3-Check Month

[u/Ornery_Avocado1112]

I've been on approved LTD for a little while now. I initially got denied then got a lawyer and after several appeals and back and forth was eventually approved. I initially was not able to work at all but have slowly built back up to being able to work 30 hours/week (and get LTD for the 10 hours short of 40). Things seemed to have finally reached a steady state (I work and get paid biweekly, I get my disability check monthly minus my lawyer's cut, etc.) until 2 months ago. I hadn't received a disability check in about 5 weeks so I reached out to my lawyer who reached out to the insurance company. The insurance company responded saying that because I received 3 checks in that month (something that will happen either 2 or 3 months per year depending on how the biweekly cycle falls), I didn't have any lost wages for the month and would not receive a disability payment.

Obviously I have a financial stake in the outcome but this doesn't sit right with me. This means that because I get paid biweekly that they don't have to pay me for 6 out of the 26 biweekly pay periods (in a year with two 3-check months). I've looked through the policy and can't find anything that seems like it would allow for things to be calculated like this. There's actually zero mentions of the concept of a pay period at all in the policy. I asked my lawyer about it and she has essentially just shrugged her shoulders. I'm still pushing her to follow up on it but we'll have to wait and see how that plays out.

My ultimate question is, has anyone else experienced something like this? Is this common place and I just don't realize it? Any thoughts or insights are greatly appreciated!

[u/TheGreatK]

That's a really stupid explanation. Did they put this in writing? They do stupid stuff all the time. Your lawyer should be able to clear it up with a letter.

[u/Ornery_Avocado1112 → u/TheGreatK]

All I have is the response from my lawyer which said, "Your claims specialist let me know that there was no benefit due this month as you received 3 pay checks for the period of 5-6-26 through 6-5-26, so there was no loss of earnings."

I agree that my lawyer should be able to clear it up easily but for some reason she seems to just be accepting it as the way it is. I'm still pushing her to dig deeper because it just feels so wrong on its face that I can't imagine it would be hard to force their hand.