Is My Insurance Company Allowed to Take An Offset of My Monthly LTD Benefit for Social Security Benefits My Kids Receive As A Result of My Disability?

It is common practice for insurance companies to find ways to limit the amount of money they have to pay to claimants. If you are receiving long-term disability benefits from a policy governed by ERISA, you have most likely been required to also file for Social Security Disability Income benefits. Insurance companies write this requirement into their policies so they can reap the benefits of any past money awarded to you by SSDI as well as reduce the amount of monthly benefit the insurance company is required to pay you. One frequently asked question is:

Whether the insurance company is permitted to not only take a offset for the SSDI benefits received by the disabled insured, but whether it is also permitted to take a offset for benefits the insured’s dependents are receiving (DSSD) as a result of the insured’s disability?

According to a New York Federal Court in the case of Brutvan v. Cigna Life Insurance Company of New York (not handled by our law firm), depending on the specific language in your policy, the answer to that question may be “No.

Cigna’s Position that Offset is Proper

In Brutvan, Cigna argued that its Plan provides for an offset of DSSD benefits received for the Plaintiffs minor children as well as it does for the Plaintiff. Specifically, Cigna argued that the Plan clearly states that Cigna may offset “Social Security disability benefits the Employee or any third party receives… on the Employee’s behalf.

Since the Plaintiff’s daughter receives the DSSD benefits only because her father was found to be disabled by the Social Security Administration, Cigna claimed it would also be entitled to take an offset for those benefits. Furthermore, Cigna argued another reason it was entitled to the offset is that the Plaintiff signed a reimbursement agreement obligating the Plaintiff to reimburse Cigna for any benefits received by his dependents.

New York Court Says No Setoff for DSSD Benefits

The Court in Brutvan held, as a matter of law, the Plan language at issue manifests a plain and unambiguous intent to provide LTD benefits without offsets for DSSD. The Plan specifically states that a offset may be taken for SSDI benefits the Employee or any third party receives… on the Employee’s behalf. The Court refused to look outside the Plan for evidence of intent of Plan terms, stating that “if Cigna had intended for DSSD benefits to be offset against LTD benefits it could have made specific reference to “family, spouse, children or dependents in the Plan,” however, it did not.

This ruling is a definite windfall for policyholders who have ambiguous policy language regarding what the insurance company is permitted to take as a offset. This case was not handled by our firm, but we believe it is an example of why it’s important to read your policy carefully prior to agreeing to allow your insurance company to improperly take an offset of your monthly benefits. If you have questions or concerns regarding your disability benefits and would like to speak with one of our experienced attorneys, please feel free to contact Dell & Schaefer.

Comments (65)

  • Are LTD insurance companies allowed to inquire and receive very personal information from Social Security Office who the disabled person’s children are and how much in benefits they receive as dependents of a disabled person? this is very personal information protected by PRIVACY ACT and it seems inquiring about such information would be illegal. And if they are not allowed to inquire about such information can we sue LTD insurance company for obtaining such personal information without our consent? My husband never signed anything allowing LTD company to inquire how many children if any he has.

    Agnes S. Jan 9, 2022  #65

  • Hello I am currently on LTC disability through a employee sponsored benefit with a reputable insurance company in Connecticut. Shortly after LTC policy was approved by private insurance the insurance company asked me to file for Social Security Disability. I waited six months and received an award letter from Social Security. The amount awarded was roughly 65% of what the LTC private insurance company was paying. So moving forward I receive 65% from SS and 35% from LTC private insurance.

    My ex wife and I are divorced and she is remarried (quickly). She has plenty of income and child support I pay helping her every month. I filed for family benefits for my two dependents.

    I just found out that because my ex wife is who my daughters live with full time due to school system preference, she recieves all of the backpay Social Security is sending $18k and will recieve approximately $1800 per month for my dependents (daughters) on top of what I pay her for child support. Net Net this drastically reduces my disability income to a point its going to cause major issues in the way I pay to basically survive and seek continuous medical treatment after having a significant issue with a recent organ transplant.

    I thought that what the insurance company pays me along with social security payment that would total up to what I was initially promised to be my benefit payment until the age of 62. I also thought that family benefit coverage from SS would be in addition to that to help provide opportunities to support my children, college eventually, etc.

    From what I’m being told by both private insurance and social security is that they are looking at the family benefit as an offset and will require payment for money that will never be sent to me, just my ex-wife. How in the world is this ethical and legal? from state of Alabama.

    Jon Jan 5, 2022  #64

  • I am receiving SSDI, my wife is being told to apply for dependent SSDI. If awarded, it would be an offset to my LTD benefit. My question is: Does she have to apply? and if so, does anything change if she were to get a job, like part time?

    Paul K. Mar 24, 2021  #63

  • Julie, unfortunately under most group disability insurance policies, the insurance company is allowed to offset both your primary and your dependents’ social security disability benefits that are paid due to your disability. To truly know, you must have a copy of the governing LTD policy. If you can acquire a copy of the governing policy, we will gladly perform a review for you via a free consultation.

