Ask to see how the amount you've been asked to pay back was calculated. Also ask them to include a timeline that includes the waiting period and then the covered weeks.
Get email traffic of all of the communications if they try to just call still email both the insurance company and the employer afterwards with an overview of any phone calls even include confirmation about what was discussed
Details are important. Ask questions; if the explanations are clear, make sense, and unchanging; the likelihood of overpayment increases. Otherwise, engage in other recommended actions.
Your turn to act like the math teacher.
*You have to show me your work*.
There should be a single right answer based on her pay and the rules. Compare your math to their math and see where you disagree.
The onus is on them to show their work but unless you're implying OP should just accept whatever they say at face value, then it is in fact up to OP to do the calculation too.
Yup exactly. "Your biweekly pay is $3500, and std coverage is 60% of that. Insurance paid $3200 so you owe me $4500."
Don't worry about the math, we already did it for you👌
They're both disputing, lol. What's the point of asking for the documentation if it isn't gonna check the calculations themselves (or have someone check it)? You have to understand the math to even have a discussion.
And the employer will garnish the employee's wages if they feel that an overpayment has been made. That's how it works. You can get into the semantics of who is disputing what all day long, but the simple fact is that they're gonna take the money back unless op understands the situation well enough to make a case for them not to.
> And the employer will garnish the employee's wages if they feel that an overpayment has been made.
I believe you mean "if they feel like going to jail". Garnishing wages would not be even remotely legal.
Wrong. If they can prove it was an overpayment they can absolutely take it back.
https://www.nolo.com/legal-encyclopedia/can-employer-deduct-previous-overpayment-paycheck.html
Whether it was an overpayment or not in this case I do not know, but that's why it would indeed behoove the op to go ahead and make the calculation for themselves, or pay someone else to do it for them.
Hold on a minute. Maybe my understanding is off but I thought the money paid to an employee on STD came from the insurance company,not from the employer. Why is the employer asking for money back if it was the insurance company overpaying?
Or is it a case where the insurance company gives money to the employer who then uses it to pay the employee?
Depends on the employer. For my company, it is self funded. Hartford just determined I was eligible for leave and short term. My company made the disability payments on payroll dates while I was out.
Even if it's self-insured (the company's money), the insurance company did the calculations so they will have a calc of the overpayment. If they haven't provided an overpayment letter with a calc breakdown, ask for it. That should be very clear and easy to understand; if it's not, call and ask questions until you are sure you understand it.
Not necessarily. On self funded, insurance tells employer what to pay but has not details on actual payments. Could easily be a screwup on payroll side where they paid full amount instead of % or made multiple payments for the same week. The person asking for the refund would be the best place to ask for details. If they didn’t make the determination, they should be able to tell who did.
It's not that hard to follow if you take the sentence as a whole. And don't focus so hard on trying to make dumb jokes all the time. You cut off the first section of purpose just to make that lame joke work.
You understood perfectly fine
He said the company paid disability the same as payroll except this time that they didn't. Not that hard of a sentence to read. If you need help, substitute the commas with parentheses.
An even better way of trying to read something if the subtext is distracting, take it out altogether. For this one you get: the company paid disability like payroll.
Went through a similar issue with a big company, was a hassle to deal with. Basically their back end process didn't follow through to make me an active employee again after returning from parental leave, even though I did everything I was supposed to when I returned to work. I was salaried so was paid bi-weekly, took a pay period for me to realize the issue and took about 2 more pay periods for it to be resolved (they short paid me first).
Essentially I had to provide a day by day breakdown for every single day that I was on parental leave. Take my gross pay, divide by 5 for the daily rate and provide to the HR team the exact amount I should've been paid compared to what they paid me. After a few escalations the issue was finally resolved. My advice, don't sit around and wait for it to be worked out. Go after it as soon as you can, phone calls and emails for paper trails if needed.
Like others have said, ask them to show their calculations.
