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Question

Is it legal for MetLife to change the definition of disability?

Asked on May 26th 2016 by Robert
I was put on std from my employer then it turned into ltd 2 level spine fusion with a morphine pump in my stomach feeding my spine due to pain. I got ssd of 1800 and that amount subtracted from ltd payment which leaves me 450 a month from metlife. They have asked for 5 different time a functional cap test. Dr pretty much said no work no lifting no bending and so on. Jan. Metlife called and told me deffinition of disability changes. How can they change definitions of words, is that legal? Can I change definitions also? If they can I should be able to. If my doctor said I can’t work can Metlife say oh I can work? They said they take into consideration my age what I can do and it must be 80% of my gross pay when I was working. I have been a welder only which no way I can do now. Whats going to happen in nov 2016 80% comes out to 16.50$ an hour. Will they try to cancel me and my crummy 450 a month?

Answer

Answered on May 20th 2016 by Attorney Stephen Jessup

Robert, with respect to your question as to change in definition of disability- yes, that is legal. Your policy has language that reads after a certain period of time (usually 24 months) disability will be defined to mean the inability to perform any occupation and in your case it looks like it would have to pay you 80% of your pre-disability earnings. MetLife can always have your claim reviewed by a doctor and if that doctor disagrees with your doctor’s opinion that could be enough for MetLife to deny your claim prompting need for an appeal. Have you performed a functional capacity evaluation? Please feel free to contact our office to discuss your claim. There may even be a chance to try to secure a lump sum buyout of the policy from MetLife.

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