    Alex Palamara Dec 9, 2020  #62

  • I have Mutual of Omaha for LTD and they have taken my SSDI benefits in lump sum to offset my income but now they want my Son’s SS Dependant benefits to also offset my LTD income received. I want to know if this is something I can challenge because I don’t feel its fair to take benefits which are due to him (meant to offset my loss of income in supporting him).

    Julie B. Dec 9, 2020  #61

  • Lisa: You may have some options. I suggest you contact our office and speak with one of the attorneys to address your specific situation as well as your options.

    Jay Symonds Mar 9, 2020  #60

  • Prudential says they will hold back money my son would be entitled to from the retroactive approval SSDI date to the date my son turned 18 or graduated from HS (around $43,000). My son was over 18 when I received SSDI approval for benefits in October 2019, which are retroactive to October 2016.

    My son is an adult and is at college He says has no time in the middle of the day to apply for SS dependent benefits , especially if all the money goes to Prudential. He said he would apply if they give him half the whatever is awarded or he just won’t apply.

    When I received the approval from SSDI for benefits my son was already 18. Prudential said they will take the 43,000 out of my future paychecks regardless of if my son decides to file for his retroactive benefits. I have no control over what he does as an adult, thought we have a good relationship and we still cover his college expenses.

    My son turned 18 years old in spring 2019 & Graduated Hight school in June 2019 I received SSDI in October 2019. Due to the timing or the reward and his being an adult, can they hold me accountable for this money? Or is this actually a loophole which could benefit my son and Foil Prudential trying to take his benefits?
    sorry if I went around in circles – cognitive issues : )

    Lisa Mar 9, 2020  #59

  • Jerry, I’m so sorry to hear about your son’s condition and the trouble your are getting from Liberty Mutual. If you would like to speak to me about this in detail please email me at Rachel Alters, Esq.

    Rachel Alters Jan 17, 2020  #58

  • My son’s ltd was offset by Liberty Mutual because of his son’s receipt of social security. I am my son’s POA. They contacted me after his son had been receiving benefits for over 3 years. They informed me of the offset and the arrears amount of nearly $40,000. I asked why they had not sought to offset for that long and was told the another department failed to handle. This was all after an in depth review of my sons case and a neuropsyche evaluation stating he would not report to work. He is a third stage brain cancer patient. After much rumbling from me to his former employer for allowing this language in the summary plan and a letter to Liberty Mutual ceo, I was sent a letter stating that although they “manage all their claims fairly and equitably, they would drop the arrears request if I considered the matter closed”.

    Can they legally offset but not request arrears? Can they legally collect arrears from some people and not all? Is this a violation of their own policy to manage all claims fairly? If others heard of this could their not be a class action? I am grateful for their relenting but also feel the monthly dependent offset is unfair. They were already offsetting his social security.

    Jerry Jan 16, 2020  #57

  • Tony, your LTD policy will give language governing this situation. But in all likelihood, because your dependent is receiving SSDI benefits due to your disability, it will likely still remain an offset. If you have a copy of your LTD policy, please feel free to contact us for a free consultation.

    Alex Palamara Oct 25, 2019  #56

  • I receive LTD through a major insurer and my SSDI (including SSDI for my two kids) has been offset against the LTD claim. My daughter turned 18 but won’t graduate high school for another 7 months. Social Security sent her a letter explaining that her check will be sent directly to her instead of me. Her checks are now in her name only. Can my LTD insurance company continue to offset her entitlement which is paid because of my SS award? If she chooses not to transfer the money back to me do I have any legal options? Seems strange since I can’t claim her entitlement income on my taxes going forward but yet my insurer continues to offset my income from SS. I’m assuming so since after reading these comments it seems that disability companies can basically do whatever they want.

    Tony Oct 25, 2019  #55

  • Hello –
    I enrolled in a supplemental long-term disability program through my employer. The application was brief and asked if I had four specific pre-existing conditions, which I do not.

    However, I noticed two items: The brief application only lists a few specific pre-existing exclusions but then has language at the bottom of the application that states that the applicant will authorize the carrier to consult with your medical or mental health provider if needed


    1) Why does the carrier need to potentially consult w/ my mental health care provider if there are no mental illness-related issues stated as any type of exclusion on the application form?

    2) From the research I have done, most of these supplemental LTD policies are governed by ERISA plans which have far more obstacles to them than private plans do (which I was led to believe these employer-offered plans are). Does the carrier need to state explicitly on their application whether this plan is governed by ERISA or not?

    Many thanks – Kyle

    Kyle Acton Aug 17, 2019  #54

  • Mindy, no. The only potential offsets that can occur to your monthly LTD benefit are sources of income directly attributable to you.

    Stephen Jessup Jul 23, 2019  #53

  • If I marry will my future spouse income affect my Ltd monthly payment. I recently was approved for SSDI benefits. I’m aware my SSDI benefits will not be affected.

    Mindy Jul 23, 2019  #52

  • Lisa, unfortunately, this is one of the worst things about employer provided disability benefits – the ability to offset not only for your SSDI but also your dependent. Courts have ruled these provisions to be enforceable as they are clearly stated in the plan language.

