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So my wife got a letter


Longjohn
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4 minutes ago, Kirby said:

Are they still paying her (so that they can offset against those amounts while the dispute is going on) or are they expecting you to pay?

 

They said her payments will be suspended until she returns the overpayment.

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Some good suggestions in this thread.  Also, as a last resort, is there a local consumer affairs reporter in the area?  Sometimes they can put on pressure that gets a resolution just so the company can avoid some bad press.  I'd follow the more constructive suggestions in this thread first, but keep it in mind for a last resort.

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3 minutes ago, team scooter said:

Mrs Scoot is in health insurance. She says first, appeal it, and send a copy to your State Commissioner. That info should be on the letter they sent you. They'll investigate and and determine if your provider processed your account correctly, and let you know your options.

What Scooter said. Put C.C. PA State *Comissioner at the end so the long term care provider knows the authorities have received notice and you only have to write one letter and mail two. Stick to the facts with dates etc. Certified mail is a good record for you too. *whichever commission oversees the insurance industry in PA. 

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The thing of it is they probably did overpay her. They said they were going to help her apply for SSI benefits and they would deduct the SSI money from the long term disability. She told them she had already applied for early retirement Social Security benefits so she probably could not get SSI.  They never followed through with anything and my wife is bedridden and can’t go to any appointments. Actually she has had a lot of trouble talking with them on the phone since her brain tumor.

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2 minutes ago, Longjohn said:

The thing of it is they probably did overpay her. They said they were going to help her apply for SSI benefits and they would deduct the SSI money from the long term disability. She told them she had already applied for early retirement Social Security benefits so she probably could not get SSI.  They never followed through with anything and my wife is bedridden and can’t go to any appointments. Actually she has had a lot of trouble talking with them on the phone since her brain tumor.

And she should not have to do any of this from her hospice bed.  Please get someone to help you navigate through this.

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27 minutes ago, Airehead said:

And she should not have to do any of this from her hospice bed.  Please get someone to help you navigate through this.

Our system sort of sucks in that when you are old and completely worn oot from dealing with bureaucratic bullshit all your life, it all gets exponentially more burdensome.

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1 hour ago, team scooter said:

Mrs Scoot is in health insurance. She says first, appeal it, and send a copy to your State Commissioner. That info should be on the letter they sent you. They'll investigate and and determine if your provider processed your account correctly, and let you know your options.

Ahh, the wisdom of community!

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16 minutes ago, Page Turner said:

ASk for a clearer explanation of  why they think she is overpaid, and how, and try to establish from the gitgo that your wife told them exactly this (that she would never get SSI), and she told them about it. 

They are deducting her Social Security retirement money. She gets $832.00 a month SS early retirement income. The lady at Social Security office talked her into that. Dumb move but we didn’t know.

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44 minutes ago, Longjohn said:

They are deducting her Social Security retirement money. She gets $832.00 a month SS early retirement income. The lady at Social Security office talked her into that. Dumb move but we didn’t know.

...if you are still within the first year of her starting to get those benefits, you can withdraw it.

Withdrawing Your Social Security Retirement Application

 

Get someone who is good with numbers to crunch them for you on this, and see if it makes sense. If it's a possibility, notify them right away that you want to do so.

This was the other reason I got out of that career.  I worked with a lot of people who did not understand the complications, and in a private enterprise, would probably have gotten sued for malpractice. :urfired:

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6 minutes ago, Page Turner said:

if you are still within the first year of her starting to get those benefits, you can withdraw it.

Too late, they say they overpaid her for 15 months before they told us. I think in her case the bottom line will be about the same. If she was expecting to live for more years she should have waited to collect full retirement.

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4 hours ago, Philander Seabury said:

Our system sort of sucks in that when you are old and completely worn oot from dealing with bureaucratic bullshit all your life, it all gets exponentially more burdensome.

Not just sorta. It sucks big time. If you can't produce you're a drag on society. 

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...I am here finishing up a set of wheels, and when I do that, my mind wanders.  It occurred to me that long term disability policies are written in two basic ways (at least the ones with which I am familiar.)  

 

One  offsets any benefit they pay, (which is supposed to replace your lost income from working,) for any additional other income you might receive (like social security retirement benefits.)  The other applies an offset only in the event such other income is also based on a determination that you are disabled.  In which case social security retirement benefits, taken early and based on age, would not be an offset to the policy benefits.

 

The language is usually way back toward the last pages of the policy as written, in paragraph 69, subsection b or something like that. It's not unheard of for an insurance company to make an error in this assessment, assuming the payments your wife receives from SSA are also based on disability.  So you ought to read that section of the policy, when you get an hour to kill, with your fine print reading glasses on full magnify.  That's all I got. The wheels are done. Good night.

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