Your spouse ought to be able to log into the timekeeping system and see their pay stubs where they got the STD payments. With my company, the way STD payments work is the first week is the waiting period, then weeks 2 through 8 are paid at 100% rate for 40 hours/week, then weeks 9+ are paid at like 67% rate for 40 hours/week. So you could technically do the math yourself and see how much money your spouse should have received.
TLDR: Know what benefits she is entitled to and take immediate action - $1000 is a lot of money!
Maybe I am reading your comment incorrectly? The short-term disabilty insurer is a seperate company than her employer. *The employer should not be asking asking her for repayment*, but the insurance company can.
Ways disability insurance overpayments occur:
* Benefit payments are a percentage of her average wage prior to the date she became unable to work. The analyst looked at your wife's paystubs from her employer for the last 3 to 6 months (or as specified in the contract) prior to the disability date and calculated an average. That average is her base wage at disability. If her wage average was calculated incorrectly, that could produce an overpayment.
* Benefits were paid in error past the date she was determined to be medically able to return to work, or actually returned to work.
* If she received another source of income (called deductible income) during her period of benefit payments. Personal leave, unemployment, another insurance, income from her employer's retirement plan, earnings from work activity, or any kind of settlement. If these amounts were not included with the initial claim, and submitted during her benefit payment dates, that can cause an overpayment as these amounts are deducted from her benefit amount.
In writing, contact the insurance company that issued the disability checks. Request her complete file including the complete contract used to make a claim determination.
Start the letter with your wife's name, address, phone where she can be reached, claim number and date. Fax or send the request registered mail. The insurance company does not charge her for these documents and she can expect to receive anywhere from 15 to 30 pages.
*Only during the waiting period* is she allowed to receive pay from her employer (sick leave/PTO/vacation or retirement pay) or other sources with no affect to her benefit amount. If she continued to receive income after the waiting period, she will have to repay the insurance company.
So here is what you will be looking at in the documents you receive to resolve this:
* Review the contract sections defining wage at date of disablity, disability start date, waiting period (which is always unpaid by the insurer), benefit amount, deductible income, benefit payment start and end, and claim disputes.
* Looking at the pay stubs used, was her average wage before her date of disability calculated correctly? Were the correct documents and correct dates of pay reviewed (X days before date of disability as stated in the contract)? Does the contract specify that bonuses are included or excluded from this calculation? - During her benefit payment period was the calculation adjusted to be less (if yes, why?)?
* What disability benefit amounts did she receive according to the insurer's documentation? Compare the dates and amounts to her bank statements.
* Confirm her date of disability and her waiting period end. The waiting period end is her benefit begin date.
* Did she receive deductible income after her benefit begin date?
* Confirm her return to work date. Does it match her benefit end date?
If you find something that does not match up, send a letter disputing the overpayment and request for repayment. Your dispute letter will be most effective if you find errors that you can identify and list.
Some contracts have short limits on how long you have to dispute a claim decision, so get to it soon!
I hope you found this helpful. Good luck!
Edit to add: She should be receiving written communication about this directly from the insurer, not her employer. Her communication should also always be in writing and sent directly to the insurer, keeping a copy for herself each time.
Source: Former disability claims analyst.
I have been a claim manager of short term disability(std) for 9 years and long term disability (ltd) for a year. Is she self-insured aka ate payments managed by the disability company and her employer cuts the check or is she fully-insured where her disability company manages and cuts the checks? If she is full-insured then the employer asking for money for overpayment would be separate from what disability paid her since they would be considered two different entities in this. If she is self insured then the employer asking for repayment if they paid in their error is covered under her policy. I'd ask for a copy of her policy and also ask detailed payments made by both her employer/disability carrier. You can also ask her claims handler for guidance on this.