    Stephen Jessup Jun 28, 2019  #51

  • I am on SSDI and was informed I could receive benefits for my child as well. I submitted the paperwork and was approved to start receiving benefits for him on my behalf. I have LTD insurance and have recently paid back the immediate reimbursement that I was paid by SSA, to my LTD carrier. NOW, since I was rewarded benefits for my child, my LTD insurance carrier has informed me via letter (I received yesterday) that I am to pay them back my child’s immediate reimbursement as well as decrease my monthly pay by what the SSDI is paying for my child. So starting today, my LTD check is now minus the money that I am receiving for my child monthly. NONE of this seems fair!! I worked 25+ years and paid for my LTD and into SS. Does not seem right that insurance companies should be allowed to do this!

    This is what is written in my LTD insurance policy:
    *If at any time the Claims Administrator and/or Plan Administrator determines that the total amount paid on a claim is more than the total amount due, the Claims Administrator and/or Plan Administrator shall have the right to recover the excess amount from the person to whom such payment was made. The Claims Administrator and/or Plan Administrator may recover the excess by reducing or offsetting against any future benefits payable to such person, by demanding immediate reimbursement, or by any other method permitted by law.

    Lisa Jun 28, 2019  #50

  • Ann, I am happy to hear your LTD benefits are being paid. Yes, your LTD benefit should increase once your dependent receives his or her last benefit SSDI benefit check. Please get correspondence from SSA showing this and submit it to the insurance company ASAP.

    Alex Palamara May 31, 2019  #49

  • I have been on LTD/SSI with 3 children receiving SSI and being calculated as offsets to my LTD payment. My last child will receive her final SSI in June of 2020. Will my LTD benefit increase now that none of my children are no longer receiving SSI benefits?

    Thank you

    Ann May 31, 2019  #48

  • Alice, this is a very difficult and unfortunate situation. I suggest you contact our office and speak with one of the attorneys to address the specific questions you have regarding your situation and send in your son’s Group Policy.

    Jay Symonds May 2, 2019  #47

  • My son had a stroke in 2013 and is disabled. He is receiving SSD and Long Term Disability through his company insurance. His wife devastated him financially. He left in 2017 and filed for divorce. His divorce attorney told him that he needed to file for SSD benefits for his 8 year old son. SSD told us that he cannot file because only the custodial parent can file. He told his ex-wife. She filed for their son in 2018. My son got a questionaire to fill out to continue LTD. One of the questions was “Do you have any dependents?” He answered. I have an 8 year old son but my ex wife has custody. So the LTD company instantly reduced his benefits by 1100 a month (1/2 of his SSD payments). Then they sent him a letter demanding repayment of over $70,000 – the amount his son would have received if his ex-wife had filed right after the stroke. Neither my son or his ex-wife knew they could file. The LTD company never asked them to.

    In the contract it states that the Member is required to apply for disability benefits with 10 days after receipt of Written notice from the company. My son never received this notice for a dependent. The language in the contract stated that the company can reduce my sons benefits if he receives extra income. Under extra income, they list SS benefits to dependent children, even if they don’t live with the member. Can they take away that money when my son has no legal access to it? His wife received a lump sum from SSD for his son. Can they expect repayment when he could not even apply for the benefits, has no legal access to the money and did not benefit from it? He cannot work, did not receive the money, and has no credit or any way to pay it back. They can take away his LTD to pay it back and then he will not have enough money to live on.

    Alice May 2, 2019  #46

  • Ramon, the fact that your 2 remaining dependents will now be receiving more money each month is not a COLA increase. Unfortunately, I believe the insurers explanation and interpretation is likely correct. Most policies allow the insurance company to offset “the amount of any benefit… provided to you or your family… pursuant disability benefits under… the United States Social Security Act…” Also, while many policies will not further offset for COLA increases or any other increase so long as it “is a general increase which applied to all persons who are entitled to such benefits.”

    Alex Palamara Sep 21, 2018  #45

  • I have been on SSDI/LTD for almost 6 yrs now and have 3 children that receive DSSDI as well. Group LTD Policy has a no COLA provision and doesn’t make any adjustments to the offsets. Even when SS makes increases to my and dependents benefits. At the time that my offsets were calculated, my children received $125.00 each a month. So, my offset were $475.00 from my monthly LTD payments. I have 1 child that just graduated High School and asked the Ins Co. if the $125.00 that they were offsetting for her would come off. Claims examiner tells me that, no it would not be reduced. He says it won’t be reduced, because SS will then split the benefit that my my daughter was getting between my 2 younger children. Also, that the full offset will come off when the youngest child, no longer receives DSSDI benefits. No where in the policy does it state that, there explanation is that since SS is splitting the benefits 2 instead of 2 ways that I am coming out the same.

    Am I wrong in saying that, since there is no COLA adjustments in my LTD benefits, it doesn’t matter what or how much the children are splitting. Cause the offset was started with 3 children and not 2. Please let me know where I may have the disconnect or confusion. Thank you for your response!

