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Guardian Life Insurance seeks overpayment of disability benefits for child social security disability benefits awarded to disabled claimant’s daughter

A recent lawsuit filed against Guardian Life Insurance Company highlight an issue that comes up regularly for disability insurance claimants that have minor children and are approved for Social Security Disability Benefits. Monica Johnson has been receiving long-term disability benefit payments from Guardian Life (Guardian) since August, 2003 as result of her becoming completely and totally disabled in April, 2003. Under the terms of the group long-term disability benefit plan Monica purchased while working for EBE Office Source, Inc., Guardian is allowed to offset her monthly benefit payment according to the amount of Social Security disability income she receives.

Ms. Johnson applied for Social Security Disability Income (SSDI) in 2005, and was approved by the Social Security Administration on or about August 18, 2009 to receive disability income payments retroactive to July 1, 2005. Ms. Johnson’s monthly SSDI payments amounted to $1,545.80. Guardian was already paying Ms. Johnson $2,505 per month up until the time she was approved for SSDI in 2009. That means Guardian can offset Ms. Johnson’s payment by $1,545.80.

Guardian did some calculating upon being notified of Ms. Johnson’s SSDI approval, and concluded that they overpaid Ms. Johnson to the tune of $70,232 between July 1, 2005 and January of 2010. At that time, Guardian withheld payment from Ms. Johnson until a time such that Guardian felt that they had been properly reimbursed for overpayment of benefits. With the combination of a lump sum payment made by Ms. Johnson and Guardian withholding disability benefit payments from her, Guardian informed Ms. Johnson it in a letter dated December 8, 2010 stating that terms for reimbursement to Guardian have been satisfied.

But now, Ms. Johnson’s daughter, Jenna, is thrown into the mix.

As an unmarried minor living with her mother who is completely and totally disabled, Jenna Johnson is entitled to apply for child benefits under the Social Security Act. Having been approved to receive Social Security benefits, Jenna received a monthly benefit of $772 per month as of July 1, 2005.

Monica Johnson, the aforementioned claimant and Jenna’s mother, received a letter from Guardian on February 17, 2011 stating that per terms of the group long-term disability plan she purchased prior to becoming completely and totally disabled Guardian could use the amount of the monthly Social Security benefit Jenna receives to offset the payment Guardian makes to Monica every month. With that said, Guardian claims they overpaid Monica and additional $49,168.54 since Jenna’s monthly Social Security benefit was not factored in to Monica’s monthly payments from Guardian. Guardian said they would withhold monthly payments to Monica and also demanded Monica to pay a lump sum of $41,448.54 to Guardian until reimbursement had been made.

Not so, says Monica. That’s why she filed a civil complaint on behalf of her daughter in United States District Court for the Eastern District of Pennsylvania against Guardian with the help of her disability attorney to prevent Guardian from, in essence, taking away Jenna’s monthly Social Security benefit.

Ms. Johnson alleges that her daughter relies on her Social Security benefit so she may have a place to live, food to eat, clothes to wear, and other necessities of life. Furthermore, Monica alleges that neither she nor her daughter assigned Jenna’s Social Security benefits to Guardian. Ms. Johnson further alleges that pursuant to section 207 of the Social Security Act, “Jenna’s future SSD child benefits may not be assigned or transferred.”

Therefore, Monica Johnson is suing on her daughter’s behalf to keep Guardian from essentially taking away Jenna’s child benefits from Social Security. Ms. Johnson is asking the court to compel Guardian to pay her long-term disability benefits without deducting the amount her daughter, Jenna, receives from Social Security. Additionally, Ms. Johnson is asking for any lost income benefits that were withheld as result of Guardian deducting Jenna’s monthly Social Security benefit. Finally, Ms. Johnson asks the court for reasonable attorney’s fees and costs related to this litigation.

It will be interesting to track the outcome of this case. If the disability policy specifically allows for an offset for child disability benefits, then this will be a difficult case for the claimant to win. However, if the policy has language which violates state or federal law, then the court can rule in favor of the claimant.

There is one comment so far

  • What is the outcome in this case? Did Gaurdian pay a benefit regarding Jenna? If not how can they justify withholding Monica’s and/or Jenna’s benefit based on Jenna’s receiving a benefit from SSA based on her mother’s disability?

    John Cox Jul 24, 2013  #1

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We represent Guardian clients nationwide and we encourage you to contact us for a FREE immediate phone consultation with one of our experienced disability insurance attorneys.

Can you help with a Guardian disability insurance policy?

Our disability insurance lawyers help policy holders seeking short or long term disability insurance benefits from Guardian. We have helped thousands of disability insurance claimants nationwide with monthly disability benefits. With more than 40 years of disability insurance experience we have helped individuals in almost every occupation and we are familiar with the disability income policies offered by Guardian.

