Guardian Life Insurance seeks overpayment of disability benefits for child social security disability benefits awarded to disabled claimant's daughter
A recent lawsuit filed against Guardian Life Insurance Company highlight an issue that comes up regularly for disability insurance claimants that have minor children and are approved for Social Security Disability Benefits. Monica Johnson has been receiving long-term disability benefit payments from Guardian Life (Guardian) since August, 2003 as result of her becoming completely and totally disabled in April, 2003. Under the terms of the group long-term disability benefit plan Monica purchased while working for EBE Office Source, Inc., Guardian is allowed to offset her monthly benefit payment according to the amount of Social Security disability income she receives.
Ms. Johnson applied for Social Security Disability Income (SSDI) in 2005, and was approved by the Social Security Administration on or about August 18, 2009 to receive disability income payments retroactive to July 1, 2005. Ms. Johnson’s monthly SSDI payments amounted to $1,545.80. Guardian was already paying Ms. Johnson $2,505 per month up until the time she was approved for SSDI in 2009. That means Guardian can offset Ms. Johnson’s payment by $1,545.80.
Guardian did some calculating upon being notified of Ms. Johnson’s SSDI approval, and concluded that they overpaid Ms. Johnson to the tune of $70,232 between July 1, 2005 and January of 2010. At that time, Guardian withheld payment from Ms. Johnson until a time such that Guardian felt that they had been properly reimbursed for overpayment of benefits. With the combination of a lump sum payment made by Ms. Johnson and Guardian withholding disability benefit payments from her, Guardian informed Ms. Johnson it in a letter dated December 8, 2010 stating that terms for reimbursement to Guardian have been satisfied.
But now, Ms. Johnson’s daughter, Jenna, is thrown into the mix.
As an unmarried minor living with her mother who is completely and totally disabled, Jenna Johnson is entitled to apply for child benefits under the Social Security Act. Having been approved to receive Social Security benefits, Jenna received a monthly benefit of $772 per month as of July 1, 2005.
Monica Johnson, the aforementioned claimant and Jenna’s mother, received a letter from Guardian on February 17, 2011 stating that per terms of the group long-term disability plan she purchased prior to becoming completely and totally disabled Guardian could use the amount of the monthly Social Security benefit Jenna receives to offset the payment Guardian makes to Monica every month. With that said, Guardian claims they overpaid Monica and additional $49,168.54 since Jenna’s monthly Social Security benefit was not factored in to Monica’s monthly payments from Guardian. Guardian said they would withhold monthly payments to Monica and also demanded Monica to pay a lump sum of $41,448.54 to Guardian until reimbursement had been made.
Not so, says Monica. That’s why she filed a civil complaint on behalf of her daughter in United States District Court for the Eastern District of Pennsylvania against Guardian with the help of her disability attorney to prevent Guardian from, in essence, taking away Jenna’s monthly Social Security benefit.
Ms. Johnson alleges that her daughter relies on her Social Security benefit so she may have a place to live, food to eat, clothes to wear, and other necessities of life. Furthermore, Monica alleges that neither she nor her daughter assigned Jenna’s Social Security benefits to Guardian. Ms. Johnson further alleges that pursuant to section 207 of the Social Security Act, “Jenna’s future SSD child benefits may not be assigned or transferred.”
Therefore, Monica Johnson is suing on her daughter’s behalf to keep Guardian from essentially taking away Jenna’s child benefits from Social Security. Ms. Johnson is asking the court to compel Guardian to pay her long-term disability benefits without deducting the amount her daughter, Jenna, receives from Social Security. Additionally, Ms. Johnson is asking for any lost income benefits that were withheld as result of Guardian deducting Jenna’s monthly Social Security benefit. Finally, Ms. Johnson asks the court for reasonable attorney’s fees and costs related to this litigation.
It will be interesting to track the outcome of this case. If the disability policy specifically allows for an offset for child disability benefits, then this will be a difficult case for the claimant to win. However, if the policy has language which violates state or federal law, then the court can rule in favor of the claimant.
Resources to Help You Win Disability Benefits
Disability Benefit Denial Options
Submit a Strong Guardian Appeal Package
We work with you, your doctors, and other experts to submit a very strong Guardian appeal.
Sue Guardian
We have filed thousands of disability denial lawsuits in federal Courts nationwide against Guardian.
Protect Your Benefits
Get Your Guardian Disability Application Approved
We help claimants throughout the entire application process.
Prevent a Guardian Disability Benefit Denial
We manage every aspect of your disability claim following claim approval.
Negotiate a Guardian Lump-Sum Settlement
Our goal is to negotiate the highest possible buyout of your long-term disability policy.