    Ramon Sep 20, 2018  #44

  • Mary, unfortunately, if they are now receiving dependent ssdi benefits based on your disability claim there may be little that can be done to have the offset waived.

    Stephen Jessup Jul 18, 2018  #43

  • Both of my stepsons receive SSDI on my social security income statement, as I am disabled. My LTD is taking an offset of their SSDI. They are both adults and receive their SSDI checks directly, do not live with me, and are not my legal dependents. Most importantly, both of my stepsons are disabled, on Medicaid, and rely on SSDI for living expenses. I read in the comments area months ago that if the child is disabled the LTD provider cannot offset their SSDI benefits. Please provide how I can prove this to my LTD provider. This offset is costing me nearly $1000 per month. Thank you

    Mary Jul 17, 2018  #42

  • Mr. Fedop, you should not trust MetLife when they tell you they just want to “ask you a couple of questions” and “walk you through the appeals process.” Disability insurers hope and try to persuade you to prematurely submit notice of your appeal without requesting and reviewing the administrative claim file, specifically addressing the reasons for denial and without submitting additional evidence supporting your disability. If you one day have to pursue legal action against MetLife in Federal Court your case may be won or lost depending on the additional evidence submitting on appeal and how well it was prepared. In other words, your Appeal may make or break your case. Please feel free to contact our office and ask to speak with a disability insurance attorney who will be able to further discuss your case.

    Cesar Gavidia May 31, 2018  #41

  • What is one to expect when Metlife wants to “ask a couple question about your appeal and walk you through the appeals process”? This call is 111 days after the appeal (1st) was submitted and I never received any letter regarding the 45 extension. The customer service rep stated the claim was not looked at until I called about it 12 days ago. Any suggestions?

    Mr. Fedop May 30, 2018  #40

  • Frank, the language of your LTD policy will govern your claim. In most Group LTD policies, so long as your dependents are getting disability benefits due to your SSDI claim, then it will be an offset. If your child is receiving benefit due to their own conditions, then it likely isn’t an offset. Though again, the LTD policy language will govern this. You have quite an intricate situation. If you wish for a free consultation, please feel free to contact us. We will need to review a copy of your LTD policy, so please obtain a copy if you do not already have it. Regarding your bankruptcy question, it is best to speak with a bankruptcy attorney to answer that inquiry.

    Alex Palamara May 30, 2018  #39

  • I have been awarded SSDI and now my LTD company is asking for repayment of the back benefits as well as dependent benefits. This has created a problem because they are seeking money that I have not and will not be paid nor ever have had or will have any control over.

    The specific language in the policy considers “other income” to be “Disability or retirement benefits inder the United States Social Security Act…” “…for which: (a) you are eligible to receive because of your total disability or eligibility for retirement benefits and (b) your dependents are eligible to receive doue to (a) above.”

    I have one child, now an adult, who recieves SSI and SSDI. She became disabled as a child and began receiving benefits while in state custody as a child and was not released from state custody until she became an adult. During that time the state was her payee and guardian. She reached the age of adulthood prior to my becoming disabled. Since then, she has had a guardian and a seperate payee.

    I have another child, who reached the age of adulthood and is not a student, after my becoming disabled but before I was awarded SSDI.

    I have a third child who is still a minor.

    I can understand that they are seeking payment for the amount that my minor child will receive as back pay and to reduce my benefits by her future payments for the auxilliary benefits she receives because of my Social Security claim.

    The problem is that they are also seeking repayment of the amounts received by my other adult children. While their auxilliary benefits are based on my work record and Social Security family maximum, this is not money that my “dependents” are eligible to recieve because they are not my dependents over whom I have any financial control. My non-disabled adult child, while he is able to recieve some back pay for the period of time he was a child while I was disabled, was not “eligible to recieve” that money while a dependent because my SSDI claim had not yet been decided. There would have been no way for him or I to get it.

    I have two questions for you. The first is how best can I get them to quit seeking repayment for Social Security for my two adult children. Now for the second question. This debt is insurmountable and I have other debts from medical bills, credit cards and a mortgage on my house, a house which I am no longer able to care for. Would bankruptcy protect me from having to repay this while allowing me to keep my Social Security back pay? Would the LTD company be prohibited from taking a setoff against those past benefits?

    Thank you in advence for your considered answer.

    Frank May 30, 2018  #38

  • Jerri, I am sorry to hear of this terrible predicament that you are in. I know of no way to sue employers or the insurance company for the offsetting language. The policy language will govern your claim. If your son is getting SSDI benefits for his own claim/disability/sickness, that may in fact not be an offset to your LTD claim. We need to review the LTD policy to see the actual language. Most Group LTD policies allow insurance companies to offset for dependent social security benefits if your dependents are receiving benefits due to your claim/disability. But often times, if the dependent’s ssdi benefit is due to their own conditions, it is not an offset. Please obtain a copy of your policy and please contact us.