How do you help Guardian claimants?

Our lawyers help individuals that have either purchased a Guardian long term disability insurance policy from an insurance company or obtained short or long term disability insurance coverage as a benefit from their employer.

Our experienced lawyers can assist with Guardian:

  • ERISA and Non-ERISA Appeals of Disability Benefit Denials
  • ERISA and Non-ERISA Disability Benefit Lawsuits
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  • Disability Insurance Lump-Sum Buyout or Settlement Negotiations

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Yes. We are a national disability insurance law firm that is available to represent you regardless of where you live in the United States. We have partner lawyers in every state and we have filed lawsuits in most federal courts nationwide. Our disability lawyers represent disability claimants at all stages of a claim for disability insurance benefits. There is nothing that our lawyers have not seen in the disability insurance world.

What are your fees?

Since we represent disability insurance claimants at different stages of a disability insurance claim we offer a variety of different fee options. We understand that claimants living on disability insurance benefits have a limited source of income; therefore we always try to work with the claimant to make our attorney fees as affordable as possible.

The three available fee options are a contingency fee agreement (no attorney fee or cost unless we make a recovery), hourly fee or fixed flat rate.

In every case we provide each client with a written fee agreement detailing the terms and conditions. We always offer a free initial phone consultation and we appreciate the opportunity to work with you in obtaining payment of your disability insurance benefits.

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No. For purposes of efficiency and to reduce expenses for our clients we have found that 99% of our clients prefer to communicate via telephone, e-mail, fax, GoToMeeting.com sessions, or Skype. If you prefer an initial in-person meeting please let us know. A disability company will never require you to come to their office and similarly we are set up so that we handle your entire claim without the need for you to come to our office.

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When you call us during normal business hours you will immediately speak with a disability attorney. We can be reached at 800-682-8331 or by email. Lawyer and staff must return all client calls same day. Client emails are usually replied to within the same business day and seem to be the preferred and most efficient method of communication for most clients.

Dell & Schaefer Client Reviews   *****

Jeff S. (Kansas)

Due to my vision and health issues testimonials are not typical of me. Dell & Schaefer however did such a sensational, and professional job we felt it absolutely necessary to share the experience.

I had been thinking of pursuing a lump settlement on long term disability with the insurance company for some time. Decided on Dell & Schaefer after much research on several firms across the country. Residing in the Midwest did cause some reservations about choosing a firm around 1500 miles away. However shortly after choosing Dell & Schaefer my concerns where quickly put to rest by how proficient the team is, and how they are always there with you. Never waited for a response and always felt like we knew exactly what was going on every step of the way.

I got the pleasure of working with Mr. Stephen Jessup Esquire, along with Sonia R. Nogueira, and team on my case. After contemplating my situation Steve was contacted to let him know it would be about three months before moving forward. I mention this because no pressure was ever felt to pursue or take a settlement and the firm awaited me to contact them again. No annoying emails, calls, letters, or any type of pressure to hire them. When questions arose the team was right there for me through the entire process and only a phone call or email away. Never had to wait for a response before or after retention. Mr. Jessup at one point during my case was out of country and still offered guidance when needed, almost immediately after emailing. Sonia also went above and beyond and took my call around six P.M. on a Friday to help me with some document questions. Simply an incredible level of service that seems rare anymore. I always felt truly comfortable!

Mr Jessup and everyone with the firm seemed to have a very good rapport with the insurance company. I mention this because within about two weeks of retention we had the first offer. Within less than four weeks we had reached a settlement agreement, and funds where in my account about two hassle free weeks later. This all transpired even with delays of the insurance rep taking vacation twice. Overall my settlement expectations where far exceeded. During the original consultation Mr. Jessup mentioned a monetary figure that was lower than the actual final settlement. There where no false promises or over inflated estimates as sometimes found elsewhere. Just an upfront honest answer of what could be to come. During the process I still received my monthly benefit and never had to deal with the insurance company directly. This in itself took so much stress out of my life. After three years I no longer had to continually jump through hoops when the insurance company requested something or worry that I might undeservedly lose benefits.

The above is just a small part of my experience on how I felt the professional and courteous team was always willing to go the extra mile. If you or someone you might be concerned about are in need of guidance my opinion is a better choice could not be made than contacting the team at Dell & Schaefer about options.

Because of the work done by those at Dell & Schaefer I now have the funds to live while attempting medical procedures that insurance will not cover. Hopefully because of this someday I can return to a career as I’m still almost twenty years from retirement age.

Thank you all at the firm again for returning some normalcy to my life and treating me like a person not a case!

***** 5 stars based on 202 reviews

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