when managers finally have you where they want you, they put you on probation, or you are escorted out of the building.

In addition, Unum’s managers often segregate you from your unit peers and attempt to obtain additional adverse information from them. For example, your manager may ask some of your peers to send you emails asking how you are, so they can get more information about you. My personnel file was padded with statements from my peers even AFTER I’d left the company.

(You may recall that Unum suspected me of being a whistle blower at the time of 60 Minutes and NBC Dateline shows in 2001.)

I know this to be true because Unum’s attorneys threatened my best Unum friend to give up personal emails I sent to her home the day I was terminated. These same emails plagued me for several years when I gave depositions. It is definitely NOT a good idea to respond to peer emails when you are on STD or expecting to be terminated.

Human Resources is not a Unum department to contact since they are not advocates for employees, but for Unum. I mentioned Sandy Rosen, an HR person who has, in my opinion, done more to destroy Unum-employee relations than any other personnel tool. As an employee, this is not a person you want to trust to help you get a fair shake.

When I write articles like this, my insured readers ask, “Why are you so concerned about Unum employees?” It’s pretty simple, really, Unum employees keep me informed, and as a person whose been there, I can tell them that getting fired by Unum is the best thing that  will ever happen to them!

Unum employees need to constantly “watch their six”. For those who don’t understand this phrase, it simply means that everyone who works for Unum must keep a close eye on their behind, and cover it from those who wish to do them harm.

If you find yourself on Unum’s or some manager’s poop list please feel free to give me a call. Unum can’t control who you speak to, or who you contact, and I just might be the  right person who can relate.

And, keep reading the blog….I know you’re out there.

 

 

One of the most egregious misrepresentations  continuing to plague insureds/claimants are the allegations made by insurers that certain physical diseases are in fact mental and should be only paid for 24 months.

The new/old strategies to classify impairments as “behavioral health” in order to reduce claim liability, is as popular as ever. In so far as private disability is concerned, any mention of depression, even if it is secondary to physical disease, is presumed to be the sole cause of disability and limits benefits to 24 months.

Recently, two companies have emerged as the top offenders of behavioral health claim abuse, not surprisingly Unum Group and The Hartford. Most people are unaware that The Hartford’s management originates from Unum’s old Duncanson & Holt, and its claims strategies are primarily the same with one exception. In my opinion, The Hartford places more nickels in the surveillance-investigation bucket than Unum does.

Nevertheless, the financial reserve conflicts of interest involved in limiting benefits to 24 are so obvious, the practice is no longer “secret”. I think most people understand very clearly that mention of depression could be trouble.

Unum’s “big thing” these days is to classify “migraine impairments” as mental and nervous. While insureds scurry to obtain proof of claim from their neurologists, Unum insists “migraines” are “self-reported” and any evidence submitted is subjective.

The Hartford doesn’t even wait for final investigations to be completed. The company literally “jumps in” with both feet by having medical reviews done by a company called MCN (which you can look up on the Internet), inaccurately supporting a false narrative that there is no “objective evidence ” to support a physical disability.

Neither company’s Plans or policies require “an objective evidence standard”, a fact left unmentioned in its citations and writings. Some Unum ERISA Plans limit “self-reported” impairments to 24 months, but then again it’s Unum that decides what is and isn’t “self-reported.”

The misuse of Plan and policy provisions opens the door to increased profitability for insurers, but causes periods of unsecured financial support to those who are physically impaired and cannot return to work. Therefore, there is harm being done to insureds by corporations seeking increased profits at their expense.

It seems as though fibromyalgia, chronic fatigue, secondary depression, migraines, chronic pain, and many other impairments are “positioned” to look like mental disorders when they are clearly not. Even Lyme disease, an old impairment from the past is often classified as “mental” in order to avoid paying claims to age 65.

Insureds in this situation have 24 months to submit evidence that they are in fact “physically disabled” and not mentally disturbed. In fact, it amazes me that Unum, for example, can allege a behavioral claim when the insureds has never received therapy, and is not now in consultation with a mental health provider. How is that possible?

Still, Unum’s old abuse of the Mental and Nervous provisions of the policy remains rampant and is harming insureds and claimants as it always has.

In my opinion, all states should outlaw limitations for mental illness, that should take care of the problem. In the meantime, this is an awful situation for insureds to be in.

If you ever wanted to know about the adverse affects of surveillance, please read this interesting case submitted by a reader of this blog.
I’ve been advocating for years that insureds not exceed their restrictions and limitations. Now, you can see what could happen if you do. This document contains pictures of the surveillance.
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