If your claim for long term disability benefits from the Massachusetts Institute of Technology Long Term Disability Plan has been denied or terminated, the ERISA Law Center can help you.
The Massachusetts Institute of Technology Long Term Disability Plan (MIT LTD Plan) has undergone significant changes over the years. We know that the plan was begun in 1981. We know that the plan was significantly changed effective January 1, 2000. The pre-2000 plan only applies to individuals who became disabled and entitled to the MIT LTD Plan benefits prior to January 1, 2000 – there are still some people under that plan. However, while MIT can locate the summary plan description for those pre-2000 claims, it can no longer locate the plan itself. Because MIT can no longer locate the plan itself for claims that arose prior to January 1, 2000, it doesn’t know what its terms and conditions are. In our experience, MIT and its claims administrator, Prudential Insurance Company of America, simply make up terms and conditions and assert those terms and conditions apply to claims under the pre-2000 plan when it terminates those claims. So, if you are one of the small numbers of persons still covered by the pre-2000 MIT LTD Plan and if your benefits have been terminated by Prudential and MIT, the ERISA Law Center can help you fight to get your LTD benefits back.
The MIT LTD Plan that went into effect January 1, 2000, is readily available and MIT does not claim it can no longer locate that plan; MIT will provide you the January 1, 2000 plan on request. MIT is also obligated to provide a summary plan description (SPD) summarizing the basic terms of the plan and its procedures. But the SPD that MIT provides and which it claims applies to the January 1, 2000 MIT Plan does not accurately describe the actual procedures MIT follows, in violation of federal law. So, when you are dealing with MIT about an LTD claim, be aware that you cannot trust the SPD MIT provides to you regarding the 2000 MIT LTD Plan. The procedures described in that SPD are not the actual procedures MIT follows for reviewing appeals of denied or terminated claims.
As explained above, MIT has a contract with Prudential Insurance Company of America to serve as the claims administrator for the MIT LTD plans. In 2015, Prudential internally adopted a “Group Disability Memorandum” applicable to all long term disability claims it administers. Prudential follows that group disability memorandum regarding appeals by claimants under the January 1, 2000 (and the pre-2000) MIT LTD plan even though nothing in those plans states it should do so, and even though the January 1, 2000 MIT LTD Plan, at least, is inconsistent with the Prudential Group Disability Memorandum. Most significantly for your purposes, the Prudential “Group Disability Memorandum” of 2015 provides for a mandatory appeal and a voluntary second appeal.
In 2019 MIT amended its LTD Plan and incorporated the voluntary second appeal process into the plan for claims effective July 1 2019. However, Prudential, on behalf of MIT, apparently had been following that procedure already for years and does so whenever your claim was initially made.
Prudential has a lot of other written claim standards which it will not and does not share or disclose. While we do not have those standards, it is apparent that some of them – those regarding vocational evaluations, require Prudential’s vocational personnel to act unethically and to provide vocational opinions based on made-up “facts.”
The MIT LTD plans are all subject to ERISA, the Employment Retirement Income Security Act of 1974. Under ERISA, MIT and its claims administrator, Prudential, are supposed to provide claimants with accurate information about how to preserve their rights and have their claims paid, including accurate information about the procedures they follow when claims are denied. MIT and Prudential do not do so regarding MIT LTD claims. MIT and Prudential provide false information, knowing it to be false, about the procedures MIT and Prudential follow when claims for LTD benefits are denied or terminated. MIT and Prudential hide from claimants the standards they follow and the practices they use to evaluate “appeals” from denials or terminations of LTD benefits.
ERISA benefit claims are hard enough when the plans and their administrators tell claimants the truth and give them accurate information. But they are next-to impossible when the claims administrator does not tell claimants the truth and provides misleading documents. If your claim for MIT LTD benefits has been denied or terminated, the ERISA Law Center can help you. We know “the rules of the road” which MIT and Prudential follow but which they will not tell you about – at least to the extent possible. (We do not know what the pre-2000 MIT LTD Plan states or what Prudential’s internal claims standards actually say.) We know that MIT and Prudential constantly “double talk” and mislead claimants in communications when they deny or terminate MIT LTD benefits. We know how to deal with MIT and Prudential when they do so. If your claim for MIT LTD benefits has been denied or terminated and you want help, call the ERISA Law Center.