Am I elig for a back disability insurance payment?

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Am I elig for a back disability insurance payment?

I worked for over 9 years for a large employer and paid for a long term disability
account. I left work due to disability, however the long term disability insurer
decided I didnt t meet their definition of a disabled person, and paid me a small
amount because they only considered me disabled up to a certain date. I was
subsequently found to be disabled by the soc sec disability admin and a US federal
jusge, back to the date of my leaving work. Am I entitled to reopen the decision of
the insurance co. to consider me disabled only to a certain date? the date was
about 6 mos. after I left work I appealed their decision at the time and was denied.

Asked on April 18, 2018 under Insurance Law, Utah

Answers:

SJZ, Member, New York Bar / FreeAdvice Contributing Attorney

Answered 2 years ago | Contributor

The determination by Social Security and the U.S. federal court case do not have any bearing on the determination by the insurer as to long-term disability. Since long-term disability is a different program than Social Security disability and as such has different criteria; since the insurer is not under the supervision or control of the SSA; and because the insurer was not a party to your Social Security case and so any ruling therein is not binding on the insurer (under the doctrines of res judicata and collateral estoppel, a court ruling only binds those parties who were part of the case and so had a chance to participate in it)--for all these reasons what happened with Social Security is irrelevant to your long-term disability. You have whatever remaining appeal rights for the disability case that you have not used yet, but no additional rights due to the Social Security decision.


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