    Alex Palamara May 30, 2018  #37

  • Can an employer be sued for telling employees they have LTD benefits when in actuality they allow the insurance company to offset DDS and dependent SSD even when that child does not live in the home or has never been filed as a dependent? My son is diagnosed with terminal brain cancer and was forced to apply for SSDI by Liberty Mutual in 2015. LM immediately began to offset his benefits, Now last month, 3yrs later, they are informing me that they are taking an offset for his son beginning in June and he will be liable for an overpayment. They have know for 3 yrs there was a child and never mentioned an offset. They are claiming the employer is requiring them to do this. The employer says no but they signed that contract with that language. I think in many cases employers are being duped also. My son can not work and needs his benefit.

    Jerri May 29, 2018  #36

  • Tony, ERISA does not allow for recovery of attorney fees incurred by the insured during the administrative appeal process. On the other hand, disability insurance plans often require that you pay back any overpayment of benefits which occur as a result of being awarded “other income benefits”, such as social security retirement or disability. Unfortunately, you do not have a right or cause of action to recover the attorney fees you incurred during the course of your appeals; however, the disability insurer may either withhold your benefits to recover the overpayment or may even attempt to recover the overpayment through a legal action. You should speak with your attorney about your options.

    Cesar Gavidia May 13, 2018  #35

  • Here is my question: I have been on LTD for 5 years. In that time they have cut me off twice resulting in almost 20k worth attorney fees. I was finally awarded RSDI stating I have been disabled and not able to work this whole time. I do not see me having to repay these fees to the LTD company. Both times they reinstated my LTD which shows they were wrong in the first place for cutting me off. Do I sue or withhold back payment until we can come to a agreement?

    Tony May 12, 2018  #34

  • Susan, if your dependent receives a dependent SSDI benefit on account of your disability, then yes, it would be an offset under the vast majority of employer provided disability policies.

    Stephen Jessup Nov 29, 2017  #33

  • If I didn’t have children when I signed up for LTD, can they require me to hand over back pay I received from SSDI for my 4 year old? I understand I have to hand over MY back pay.

    Susan Nov 28, 2017  #32

  • TPepper, we would need to see all of the policy information to be able to properly advise you. Please feel free to contact our office to discuss your policies with one of our disability attorneys.

    Stephen Jessup Nov 12, 2017  #31

  • I have a Guardian Berkshire private DI policy that I got at a young healthy age. I have since become ill, and just before age 45 I exercised my Future Increase Option to triple my coverage without another medical exam. This wasn’t enough to fully insure me at my current salary, and I knew that Guardian would never insure me beyond the FIO with my illness, so I simultaneously bought another private DI to cover the remainder of my salary.

    The Guardian FIO contract was signed after I had already applied for additional private disability, and I was temporarily over-insured at the time I signed the Guardian FIO. I had explained to the Guardian reps exactly what was going on at the time, and that I was planning on reducing my other DI coverage ASAP so that I wouldn’t be overinsured.

    Several years later, I’m now claiming for disability, and I see there is a provision in the Guardian claim that “The policy shall limit the amount of monthly indemnity payment at the time of any loss because of disability, to the monthly indemnity provided by this policy, reduced by the amount of disability coverage which is in for us with [my other private disability].”

    There is a place on that page for me to sign and date, but it is blank.
    However, there is a bunch of fine print above my signature on the final page, and this includes the provision “all coverage shown to be discontinued or replaced an answer to question 6a of this application will be permanently terminated on or before the dates indicated. If not, it is understood and agreed that the company reserves all rights outlined in any policy or new coverage issued. Further, benefits under any policy or new coverage issued based on this application may be reduced by the amount payable under such existing policies.”

    I had explained to them what I was doing, so they knew I wasn’t over-insured. And Guardian have been charging me for the full amount of the FIO. My disability affects my cognition, so I didn’t see this in the contract, and (stupidly) didn’t have anyone else read it over.

    Is there anything I can do about this? Why should I have paid more for a 2nd private DI to ultimately get less?

    If my claim gets rejected by my 2nd insurance, now or in future, can Guardian still pay me a reduced amount?

    **Twist: I had initially applied for the FIO *before* I’d applied for any other private DI, but due to Guardian’s admitted error, it took them months to deliver the policy to me.

    TPepper Nov 11, 2017  #30

  • Greg, your situation is unfortunately not uncommon. With respect to the DSSDI benefit – first review your policy to ensure they have a right to offset for the DSSDI. Some policies will not offset if the dependent does not live with you. As you do not receive the money paid to your dependent you can look to potentially have a child support order adjusted to account for the DSSDI benefit being received if you have such an order from a Court.

    Stephen Jessup Oct 10, 2017  #29

  • I have been on LTD for the past year and was required by my insurance company to apply for social security disability benefits. I was told that if I was awarded social security benefits I would need to pay that amount back to the insurance company.

    I was recently approved and awarded the social security disability benefit. I was prepared to pay back the amount that social security paid me which was approximately $30K. However my insurance company said that I owed them approximately $47K. Seventeen thousand dollars more than I was paid by social security.