Guardian Reviews
(660)
Policy Holder Rating
5
0%
4
0%
3
0%
2
58%
1
41%
Timely Payments
1.9out of 5
Handling Claim
2.4out of 5
Customer Service
1.9out of 5
Dependable
2.2out of 5
Value
1.9out of 5
Showing 8 of 660 Reviews
Guardian
Guardian not being flexible during Covid
Guardian denied my LTD due to doctor’s office not sending medical records quickly due to office closed because of Corona virus. There was nothing that I could do to get ... read more >
Reply
Guardian
Guardian thinks people with lupus miraculously recover
I became disabled in 2018 (Lupus and Sjogren’s). I’m 54 and I worked over 30 years (for the government) before I became disabled. I received Guardian STD and then LTD ... read more >
Reply
Guardian
Stress over Guardian caused my heart attack
All of a sudden (after 12 years), Guardian LTD is sending more and more paperwork – especially after someone stole my identity and filed taxes in my name. The IRS knows ... read more >
Reply
Guardian
The IRS should know that Guardian refuses to send my W-2 form
I have received Long Term Disability through Guardian. They cut off my checks in July of last year. I appealed their denial and won. Now I am fighting them to get my W-2 f... read more >
Reply
Guardian
Guardian cancelled my husband's claim without checking his medical records. Do better. We have children to feed and bills to pay.
My husband was disagnosed with a long term debility in October 2016. In March 2017, Guardian sent him a form that said his doctor saw him on march 3, 2017 and cleared hi... read more >
Reply
Guardian
Guardian has built-in denial for self-employed individuals
I have had a non employer Guardian LTD policy since 1991. It is for full disability. I have never had a need for it. Now that I do, I am finding they are doing all they ca... read more >
Reply
Guardian
Guardian has the least helpful folks I have ever met
Trying to get my husband’s short term debility started after a heart attack. I don’t understand their process for collecting information and making a decision about hi... read more >
Reply
Guardian
If you work for a company who offers Guardian, tell them NO and get a non ERISA provider. Guardian lied about my options and then tried to tell me I'm not disabled
I have been disabled for 15 years or so… The Guardian compelled me to apply for SSDI benefits to offset Guardian liability.. The Guardian even retained the atty… I won... read more >
Reply
Answered Questions by Our Lawyers
(24)
Showing 8 of 24 Answered Questions
Q: If I am covered by Guardian STD, why are they telling me to file with the state?
A: Guardian is telling you to file with the state as they will get an offset for anything the state pays you. Read More >
Q: I accepted and deposited a lump sum long term disability payment installment for underpayment from Guardian. Can they ask for money back if I try to work again?
A: In most lump sum settlements, once you receive a buyout then you can attempt to do anything you want once the ... Read More >
Q: How Does Guardian Calcualutate my Long Term Disability Benefit?
A: Christopher, you should request a detailed explanation and calculation of your long-term disability benefit fr... Read More >
Q: How long do I have to file my Guardian disability appeal?
A: Jennifer, if you have an employer provided policy you will have up to 180 days to file the appeal. If you woul... Read More >
Q: Can I claim a permanent disability to avoid a surgery that requires several months of down time without promising results?
A: Lia, each claim depends on the specific facts and circumstances of the case in conjunction with the specific t... Read More >
Q: Do I still need to fill out Guardian claim forms if I am eligible for Presumptive Total Disability?
A: Kate, it is common for benefit checks to be accompanied with claim forms as a matter of course. You can make i... Read More >
Q: Can Guardian make me file taxes on a non-taxable insurance?
A: Dan, Guardian cannot make you file taxes. Only a tax professional can determine whether your benefits are taxa... Read More >
Q: Does Guardian reduce the qualifying income when an STD becomes a LTD?
A: John, the document you are describing might not actually be the Long Term Disability Insurance Policy. The 270... Read More >
Helpful Videos
(910)
Showing 12 of 910 Videos
Disability Benefit Tips
(331)
Showing 8 of 331 Benefit Tips
Guardian Disability Benefit Claim Handling Tips
When you finally receive a letter from Guardian Disability informing you that your claim for long term disability benefits has been approved, it can be easy to assume it's smooth sailing from here on out. Unfortunately, approval isn't the end of the story - and if the claimant doesn't maintain the medical records and other evidence to support their continued rec... Read More >
Is Your Disability Insurance Claim a Physical or Mental Disability Condition?
Almost every Group (ERISA) Long Term Disability Benefit Plan contains a provision which limits the length of time disability benefits will be paid for a mental/nervous or mental health condition. If a disability results from a mental health condition, benefits are typically limited to 24 months and can even be limited to just 12 months. For this reason, disability insurance companies go to extra lengths to att... Read More >
Why Must Your Disability Insurance Lawyer Understand Your Disabling Condition?