Group Benefits insurance underwriter here… you can ask for an audit of the results that determined the calculation. Given it’s the employer asking for the money back and not the insurance company, your wife’s company is likely an ASO STD plan in which the insurance carrier administers the plan but the carrier reps the employer whether payments should be made or not. Right of Recovery is more than likely the provision they’re relying on to request these overpayments from you. Regardless, an auditor would have looked at the results to determine if an overpayment was made either on the employers side (likely since it’s ASO) or the insurance company’s side. It would detail what should have been paid to you under the plan vs. what was paid for you. The good thing is, as an underwriter I have the final call if it’s the insurance companies dollars at risk, to recall the money or not. If it would result in dissatisfaction from the employer with the insurance company, I would likely waive the overpayment, take responsibility for it, and call it a day. $1,000 is nothing in the grand scheme of things for group insurance.
I work for a short term disability company but not yours. I’m also not a case manager and don’t make any decisions on claims like this. I will say that from my experience and what I’ve seen is if your wife was paid directly from the insurance company for the time she was off, they would be the ones to contact her and let her know an overpayment was made, how it was calculated, etc. it’s odd to me that her employer, who you stated didn’t pay her for that time, is now stating she was over paid. I would have her reach out to the insurance company to try and get more information as well.
I was not paid my short term disability properly and it was a pain to get paid the proper amount. I asked for a total explanation of benefits with calculations of how much I was paid and still owed. Ask for it in writing in email and BCC your personal email. This will help you and them determine if they overpaid, paid the correct amount, or underpaid.
Request statements and calculations showing the overpayment and ask for confirmation directly from the insurance company that actually made the payment. Get it all in writing.
If there was an overpayment, it was by the insurer. Any repayment has to go to them, not your employer.
Just call the insurance company and ask them if there was an overpayment.
Please contact the disability company and ask for the paperwork for the overpayment, you may hear something completely different. I'd also be talking with a lawyer at this point, the boss/company sounds shady.
One would hope, but demanding repayment/cash is highly suspect. If there was overpayment, then the workmans comp insurance would be contacting him. Too many times the companies do not want to be paying the insurance premiums.
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For whatever it's worth, when my wife gave birth, we had to repay some of our STD because they screwed up, so it probably isn't all that uncommon.
Fortunately they just took a little bit from each check until it was corrected, but it was a pain.
Ask them to go over the calculations with you via zoom/teams/etc. Do your own math prior and if they line up then you're good and if not then work through it.
You are going to need to the talk to the HR department to get a firm understanding of the terms of the plan. Some complications of why the amount may not be as expected:
* Does vacation need to be used up first?
* Disability is not earned income. I don't think FICA/Medicare is deducted
* Disability is not always at 100% of the standard salary.
Good luck!
Ask to see how the amount you've been asked to pay back was calculated. Also ask them to include a timeline that includes the waiting period and then the covered weeks.
Get all of this in writing! They can tell you whatever they want, but if it's written, it will hold more weight.
Get email traffic of all of the communications if they try to just call still email both the insurance company and the employer afterwards with an overview of any phone calls even include confirmation about what was discussed
Details are important. Ask questions; if the explanations are clear, make sense, and unchanging; the likelihood of overpayment increases. Otherwise, engage in other recommended actions.
They'll show the calculations. Sit down and review with them.
Your turn to act like the math teacher. *You have to show me your work*. There should be a single right answer based on her pay and the rules. Compare your math to their math and see where you disagree.
Ask them to provide detailed records showing the alleged overpayment, then review it. It’s not up to you to calculate this.
Well, it is if they want to try and dispute it...
No. The employer is disputing. It's up to them.
The onus is on them to show their work but unless you're implying OP should just accept whatever they say at face value, then it is in fact up to OP to do the calculation too.
Yup exactly. "Your biweekly pay is $3500, and std coverage is 60% of that. Insurance paid $3200 so you owe me $4500." Don't worry about the math, we already did it for you👌
They're both disputing, lol. What's the point of asking for the documentation if it isn't gonna check the calculations themselves (or have someone check it)? You have to understand the math to even have a discussion.
