MetLife Disability Policies

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Debbie of Bryan, TX November 1, 2009

MetLife used every dirty trick in the book against me like they do against others posting here. I fought them for 5 years in court and lost even though I was examined by a panel of 50 doctors who consulted and diagnosed me with a rare disabling illness. I had doctors that insisted all along that I was totally disabled, but Metlife hired doctors who never met or examined me to say that I wasn't, and the judges bought it.

Here is my best advice for supporting your medical information. Buy a fax machine and fax a summary of every phone conversation you have to the case manager right after you have it. For example, "As we discussed today at 3:24 pm, I will be sending you the report." Next, send a copy of the fax by regular mail or certified mail, receipt requested, if it is a highly critical document. You will use the fax machine for sending documents like doctor reports and test results. Always send a paper copy by regular mail too.

Keep a notepad by the phone and record every phone call or event that happens with respect to your case including all attempted, but not completed phone calls that you make. WARNING Metlife will attempt to get a "negative" response from your physician without your knowledge. They do this by sending a FAX to your doctors, typically on a Friday afternoon, with the language something like this...."Our physician believes that she is NOT disabled. We assume that you AGREE with his findings unless you notify us within 7 days." This is a very short time period for a doctor to respond, especially when sent over a weekend. WARN YOUR DOCTORS AND THEIR STAFF AHEAD OF TIME. Tell them that this may be sent to them and let them know that you will be willing to help IN ANY WAY to meet the deadline if this occurs. Mostly, you need to be told so that you can request additional time for your physicians if they require it.

WARNING #2 Read your policy closely if MetLife claims the right to your children's social security funds and you are divorced. Under the terms of some policies, MetLife is not entitled to this money if you are divorced.

STRATEGY Review your policy. Under the terms of your policy, you may be entitled to a complete copy of your MetLife file. This is valuable information if your case should go to court because each document will be stamped with a ML document number giving you proof that they received it and when. The independent physician consultants are required to review the entire file and should be held responsible for what's in there. I said should because I feel the courts have given way too much validity to these IPC's henchmen. For some unknown reason, judges are still pretending they have some independence when it is pretty clear to most that they don't.

Lastly, if you decide to fight ML in court, look for a really good lawyer. Then, take AT LEAST another week and look for one that has good trial experience and demand to know his success rate. if he beats around the bush about it, hang up. He's not the one for you. Ask him if he has ever been to the Appeals Court or filed papers for someone to file as a pauper. If not, move on. It may seem harsh, but I thought there were very few lawyers that did this kind of work. I was wrong.

james of saugus, CA October 23, 2009

Filed a claim for Long Term Disability, as I had paid for the plan for years through my employer, and now need assistance. Have been told that they need more office notes, that the information my doctor has sent them in not sufficient for their nurse to determine eligibility, they just keep dragging their feet and delaying.

Yordith of Greenlawn, NY September 22, 2009

I became disabled on June 14, 2009 with a knee injury. I had arthroscopic surgery on July 13, 2009 with the postoperative diagnosis of Displaced Bucket-Handle Tear of Lateral Meniscus, Un-Repairable, with Synovitis of the knee. Two days after surgery I started experiencing excrutiating pain in my lower leg. I had a duplex sonogram of the leg, and found out I have a DVT - blood clot, as a result from surgery. I was hospitalized yet again. The hospital set up home health care nurses and physical therapy. I was on Lovenox injections twice daily and Coumadin.

I am now seeing my orthopeadic surgeon montly, and the hematologist twice weekly to check blood levels and to montitor my coumadin level. I last saw the surgeon on August 18, 2009. Met Life stopped payments on August 30, 2009. Since this last appointment the surgeon's office has faxed Met Life 7 times! Office notes, operative report, radiology report, physicians statement. The Hematologist has faxed Met Life twice information regarding the DVT.

Every week Met Life is demanding more and more information, and we are abiding and following their directions, including my doctors. Every week, when I speak to someone they inform me they did receive the faxes and a determination will be made in 5 business days. On the 5th day, one of the case managers that I listed will call and demand MORE office notes.

As of today, Met Life owes me 4 weeks payment. I see my surgeon on September 24, 2009, and I'm hoping he says I can go back to work. But what about the money I am entitled to from Met Life? Why are the putting me through this? They have received all the information they have requested. The doctors offices have confirmation of all the faxes. I have confirmations of all the faxes I sent to Met Life.

Marie of San Antonio, TX August 10, 2009

I was approved for LTD from January 06 through July 2012. Now I am no longer apporved because they requested information from a doctor other than my own. They saif they tried six times to get info from this doctor and when I told them that was not my doctor, they flipped through their notes and realized I was right but stated they still agreed with the closure because they had not received the requested doctors information. Huh? If you do not request info from the right doctor you won';t get any info. The rep then refused to send a request to the right doctor, the one they did have on file, becasue they had made 6 requests from another doctor. But If I had MY docotr send in my info before July 20th, they wouold reopen the claim. I did that and Metlife didn't. What a waste! I have RSD. There is no cure or treatment. I can only be made conmfortable on medications until I die. All at the ripe old age of 39.