When it comes to securing your disability insurance benefits, it's vitally important that your disability insurance lawyer thoroughly understands the symptoms and impact of your disabling condition. Doctors can help you create strong medical records, but they're not accustomed to dealing with the rigorous documentation disability insurance companies require. Lea... Read More >
Disability Benefit Denial Reason #5 – Your Medical Evidence is Weak
If you're seeking long term disability benefits from an insurance company, you may be concerned that you're facing an uphill battle. Fortunately, the stronger your medical evidence, the greater the odds that your claim will be approved. On the other side of the coin, one of the most common reasons for denial of long term disability benefits involves too-weak med... Read More >
Disability Benefit Denial Reason #4 - Your Doctor Is Misled By the Disability Company
When you're seeking disability insurance benefits, your medical records and treating physician's statement are two of the most important components of your claim. But because the insurance company has a vested interest in denying your disability insurance claim, it often will rely on tactics like ambushing your doctor with a phone call in an attempt to get them ... Read More >
Disability Benefit Denial Reason #3 - Video & Social Media Surveillance
One thing many disability insurance claimants don't know about (or expect) from the claims review process involves video and social media surveillance. Disability insurance carriers often hire people to follow claimants around with a telephoto lens - or even send social media friend requests from fake accounts - to glean whatever information they can about the c... Read More >
How Do You Fight a Long-Term Disability Denial?
Getting a denial letter from your disability insurance company is one of the ultimate insults. You are sick and not able to work, yet your disability insurance company is telling you to return to work. The disability insurance company has denied your disability benefit claim and is basically calling you a liar. When receiving a disability denial letter or a ph... Read More >
Disability Denial Reason #2 - Change of Disability Definition & Vocational Review
One of the top reasons for terminating a claimant's long term disability benefits involves the change in the disability insurance policy's definition of "disability." This definition change often happens in conjunction with a vocational review, or an analysis of a claimant's medical records that tells the insurance company which jobs the claimant should be able ... Read More >
Dell Disability Cases
(375)
Showing 8 of 375 Dell Disability Cases
Seven Surgeries and The Standard Still Denies Disability Insurance Benefits
Our client was employed with the State of Oregon as a Technical Support Representative. She sought disability through her employer provider LTD Policy with Standard due to low back, hip, and lower extremity pain. She had two hip, two knee and three back surgeries.After paying her for 1.5 years Standard hired a board-certified neurologist to perform a review ... Read More >
Sun Life Wrongfully Denies Disability After Paying For 23 Months
We represent a 57 year-old claimant who’s occupation was selling commercial vehicles for many years. Her job was very physical as it required her to climb in and out of semi-trucks multiple times a day as well as operate them which was very strenuous. She went out of work in due to ongoing and severe debilitating right hip, low back, and bilateral knee pain... Read More >
Nurse Denied Long-term Disability Benefits by Lincoln After the Definition of Disability Changed
Our client, a registered nurse for Dignity Health, found herself in a difficult situation after being diagnosed with lumbar spondylosis and left knee arthritis. She continued to work, however, struggled while attempting to work through chronic lower back pain and left lower extremity radicular symptoms on a daily basis. Sadly, her condition failed to improve and... Read More >
Lincoln Reverses Decision to Terminate LTD Benefits of Corporate Attorney after Dell Disability Lawyers Appeals the Decision
The claimant is an 64 year old former Corporate Attorney and at a prominent Florida business law firm who was forced to cease working in his highly successful and rewarding profession, job, and career on January 27, 2021, and to seek disability compensation under his policies with Lincoln due to severe symptomatology stemming from or following a viral COVID-19 i... Read More >
Transportation Manager with Brain Injury Wins Unum Disability Benefit Appeal
Unum unjustly terminated our client’s disability insurance claim after it had approved and accepted liability for six months. Unum unreasonably concluded, without any evidence of improvement, that the claimant had resumed the sustained work capacity to perform the material and substantial duties of her high level occupation as a Transportation Division Manage... Read More >
Prudential reverses decision to terminate LTD benefits of MRI Tech with Primary Progressive Multiple Sclerosis and degenerative Disc Disease
The claimant is a 58-year-old former MRI Technologist for Fairview Health Services who has long suffered from the debilitating effects of her chronic medical conditions. She has a history of neck pain as well as right arm pain and numbness dating back to 2005 with a reoccurrence of severe symptomatology in 2013. MRI of her cervical spine performed in August of ... Read More >
Engineer With Depression Wins Prudential LTD Appeal
The claimant is a former Senior Technology Services Engineer for Accolade, Inc. who was forced to cease working on May 25, 2021 and to apply for disability insurance benefits under his policy with Prudential because of severe symptomatology related to depression and anxiety. Prudential initially approved his claim for LTD benefits as his symptoms were demonstrat... Read More >
New York Life Approves Disability Benefits for School Teacher With Multiple Sclerosis
Our client, a former elementary school teacher suffering from Multiple Sclerosis, contacted our office after New York Life terminated her claim for short term disability benefits and spoke with Attorney Stephen Jessup. New York Life had initially approved her claim for short term disability benefits, but in doing so awarded benefits only on account of a mental health condition, even though our client had filed... Read More >
Disability Lawsuit Stories
(765)
Reviews from Our Clients
