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Confused about LTD, Laws, and Options in Pennsylvania

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  • Confused about LTD, Laws, and Options in Pennsylvania

    I've been looking all over the web for some answers that my employer will not provide regarding my impending change over from Short Term Dis. to Long Term Dis.

    I've been told that once my LTD is approved (pending possible surgery) that at some point my LTD carrier will require me to file for SS.

    I do not want to file for SS. While I may never be able to perform my current job again, I do not want to give up trying another career; finding a handicapped friendly and flexible workplace, or any other options that may be available to me (I am blessed with many artistic talents - I may want to start my own business, someday!)

    I'm already sick enough without having to worry about the hassle of how much to take out for taxes, how my health insurance is going to be paid back to my employer, and the possibility that if I am forced to file for SS I may owe back all my LTD payments if accepted for SS (And is that even true?)

    I am clearly overwhelmed by something I do not understand. I do not work in HR and my employer has not answered any of my questions regarding any of this.

    My LTD carrier is also not very forthcoming with information when asked.

    I'm very confused by the whole thing. How does one know what to deduct from the pay checks for Federal, State, Local? What happens with my health insurance - do I pay just my portion or do I pay the whole premiums?

    Also, can I file for a second term of FMLA for THIS year. I used the alloted amount for last year - but what about this year?

    Any advice on the law in PA would be helpful.

    I'd especially like to know what would happen if I would just decide to quit my job and no longer have the LTD benefits before they would require me to file for SS. Or is that even possible? Would I owe the money back?

    I pay for my LTD benefits. I know this makes a difference as well.

    Any help or advice is appreciated.

  • #2
    What you are discussing falls mostly under Federal law and/or the terms of your specific LTD policy, not state law. Also, quite a lot of what you are asking is employer specific.

    Many if not most LTD policies do require that, after a certain period of time and under some circumstances, you apply for SSDI. If your policy so requires and those circumstances apply, it is not a choice. You do not get to say, I don't want to. Your benefits can be cut off if you do not follow the rules of the plan. Specifically what your plan requires is not something we can tell you from here, but more plans have such a requirement than do not. However, if you are able to return to some form of work, it may not come to that since it is unlikely that you will continue on LTD if you are able to do some form of work. ONLY someone who is familiar with your specific LTD policy can give you definite answers. You will have to be on LTD for a minimum of a year and more likely two years, before the question of SSDI will come up.

    It is POSSIBLE that there will be some form of offset requiring you to repay LTD benefits. Again, that can only be determined by someone who is familiar with YOUR policy.

    The terms of LTD policies are not universal in PA or any other state.

    I have no idea what you are asking about with regards to deductions. YOU do not decide what to deduct from your paycheck beyond choosing what you pick when you complete your W-4. Your payroll department has tables presented to them by the IRS, your state revenue department, in your state your county, that tells them what to deduct, as well as information on the employee deductions for health and other insurances. It is not random. How much of your health insurance you have to pay depends entirely on your specific employer. We cannot answer this question. If this is not the question you are asking, please clarify.

    When you can apply for FMLA again depends on how your employer counts it. There are several different ways to count it, all legal. Without knowing how yours counts it or when your FMLA started, we cannot say when you will be eligible to apply again. You will have to have worked a minimum of 1,250 hours in the previous 12 months before you are eligible, regardless of what method your employer uses.
    The above answer, whatever it is, assumes that no legally binding and enforceable contract or CBA says otherwise. If it does, then the terms of the contract or CBA apply.

    Comment


    • #3
      Thanks for your response - as you can see, I am very confused.

      When I spoke of deductions - I meant that the LTD "carrier" has stated that I need to tell them what to withold from my LTD payments for each Federal, State, and Local.

      Currently, my STD comes to me from my company as a paycheck would, including all the taxes and medical taken out.

      The carrier has told me this would change, and the LTD is paid out directly from them vs. from my employer.

      As for the LTD and SS. I understand completely - should I, or my doctor, feel I have a long term permanent disability. It's just unfortunate that I have had several health issues that have set off other issues in a continuing rolling affect.

      I guess my real question here is this: Can I quit my job? Can I just choose to be unemployed and not have STD or LTD benefits any longer?

      I may never be able to work in my field again unless I want to get sick again; and I'm not sure I want to go back and find out the hard way. I dont want to go back and have to get sick again to find out.

      I can surely find something, eventually, after I am back on track health wise that will fulfill me personally in another field.

      I've also been trying to get a copy of the STD and LTD policies for months - the carrier says call my employer - my employer says call the carrier.

      Maybe because I work for a very large company and every department is outsourced, everything is harder to get done.

      I guess I am sick and tired of being sick and tired.

      I would rather quit my job than have to deal with all my medical issues and all this insurance hassle on top of it.

      I'm about to go mental just from having to deal with this all by myself. I have had zero help from the HR department at my place of employment and I don't expect to get any.

      Thanks again for the response.

      Comment


      • #4
        If you want to quit your job, you can. It might or might not mean that you no longer qualified for the disabilty benefits. In fact, it probably would not. You are not required to file a claim, of course, but quitting is not going to make everything go away. And while I don't know if you are thinking that you could just go on unemployment instead, if you are medically unable to work, you will not qualify for UI. So you would then have no income.

        You tell the LTD people the same thing you would put on a W-4 form; Single-0, Married-1, whatever. As for health insurance, you'll have to ask your employer that. (Yes, I know you've said you've not been able to get answers from your employer, but I simply do not have the answer for you - it is employer-specific.)
        The above answer, whatever it is, assumes that no legally binding and enforceable contract or CBA says otherwise. If it does, then the terms of the contract or CBA apply.

        Comment


        • #5
          Thanks again - speedy reply! I am fortunate to have found this forum where I could at least find a few answers to alleviate some of the anxiety over my entire situation.

          I appreciate your response and I guess I should concentrate on just getting through the next hurdle and find out IF I will need the LTD at all (ie, surgery), or if my doctor will be releasing me for work with a "fit for duty" form (which I know is not going to go over well either).

          But, knowing I can quit and opt to no longer have the benefits is actually a relief to me.

          I've tried to live by the motto "I may have _____, but it doesn't have me".

          Somewhere along in this particular event in my life I have come to realize that the motto does not mean to work my body into the ground, ignoring my health issues, until I am almost in my grave, literally.

          Blessings and thanks,

          Butterfly

          Comment


          • #6
            I think you are making the assumption that if you quit, you will automatically not be eligible for STD or LTD benefits. That is almost certainly NOT the case.

            I said you could quit your job if you wanted to. I also said that doing so would not make the problem go away.

            I have been administrating employer-sponsored benefits for over 30 years. In all that time, I have never seen and only once heard of a plan where disabilty benefits stopped when employment did. Depending on the way your plan is written,benefits may or may not continue automatically regardless of your employment status and regardless of what you do. It is not by any stretch of imagination a guarantee that if you quit, your disabilty benefits will stop.
            The above answer, whatever it is, assumes that no legally binding and enforceable contract or CBA says otherwise. If it does, then the terms of the contract or CBA apply.

            Comment

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