The CTA Group Long term disability Plan with Standard is difficult to read or understand.  Getting benefits from Standard under the CTA group long term disability plan can also be very difficult and quite frustrating.

 

Standard Commonly Denies CTA Insured Benefits

 

For most CTA participants, the long term disability benefits through Standard are only 24 months in duration.  For that reason, and the fact that it is an ERISA benefit, Standard often denies claims for benefits.  Since the benefit is usually only 24 months long, when claimants are denied, they may not appeal or fight for their benefits because “it’s only for a short time and not worth the hassle.”  In addition, many attorneys will not accept a case that is for such a short-term benefit.

 

Standard engages in a variety of practices to deny CTA members LONG TERM DISABILITY claims.

 

  • The policy entitles CTA members long term disability benefits if the member cannot perform the substantial and material acts of his or her usual occupation with reasonable continuity.  But Standard: commonly ignores the intellectual and cognitive requirements of teaching; commonly disregards certain physical demands of teaching; and in our experience does not address the capacity of a person to teach with reasonable continuity.
  • The policy requires that claimants apply for CalSTRS disability benefits.  And, of course, if you receive CalSTRS disability benefits that means that CalSTRS determined that you cannot do your own job.  You would think that Standard would take account of the CalSTRS determination in deciding whether you are entitled LONG TERM DISABILITY benefits from Standard.  But it doesn’t.  That is, even though Standard requires you to apply for CalSTRS disability benefits (if you qualify), even if you are awarded CalSTRS disability, Standard will not grant you own occupation LONG TERM DISABILITY benefits and will nonetheless commonly denies your claim, reasoning that the CalSTRS determination is not reasonable.
  • To evaluate your claim Standard hires doctors, most of whom either work on contract with Standard or are contracted through third parties.  Often, Standard doctors dispute your diagnosis without ever examining you or getting all of your records.
  • So, often Standard will deny a long term disability claim because it disputes your diagnosis, claiming for example, it cannot identify a scientifically validated diagnosis as the source of the disability.  But nothing in the CTA long term disability policy requires that you have a proven diagnosis, only that you be incapable of performing the duties of your own or any other occupation with reasonable continuity, i.e., only that you have a proven disability.  So Standard and its doctors engage in a “bait and switch” challenging your diagnosis, rather than performing an evaluation of your capacity to work as a teacher.

The CTA Long term disability Plan is Governed by ERISA

 

Normally, public employers are not subject to ERISA regulations.  But, since the CTA is not the employer, and since the policy is issued to the Association, claims under the group long term disability policy issued by Standard to the CTA are governed by ERISA.  So even though you are eligible for the LONG TERM DISABILITY benefits as a result of your employment by a California public school, your policy is an ERISA governed policy.  This is another reason Standard has very little to lose by denying your claim for LONG TERM DISABILITY benefits.  Under ERISA, you are not entitled to anything but your benefits – no emotional distress damages; no punitive damages; no pain and suffering damages you may have been able to claim if this were a bad faith claim.

 

ERISA Law Center Can Help

 

Throughout the past several years the ERISA Law Center has helped many CTA members obtain their benefits from Standard, either at the administrative appeal level, or through litigation.  The ERISA Law Center can help you.  So, if you need help with a long term disability claim with Standard on a denial of your CTA group disability benefits, call the ERISA Law Center.