Question
Pre-existing clause?
I went out on STD for generalized anxiety (a condition I’ve been treating for 10+ years) on July 13 which is exactly one month short of my first full year of employment with my current employer. I had ACDF surgery recently (also for a pre existing condition for 20+ years which has progressively become worse) and now may require LTD. MetLife is now reviewing my LTD eligibility due to the pre-existing clause. I met the 12 months of employment, which, as I understand, makes the pre existing condition clause no longer apply. Will I face issues with getting LTD approved? And if so, is this something I should consider legal representation for?
Answer
Healing, most pre-existing condition clauses require that you be covered under the policy for 12 total months. That means you have to be an active employee / actively working for 12 months. As you left work for a period of time during the initial 12 month period, the initial 12 months of employment was delayed. I would need specific dates and a copy of the governing LTD policy to see if the pre-existing condition clause should be ineffective or whether it still might have some teeth. Please contact us at your convenience for a free consultation so we can learn more information.