    I am divorced and have a 17 year old daughter who lives with her mother. I don’t understand how they can recalculate my benefit and ask me to pay back more than I received from social security. I didn’t receive any disability benefits for my daughter.

    I struggle day to day just to make ends meet. From my insurance disability check each month I pay my ex-wife $1700 in child support and I live on the other $1700. Now that I have been awarded social security disability by monthly income or benefit is exactly half of what my insurance company provided and they are asking me to pay back $17K more than I received from social security. The amount I provide in child support will be reduced to about $1000 a month and I will live on the other $1000 a month and am being asked to pay back $17,000 that I don’t have. They willing to take payments which will literally eliminate my ability to pay any child support and leave me with $0 each month until this is paid off.

    I not only struggle financially by with my disability I have limited ability to understand this situation and my disability is worsening as a result of the added stress from this. Are there any options for me or places I can look for assistance with this?

    Greg Oct 8, 2017  #28

  • Patti, yours is a very unique situation that I honestly have never dealt with in computing a SSDI overpayment. I would agree though that any offset should only be computed as a result of the increase from the benefit already being received. I recommend you provide the carrier with all of the information you can from the SSA as to how the DSSDI benefits are now being computed in addition to the information relating to the benefits on account of your husband’s retirement. I would also be very interested to hear what they have to say when presented with the information so please keep us informed.

    Stephen Jessup Sep 18, 2017  #27

  • I am on LTD and recently approved for SSDI. The plan states they can take mine, my spouse and my children’s benefits I/they receive based on my disability. Before I became disabled, my husband retired about 7 years ago and we have 3 children. One child is now adult. He is disabled and receiving his own disability benefit based on his father’s retirement and the other two are still under 18 and receiving a child’s benefit off their father’s retirement SSA benefit. My husband was/is collecting retirement benefits on his earnings record w/SSA.

    Because I was recently approved for SSDI, the SSA does a combined family maximum, recalculates the benefits to the children based on both of our earnings records and now the children will receive about double what they were getting on my husbands retirement benefit.

    I do not believe the LTD co. should get the whole amount of the children’s recalculated benefit because if I wasn’t disabled, they would still receive a child’s benefit on their father’s record until they age out of the benefit. Have you heard of this before and how can I ensure they will only take the difference between the amount based on their father’s retirement and the new amount based on both parent’s records? My husband will not get a spousal benefit because his amount is higher on his own record than what he would get on my SSDI.

    Thank you for your time.

    Patti Sep 11, 2017  #26

  • Jeanette, you can write to your congressional representatives as it would take a change to federal statute to change the law regarding ERISA disability insurance plans and application of offsets for SSDI. The offset has been deemed legal and enforceable. Employer provided policies come at very low premiums compared to privately purchased individual disability policies, and with that comes policy language and laws very favorable to the insurance companies. The only way to avoid having a disability policy that does not contain such language is to purchase private coverage through an agent.

    Stephen Jessup Aug 3, 2017  #25

  • I’m being forced to apply for social security disability benefits. I plan on going back to work in the next few months. Even so Cigna will terminate my LTD (which just started last month) benefits if I do not apply. Im told this process takes 5 – 6 months. So if I’m declared disabled any LTD benefit paid to me from June 7(LTD start date) to the time I’m approved will be paid back to Cigna. Reading other posts I understand this is legal. My question is not about that. My questions, how did the insurance companies arrange to be basically paid twice, once by my premium payments and once by social security?

    Also how do we go about having this practice reviewed and or changed? I know if I charged the contractor I work for and the DOE for my service this would not be allowed. But the insurance companies are doing just that. Who do I contact to express my disapproval and even go about changing this ridiculous practice. No wonder social security is in “trouble”. I’m going back to work! Social Security has just spent, who knows how much, processing my claim for absolutely no good reason. Another unnecessary cost the U.S. gov’t has incurred! The insurance companies make ridiculous amounts of money and I guess its practices like this that do it.

    I really want to challenge this, who would I write to?

    Jeanette Aug 1, 2017  #24

  • What happens. I was awarded LTD In 2013 approved thru 2025. My husband was drawing SS for our son but went back to work in 2016. I was awarded SS in 2015 which I had to give all backpay to Metlife. After my husband went back to work I then applied for SS for my son. Will his SS be considered income if so I might as well close my claim to avoid the hassle this doesn’t help my health issues. So tired. I paid for this policy through my job. Why is this so unfair as I paid in my Social Security. What is the benefit of LTD if you just have to pay it back. And why do you have to claim the backpay as income on your taxes. Should I close my claim to prevent stress??

    Elizabeth Feb 2, 2017  #23

  • Becca, your employer has obviously failed to give you a complete copy of your actual policy. You can make your written request to them more specific that you are requesting a complete copy of your disability plan through [Insurance Company Name], Policy ####. Additionally, the insurance carrier may give you a copy of the policy upon request. At the very least they should provide you with the applicable plan language relating to the offset being applied. Offsets for dependent SSDI are almost universal in policies, though some do limit the extent by which the carrier can apply dependent SSDI benefits as an offset.

