ASK "BERNIE THE ATTORNEY"
From Spring 2012 Forum
Q. I am a recipient of SSDI and now that the year is 2012, how much gross before taxes can I earn per month without being considered as engaging in substantial gainful employment activity and thereby jeopardizing my monthly SSDI Benefits?
A. The monthly amount has been increased by $10.00 per month so that the total gross amount you can earn before taxes, if you are not deemed blind, is $1,010. per month. If you are blind, you can earn $1,694.00 gross before being considered to be engaged in substantial gainful employment activity. However, there are exceptions to both of those. If you are also collecting long-term ERISA disability benefits from an employer sponsored ERISA plan, such work activity could result in your being classified as capable of regular sedentary employment and could result in loss of your ERISA long-term disability benefits. In addition, if you have signed up with Social Security for a 9 month trial work program, during those 9 months --- and they need not be consecutive months, any gross earnings in excess of $780. per month will count as one of the months used in your 9 month trial work period. Another area of concern is that if you work part-time for a company which gives all of its employees bonuses if the company does well regardless of your individual, limited participation, that unexpected bonus is additional income so that if in any one month your pre-tax earnings and your bonus total $1011 or more, eventually SSA will be in contact with you to require you to repay the regular SSDI SSA Benefits you received that month. Therefore if you received regular SSDI Benefits of $2,000. for that month, that extra bonus, even if it was nominal such as $50. which caused your income to exceed $1010 that month, will require you to repay the entire $2,000 back to SSA. If you do not have the $2,000 they will deduct it from a future payment due you unless you can show that it was not related to your own limited accommodated work or unless you engage counsel to oppose the repayment by showing that it was unrelated to your own performance and was similar to a dividend, i.e. paid to every employee regardless of his or her own efforts at work. If you had been on the 9 month trial work period plan, then your benefits continue without risk regardless of what you may have earned in any month during the 9 month trial work period. As a practical matter, the 9 month trial work period often has a 2 month grace period so that, in effect and on occasion, the 9 month trial work period can actually be an 11 month trial work period. If any questions, check with SSA or your attorney, or if you do not have an attorney, you may send your inquiry to the National CFIDS Foundation, Inc. c/o "Bernie The Attorney."
Q. Before becoming totally and permanently disabled, I worked for a large company which sponsored an employee welfare long-term disability benefit plan also known as an ERISA plan. When I first became employed, the plan's benefits did not discriminate between "mental and nervous condition," or a strictly physical disability. Several years after I had been working there, the plan's terms changed so that those employees who are totally disabled by what the adjusters consider to be a "mental and nervous condition," are entitled only to 24 months of benefits while those whose disability is deemed "physical" are still covered until age 65. Is there any thing I can do to contest what I believe is a discriminatory lowering of benefits for those of us who are totally disabled by what the plan deems a "mental or nervous condition," with maximum entitlement being only 24 months?
A. Yes, there are several things which may be done. The first is to be sure that you timely file all of your internal appeals with the plan administrator AND its insurance underwriter. Second, file a complaint for discrimination with your local state Commission Against Discrimination and with the local federal EEOC office. Third, file a complaint with the Office of the Attorney General of your state, consumer protection division. Fourth, file a complaint with the local federal Department of Labor. Fifth, file a complaint with the Commissioner of Insurance in your state as well as determining if the plan insurance underwriter notified your state insurance division and, if it did, whether or not the insurance underwriter or the plan received written permission to reduce benefits without reducing its premiums to the employer which sponsored the plan or the insurance underwriter acting as an administrator of the plan. Fifth, file a written demand of the plan administrator and the insurance underwriter (and check Human Resources and the language of the plan to verify the accuracy as to who exactly is the plan administrator and who exactly is the current insurance underwriter) and make sure to send each a letter by Certified Mail, Return Receipt Requested demanding copies of the true accurate and complete actuarial tables and employee handbooks and manuals which justify the reduced benefits of only 24 months for any employee-beneficiary totally disabled by what the plan, the insurance underwriter and their adjusters consider to be a "mental or nervous condition." Not since the days of Prohibition and Al Capone has any business reaped such huge and undeserved profits as has the long-term disability insurance industry in the payment or more appropriately, the non-payment of ERISA (employer sponsored long-term disability benefit plans, more accurately the Employee Retirement Income Security Act) and the tortuous treatment perpetrated by them on the plan beneficiaries whose only wrongdoing was to become terribly ill and totally disabled. For more about this, check the internet for the "Ten Worst Insurance Companies," and also a small entity which helps guide the insurance giants to avoid disability payments to the totally and permanently disabled employee-beneficiaries. The name of this profitable "non-profit," is Disability Management Employer Coalition and its web site is www.DMEC.org.
If any questions about any of the foregoing, please contact your own attorney. If you do not have an attorney, you may then address your questions to "Bernie The Attorney," c/o the National CFIDS Foundation, Inc. 103 Aletha Rd., Needham, MA 02492-3931 or by e-mailing via www.NCF-NET.org or by calling (781) 449-3535.
If anyone is interested in participating in any class action against a particular employer plan administrator, or an insurance underwriter, or a long-term disability insurance company, or long-term disability benefit insurance plan administrator, please likewise contact "Bernie The Attorney," as above.
The National CFIDS Foundation * 103 Aletha Rd, Needham Ma 02492 *(781) 449-3535 Fax (781) 449-8606