Lori of erlanger, KY July 16, 2009

I have all documentation to support a short term dis and metlife is refusing to pay this out on unexplained grounds i have put in about 1000 calls that have never been returned and have been told that my dr. office never calld in info that had been documented by my office that they called on 3 seperate occasions

sharon of clayville, NY July 14, 2009

metlife denied my long term disability claim in march 2009, and I have yet to find this out. I've been calling each and every week on my claim....was told to send more drs notes. now, today 7/14/09, I'm told I need to appeal the denial! WHAT DENIAL!!!Noboby calls back, nobody will help, what am I suppose to do? I was told by a customer service rep , that I have 90 days to appeal! How do I do this?I have been sick for 2 years with Meneires disease. Not only is there NO CURE for this disease, no only has it robbed me of a normal life, I have to deal with this from metlife!!! I even have to have someone else do this complaint for me.

Eric of Oakland, CA June 23, 2009

On September 24, 2007, I sustained an injury while on the job. MetLife's disability insurance was purchased through the union and premiums were paid through Mar 2009 when my sick pay was exhausted. I applied for benefits on October 2007 and to this day, I keep getting obstacles to overcome before I would even be considered for benefits. On June 20, 2009, I received a packet that I had to verbally request from Ms. Bruce explaining the process that is preventing me from any benefits. The packet stated that information needed to be returned to them by June 19. Mind you, I got the packet on the 20th. It seems that they will do anything to avoid paying benefits without a denial.

Okimma of Sacramento, CA June 18, 2009

In september of 2007 i was was brutally attacked by my ex husband at work to wear i had to go on short term disability which I ended up being out longer than expected so i was told by my employer that they had started a ltd with metlife for me because i had been diagnosed with anxiety and post traumatic stress from the attack and having to testify against my ex husband.

I was asked by metlife to fill out this book of paper work and have my dr do so as well they kept saying they didn't receive it they need more info and everytime i sent it the last and final time was 05/27/2009 i watched my dr fill out the paperwork and fax it over to them and get a comf number stating that the fax was sent they called me and adv that the claim had been denied for not enough info supporting my claim adv that i was released to go back to work on 01/29/2008 which was the date my ltd payments should have started from them however i was still going to court and seeing my victims of violent crimes counselor and recieving std payments and they had the documents saying that i was released to go back on the 13th of apr 2009 per there rep

due to them not paying me I lost my car,house, medical benefits, and had to beg to return to work so that my benefits could kick back in so that i could continue treatments

Dennis of Hamilton, NJ May 11, 2009

IV paid out of pocked for one of MetLifes LTD policies for 27 years! Mever having to use in until just recently. They started paying my claim right away. But only 50% of my income. Now keep in mind, that IV worked for the same company for 27 years. I was forced to file for SSD and was also told by MetLife that If I had any savings or even sold my vehical, this would result in an overpayment and I would have to send them 100% of any financail gain I should get. I won my workmans comp. and was paid three years of my former salary. But I was also terminated by my company, becasue they claimed I was no longer employable. So MetLife decided to stop my LTD until I paid them everything I won in my wrokmans Comp. settlement. Wich was only two years salary lump sum.

Amber of Orange Park, FL May 5, 2009

In October of 2008, I started having horrible pain in my abdomen. My doctor starting doing tests to try to figure out what was going on and decided that I should stay out of work until we could figure out what was going on. I called my boss at Citi to inform him of this and he proceeded to tell me about Metlife and that I should call them and get started on the claim. I did that and they told me what they needed. My doctors office as well as myself, faxed over all the medical information that they needed. They said it wasn't enough information for anything and asked that we had the Doctor call.

I was in the doctors office atleast twice a week from October till November when my primary doctor said after my cat scan that I should go to a specialist. I went to see the specialist and he said that I needed to go into Surgery, which I did on December 10th 2008 for Laproskopy. When I found out that date, I contacted MetLife and told them of such. On that day they called and left several messages even though they had on file the day and time I was going into surgery. I had a family member dealing with them at this because I could not understand why they weren't approving me.

In December I was finally approved for part of October's absence. Which Citi managers are saying they already paid me for my disability in October, which they haven't. Yet the regular customer service people also say that I have not been paid anything. Since December the only thing that they've been saying is we need more information we sent over all my medical records when they recieved that we contacted them two days later and they said that that wasn't enough they needed a letter from the doctor stating the scale of the pain on a 1 to 10 base, why I've been out for so long, when my follow ups are and what my restrictions are.

Then when recieving said letter, we were told that it was just a letter that there is no medical information to support that. They also said that their nurse says that I could be going to work this entire time. My doctor still hasn't released me to go to work yet, and as it stands I'm on an experimental treatment. I am on and have been on various pain meds since October. I recently recieved a letter from my job saying that I will have resigned my job as of April 30th because MetLife told them that I hadn't appealed yet, when I wasn't even informed that I had been declined, since the last information that we sent them. Also they said since I have an original appeal letter in the file that that would be my appeal letter once it actually got to the appeal process.

I called recently to figure out what was going on when I recieved that letter a week and a half ago, and they said well you're still in appeals let me pass you over to the manager that should be handling your case. They do so and that manager is on vacation until June or July 27th. Every other time I call they say that their systems are down and noone will talk to me. They have been giving me a run around for the past few months, and wont approve me because apparently endometriosis isn't a reason to stay home.

The doctors have even said I have a rare case where one its burrowing into my organs and well as the fact that it is growing rapidly for some reason. Both of the doctors I have been seeing have said I can not go to work. But because MetLife says I should be able to they won't pay me for my disability. Its either not get paid by MetLife and stay home and have my normal insurance pay all my medical bills for surgery and the medicines and the pain killers and follow up sessions I have to go to, or I break the law drive in horrible pain to work taking my pain pills at work and have my insurance not pay my medical bills because the Doctors said I shouldn't be going to work. I'm still not released to do so. I'm still on pain meds and muscle relaxers all the time.

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