    Stephen Jessup Jun 21, 2016  #22

  • I have requested the complete long term disability policy from my past employer but was just given a handbook which has no to little information in regards to the LTD.. there is no mention of offsets .. my issue is that my children are now adults and therefore all of the back pay a mounts go directly to them according to SS.. they would not even give me amounts or talk to them .. but now I have LTD stating I have to give them all the back pay .. This is a substantial amount that I don’t have access to . I have researched the website but cannot find the specific language regarding offsets of Dependent SS benefits .. would the LTD company be required to give specific info of this before they can request the money ? I am already going to have a heavy burden this year because I have to pay taxes on the lump sum they made me pay them from my SS back pay ( although I already paid taxes on this and don’t even get the money ) .. seems like the disabled is really getting ripped here ..

    Becca Jun 21, 2016  #21

  • Joy, if you do not want to allow them access I would suggest you obtain his complete Social Security file and provide to them.

    Stephen Jessup Apr 15, 2016  #20

  • My husband has been receiving long term disability benefits for the last 2 years and is entitled to another year. He had been getting disability social security and since he has turned 65 in June of 2015 it is now regular social security. The question that i have is the disability insurance company is threatening to stop his benefits for this next year unless i allow access to his social security records. I do not want to allow them access and told them so. I said i will send anything they need from social security but it has to go through me. I also said they can have all the medical records needed with out a problem. They said it was “company policy” to get access to his social security records. We have been victims of identity theft in the past and am very careful about allowing information to the “public”.

    Joy M. Apr 14, 2016  #19

  • Joe,

    The policy language is likely along the lines that any money received by a dependent on account of your disability is an offset – it doesn’t matter or distinguish as to when the child is eligible, just that the dependent is. If so, the argument is one that can certainly be made, it may just not result in any positive end result.

    Stephen Jessup Jan 13, 2016  #18

  • Thanks in advance. Approved for both SSI and LTD benefits in 2004. Had a child in 2008. I’ve been receiving dependent care benefits from SSDI since and now supposedly owe LTD insurer 7 years of back offsets. Wuestion is since my child was born 4 years after being approved for LTD and SSDI, is there an argument that benefit calculation should only be made at time of disability?

    In other words 60 percent of my pay in 2004 less any offsets for SSDI and Family benefits. My policy does not state family that may exist in the future.

    Joe Jan 12, 2016  #17

  • Joe,

    I do not see where you would have an actionable claim against your employer as ultimately the policy would have been available to you upon request for review. Unfortunately, most employers do not understand how LTD policies work.

    Stephen Jessup Sep 25, 2015  #16

  • I, too, just received my first LTD payment from Anthem and was informed that whatever SSDI I receive is to be turned over to them. I got a copy of the Policy Handbook from HR and it is consistent with this premise. My problem is that I discussed this with HR as far back as last year, and the verbal information he gave me was that I would receive both. When I found out otherwise and called HR, not only was he not aware that this was a provision contained within our policy, but he was as surprised as me having never even heard of the concept. I had to bring him up to speed. I would like to sue the company for having someone so inept directing HR. Had I been furnished with accurate information, I could have acted and made better provisions for me and my family. Is the Company at all responsible for my dilemma?

    Joe Sep 24, 2015  #15

  • My wife is disabled and has been receiving Social Security benefits for my 13 year old daughter of $280. Aetna has forced the application for Social Security Benefits for my daughter under my disability. I have been awarded the social security benefits of $1100, which will stop any payments under my wife because I receive more than she was. Aetna will “offset” my LTD by the amount I receive for my daughter, $1100. Because the $280 is now gone from my wife and Aetna offsets the total amount from my LTD we will have a reduced monthly income by $280. How can Aetna legally reduce our total monthly income? I understand the “offset” amounts they take but because they force me to get benefits for my daughter we lose income!

    Bill Oct 8, 2014  #14

  • Bob,

    If you previously signed a release at any point during the claims process then they could have access. However, as you state you didn’t sign anything then I am not sure how they received it. It sounds like it would be more of an issue with the SSA releasing information without authorization. You could contact your local SSA office to find what was sent and under what authority.

    Stephen Jessup Oct 4, 2014  #13

  • Do insurance companies have legal access to an individual’s SS Master Benefit Record? SS says no, however an insurance company has claimed they received benefit information directly from SSA. The insurer is trying to determine if an individual is receiving family benefits. A number of requests for permission were sent by the insurer, stating “You’ll never have to bother with us asking for information again, just sign all these consent forms and we’ll take care of it all for you.” Nothing was signed, yet an official SSA letter was sent to the insurer with the member benefit amounts and dates. There are no written or otherwise communicated permissions to query an individual’s SS account.

    Bob Oct 3, 2014  #12

  • Terry,

    Unfortunately, offset provisions for sources of Other Income are enforceable regardless of whether you were are aware of this policy language when enrolling for the policy through your employer.

