To Share or Not to Share: LTD and the Internet (Professional Relations Services)
Surveillance is one of the tools an insurance carrier may sometimes use in assessing a claim for long-term disability (LTD) benefits. This is not a new practice nor is it illegal. But did you know that the personal information you share over various Internet social networks may also be used in assessing a claim for LTD? Some Internet users share a wide range of personal information on Internet postings and for insurance companies an Internet search is much less expensive than hiring a company to conduct surveillance.
Information disseminated on blogs, chat rooms, websites, Facebook, Twitter, etc. is in the public domain and potentially available to anyone; it cannot be controlled. More and more employers are using these networks for a wide variety of purposes: for background checks on those applying for jobs or post-secondary education, in various kinds of litigation, and in assessing LTD claims. Remarks made in social network conversations that may seem benign to the casual reader could prove problematic to the success of an LTD claim. Carriers will look for personal descriptions of events (e.g., vacations, trips) and activities (e.g., sporting events, recreational activities) that suggest that the author is not as disabled as claimed. The frequency, complexity, and coherence of postings will be compared against claims of cognitive restrictions. Criticisms of the insurance carrier or participation in chat groups defined by a specific diagnosis or condition will be scrutinized. The carrier may use postings to assess or impeach the credibility of the claimant.
Many believe Internet networking sites are not accessible to third parties, and that the information they share is private. But there are ways of garnering information without your explicit knowledge, information that could be used against you when you claim LTD benefits. As well, the insurer does not necessarily reveal what information it has, so you would have no way of knowing that this type of “surveillance” has been used in assessing your claim. In the course of a court action, you could be ordered by the court to provide the carrier with your Facebook account access and other Internet information.
To Pay or Not to Pay: Continuing LTD premiums during a leave of absence
One of the questions members frequently ask is whether to continue paying LTD premiums during an approved leave of absence. In general, this is your decision to make as a member of your group plan. But there can be significant consequences when LTD premiums are cancelled, and you should know what you are giving up. If you elect to discontinue LTD premium payments during a leave, your LTD coverage may still be reinstated when you return to work. However, you will be treated like a new hire by the insurance carrier. Any future claims following your return to work will be subject to pre-existing limitations for a period (often a year or more) after reinstatement of your LTD coverage. If a disability in that initial period relates to an entirely new condition, benefits may be paid. However, disability benefits may be denied if you had medical care related to the condition in the period before you returned to work. Such medical care may include consulting a doctor, using medication, or receiving other medical services or supplies. In this case you could be denied disability benefits beyond the year or more that the limitations clauses stipulate. While you still have the option of using your sick leave credits, if your illness is prolonged these may expire long before you can return to work.
Unfortunately, we do hear some very sad stories about members who have chosen to cancel premium coverage, and have subsequently suffered a significant illness for which they were not covered.
ETFO has always recommended that members continue LTD premiums during any leave of absence. While saving money upfront might be very appealing, cancelling premiums can cost you far more than you expect.
Professional relations services (PRS) staff at ETFO are trained to help you with a variety of issues:
- resolving conflict with colleagues, administrators, or parents
- legal issues related to your employment
- allegations related to employment responsibilities
- concerns about teacher performance appraisal
- College of Teachers matters
- Workplace Safety and InsuranceBoard(WSIB) matters
- long-term disability claims.
All services are completely confidential. If you have a question or concern, please call 1-888-838-3836 or 416-962-3836 and ask to speak to the PRS staff person “on call.” After regular office hours, an answering service will direct your urgent concerns.