Why is my mother's insurance company holding back her disability checks?

In My Humble Opinion
1

She fell very ill almost six months ago, she is doing better now, but is still unable to work. I believe that she received her disability checks for two months and then it was cut off.

My mother is trying to apply for permanent disability now, but they are taking forever to send her checks. They keep saying they need this or that from her doctor and her previous job. My parents send in the stuff, the company say they will send them her check, they don’t get the check, my parents call them back, and the company says they need more documents. This cycle has been going on for almost four months.

Another thing, my father is trying to get certain documents from my mother’s job that list figures of what she made and what was taken out of her check for thing like social security. They keep sending him letters, but none of them have figures.

Sorry if I am not being clear, my father is not the best communicator (and I know nothing about money matters), and this is what he told me. Bottom line is that my mother has not received any money from disability or any other service in 3 months, eventhough they have been applying for them.

2

If your father has access to their tax returns from last year, that should show all the deductions (well, the W-2s would).

Is the disability insurer associated to your mother’s job? If so, they should complain to the HR department at that employer.

Also consider filing a complaint with the state insurance commissioner.

Maybe even a lawyer specializing in disability cases.

The short answer to your question is probably “because they’re scum and are trying to weasel out of paying”.

3

this is more mrAru’s area of expertise, he does short term disability casework for a major insurance company … but Ill have a go at it.

From what I understand your mother was apparently on short term disability. The amount of time you can spend on STD varies by the arrangement that her employer has with the insurance company. She had to qualify to get it - mainly the employer had to have it as part of the insurance coverage, she had to have a diagnosis and certain claim forms from her doctor. Obviously she qualified to get it for at least the period of time she was getting the checks

Now it gets tricky. I am not a STD case worker and not involved in her insurance company and not a lawyer and any other comments I should make …

I am going to say for sake of argument that your mom had her head removed as I have no idea what she had done …

So the doctor scheduled her for surgery to have her head removed and they lopped it off. It is now on the nigerian site as a roomie of the guy who claimed he was a disembodied head. Her body is now at home recovering.

Now, the insurance company s working from a book that has listed the acceptable timeframe for short term disability. Their book says that the approved recovery time for this operation is 3 months. The doctor provided documentation that her head was removed and she was released to home. She then got the appropriate checks in the mail for 3 months. She should have gone back to work, but something happened where she needs to change from short term [typically 3 months and under] to long term disability.

At this point in time, the poor STD caseworker is going nuts trying to get documentation from the doctor to move her to long term disabiliity, and she will get a check to make up for the missing income from the time STD ended and LTD started.

Alternately, the company only got the 3 month with no long term disability, in which case she is hosed because there is no provision for long term so she needs to contact social security and get put through a lot of torment proving that she can not work.

Since I read that she was on disability for 6 months, she may have fallen under the term limits of disability for short term, and now needs to be changed to long term, but for some reason the documentation is not being provided - from the physician, not her payment records … Disability has actually nothing to do with you r paycheck as they already had that information [note she did get checks for 2 months]

I believe what you need to do is contact her specific case worker, make certain the exact documentation they need, and if it is from the doctor, get on the phone and demand that his office respond to the insurance company immediately. [you have no idea how much mrAru complains about doctors offices never calling him back with the documentation he needs]

As to the information your dad is trying to get, any paycheck stub will have that information on it, as will her W-2 form from January … and by law they have to provide that information in most states in the US. Get in touch with your local labor board if they keep stonewalling him on her pay information.

4

It sounds like you described the problem in the OP. They aren’t paying the disability because they haven’t received the pay information. It doesn’t sound like the insurance company is holding anything back, they are unable to pay because they don’t have the needed documentation.