    Stephen Jessup Aug 31, 2014  #11

  • I have an LTD policy & have become disabled. I was forced to apply for Social Security Disability as well, not to benefit myself, but so they could offset what they agreed to pay me. There was no mention of any offset when I took the coverage out through my employment. I don’t think my employer paid any part of the LTD on our behalf. It was just offered to us if we wanted to purchase it. My gripe is I paid in to social security & should be able to benefit from it. I also paid the LTD insurance premiums every 2 weeks to provide 80% of my income, in the event I became disabled. They even took all the backtime, including an overpayment which social security had already deducted from the backtime. My insurance company took that amount out of my checking account (I also had to give them permission to access my bank account).

    I think it should be illegal for them to offset with social security benefits. I paid for both & I should be able to receive both, without using one to offset the other. I paid my LTD premiums for them to pay me 80% of my income & that is what they should be paying me.

    Terry Aug 30, 2014  #10

  • I just think this is a lot of misrepresentation going on. Insurance regulators constantly fine healthcare companies for not disclosing policies to policy holders all the time. Why is it that employers and insurance companies can write a policy for employees and not let them see what they are buying? I currently have the US DOL investigating my policies and I refuse to pay them anything back at this time. My enrollment forms don’t match my policy book.

    Another interesting thing is the insurance company can put pages in book and supplement the policy and nothing is signed. They can change up the policy and you wouldn’t even know it.

    We are not attorneys, these policies are written for attorneys not regular people.

    As far as I’m concerned, I didn’t sign anything, I did not agree to any provisions or exclusions of any said policy… and there is no signature in policy book of the employer either. Just saying…

    Also, no where does it say I bought a policy in another state either… Thought I was buying a policy in the state I lived in.

    Frustrated Jun 7, 2014  #9

  • Tony,

    If your policy states they can reduce your benefit by sources of other income you receive or are eligible to receive, then voluntary surrendering of the DSSDI benefit could allow the carrier to argue you are eligible to receive the benefit and therefore continue to reduce your benefit by same.

    Stephen Jessup Jun 6, 2014  #8

  • If my ex-wife advises that she no longer wishes to receive the amount my daughter is eligible for, can the LTD carrier still offset my payment even if no monies are being received from SSDI by my daughter?

    I would like to think that would be theft if the department is not paying, yet they are offsetting?

    Tony Jun 5, 2014  #7

  • Tony,

    Unfortunately you have found yourself in a situation that is quite common. Under the terms of most policies the carrier is allowed to offset for the amount received by a dependent on account of your disability. As such, you may have to explore other avenues to minimize your financial expenditure on account of the fact your carrier is reducing your benefit by money you never receive.

    Stephen Jessup Jun 4, 2014  #6

  • I recently was awarded SSDI – my ex wife found out that she could file for an award for our 8 year old daughter and was granted. My LTD carrier is not only planning to reduce my monthly amount by the amount I will receive personally, but the amount my ex wife claimed. I currently try to save a little money for my kids future each month, but if my carrier is allowed to offset my payment by the amount awarded to my child then I won’t be able to continue to plan for her future. I do not claim her as a dependent, my ex wife has full custody and cloaks in her taxes.

    It would seem very wrong that the LTD carrier can profit at the department’s expense, and reduce my payment for money that I have zero control over!

    Is there any way to resolve? What if my ex wife agreed to tell the department to cease the payment if I give her some of my monthly payment – she has a very good job and doesn’t need the money. She is also a ‘spender’ and I doubt any of the money is going to my kid’s future.

    Tony Jun 4, 2014  #5

  • Tammy,

    You can request a copy of the policy from your husband’s former employer. Under the law they are required to give it to him. Each policy writes the set off for DSSDI differently. In the case at hand the court argued that Cigna was not specific enough with the language it utilized. If your husband’s MetLife policy specifically states “family, spouse, children or dependents” then the argument and analysis utilized by the court would not be applicable.

    Stephen Jessup Apr 18, 2014  #4

  • I’m in the same boat here. We don’t receive our long term policy so we have no idea what it says. My husband became disabled and MetLife has made us pay back anything Social Security has paid for our son in addition to including his benefit in the reduction of MetLife’s responsibilty. I have felt it was wrong all along but my husband doesn’t understand all of the technical stuff and hasn’t said anything.

    Tammy Apr 17, 2014  #3

  • Tony,

    I would agree 100% with you that the Social Security system is further overburdened by private insurance companies forcing insureds to apply for any and all benefits. However, there seems to be little in the way of any indication that this will change.

    Stephen Jessup Nov 11, 2013  #2

  • Just so you are aware a lot of times the employee doesn’t get to see any provisions or exclusions of any plan. The employer picks everything. If these insurance companies are going to include all these other income provisions they should have the spouses sign off on the plan as well. It’s misrepresentation by the employer and the insurance companies. The insurance companies make you apply for social security early so they get all their money back. (when you don’t sign their agreement to pay SS back they stop paying you.)

    Maybe social security wouldn’t be in so much distress if the insurance companies stopped forcing people into it.

    They also take your spouse’s $$ without their permission.

    Tony Nov 10, 2013  #1

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