Veterans Benefits Can Offset a Long Term Disability Insurance Payment? Judge Steven Colloton on the Watchlist.

At MS Activism and at Illness and Insurance Hell, I have written extensively about long term disability insurance policies. If the plans are group plans, they are worthless for you the consumer. As a means for making billions for the insurance companies, they are stellar.

Here is a link to the 2009 U.S. Group Disability Mid-Year Market Survey Summary of Results. On page 5 of this survey you will see that with 27 insurance carriers reporting, that is 95% of the group disability insurance market! They have a strong hold on the market and on making sure that claims are never paid out.

And if you have a group disability plan and you have Multiple Sclerosis, this is particularly dangerous since those with MS suffer from an incurable and expensive disease. Your group LTD plan will fight to NOT have to pay your claim should you become too ill to work.

They also do something else: Offset your plan benefits with other “sources” of income, with sources being open to interpretation under ERISA and the judge listening to the case. Which brings me to Judge Steven Colloton.

If you, the MS sufferer, do not have other sources of income for your disability, they will force you to apply for them. They will force you to apply for Social Security Disability benefits or they will deny your claim. That is what CIGNA told this family in 2008.

You know what else these fine upstanding corporate citizens do? They try NOT to pay their contractual obligations by offsetting disability payments through Veteran’s Benefits. I present to you Riley v. Sun Life and Health Insurance Company. Their “leadership” page is here.

Mr. Riley has Multiple Sclerosis and his group plan, Sun Life, did not want to pay him the full benefit amount because he receives Veteran’s Benefits.  Sun Life, using ERISA, deducted the amount they agreed to pay him through his group LTD policy by the amount he receives for being a veteran of these United States.

Riley is a veteran of the Vietnam War and receives monthly disability benefits pursuant to the Veterans’ Benefits Act, 38 U.S.C. §§ 101 et seq., (VBA) as a result of his MS. The administrative record indicates that Riley’s MS is considered a service-related disability contracted during a period of war.1 In 2007, in the process of updating Riley’s records, Riley completed a supplemental questionnaire from Sun Life disclosing his receipt of these VA benefits. After gaining this knowledge, Sun Life took the position that it was entitled to offset the amount that Riley received in VA benefits. The Plan provides that monthly disability payments can be reduced by “other income,” and, as relevant and relied upon by Sun Life, the Plan defines “other income” as “[a]ny amount of disability or retirement benefits under: a) the United States Social Security Act [SSA] . . .; b) the Railroad Retirement Act [RRA]; c) any other similar act or law provided in any jurisdiction.” Sun Life recalculated Riley’s benefits offsetting his VA benefits and claimed a net overpayment of $20,831.06 for the years that Riley received both VA and Plan benefits without offset.

Two of the judges of the Eighth Circuit sided with Mr. Riley. One did not. Judge Steven Colloton dissented.

Judge Steven Colloton dissented and sided with Sun Life thereby wanting to put into the hands of a corporation money contractually owed Mr. Riley by the amount deducted from the taxpayers of these United States for taking care of our veterans.

Judge Colloton was appointed to the Eighth Circuit in 2003 by George W. Bush and is now on the Multiple Sclerosis Activism Foundation’s Watchlist.

 

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