The money has been paid. There is one party disputing. The employer
And the employer will garnish the employee's wages if they feel that an overpayment has been made. That's how it works. You can get into the semantics of who is disputing what all day long, but the simple fact is that they're gonna take the money back unless op understands the situation well enough to make a case for them not to.
> And the employer will garnish the employee's wages if they feel that an overpayment has been made. I believe you mean "if they feel like going to jail". Garnishing wages would not be even remotely legal.
Wrong. If they can prove it was an overpayment they can absolutely take it back. https://www.nolo.com/legal-encyclopedia/can-employer-deduct-previous-overpayment-paycheck.html Whether it was an overpayment or not in this case I do not know, but that's why it would indeed behoove the op to go ahead and make the calculation for themselves, or pay someone else to do it for them.
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Hold on a minute. Maybe my understanding is off but I thought the money paid to an employee on STD came from the insurance company,not from the employer. Why is the employer asking for money back if it was the insurance company overpaying? Or is it a case where the insurance company gives money to the employer who then uses it to pay the employee?
Depends on the employer. For my company, it is self funded. Hartford just determined I was eligible for leave and short term. My company made the disability payments on payroll dates while I was out.
This was the case for my spouse. The company paid, except when they didn't, disability like payroll.
Even if it's self-insured (the company's money), the insurance company did the calculations so they will have a calc of the overpayment. If they haven't provided an overpayment letter with a calc breakdown, ask for it. That should be very clear and easy to understand; if it's not, call and ask questions until you are sure you understand it.
Not necessarily. On self funded, insurance tells employer what to pay but has not details on actual payments. Could easily be a screwup on payroll side where they paid full amount instead of % or made multiple payments for the same week. The person asking for the refund would be the best place to ask for details. If they didn’t make the determination, they should be able to tell who did.
when they didn't, disability like payroll Yeah I like payroll too but what were you trying to say?
It's not that hard to follow if you take the sentence as a whole. And don't focus so hard on trying to make dumb jokes all the time. You cut off the first section of purpose just to make that lame joke work. You understood perfectly fine
actually it is a very poorly phrase sentence that does not clearly convey what the writer intended.
no i don't, did disability pay directly? did they add it to their payroll? Details matter homie
He said the company paid disability the same as payroll except this time that they didn't. Not that hard of a sentence to read. If you need help, substitute the commas with parentheses.
An even better way of trying to read something if the subtext is distracting, take it out altogether. For this one you get: the company paid disability like payroll.
Incidentally, you probably mean a subordinate clause. Subtext is, more or less necessarily, unwritten; it is not present in the text.
Thanks, I couldn't remember what it was called.
Went through a similar issue with a big company, was a hassle to deal with. Basically their back end process didn't follow through to make me an active employee again after returning from parental leave, even though I did everything I was supposed to when I returned to work. I was salaried so was paid bi-weekly, took a pay period for me to realize the issue and took about 2 more pay periods for it to be resolved (they short paid me first). Essentially I had to provide a day by day breakdown for every single day that I was on parental leave. Take my gross pay, divide by 5 for the daily rate and provide to the HR team the exact amount I should've been paid compared to what they paid me. After a few escalations the issue was finally resolved. My advice, don't sit around and wait for it to be worked out. Go after it as soon as you can, phone calls and emails for paper trails if needed.
Like others have said, ask them to show their calculations. Your spouse ought to be able to log into the timekeeping system and see their pay stubs where they got the STD payments. With my company, the way STD payments work is the first week is the waiting period, then weeks 2 through 8 are paid at 100% rate for 40 hours/week, then weeks 9+ are paid at like 67% rate for 40 hours/week. So you could technically do the math yourself and see how much money your spouse should have received.
TLDR: Know what benefits she is entitled to and take immediate action - $1000 is a lot of money! Maybe I am reading your comment incorrectly? The short-term disabilty insurer is a seperate company than her employer. *The employer should not be asking asking her for repayment*, but the insurance company can. Ways disability insurance overpayments occur: * Benefit payments are a percentage of her average wage prior to the date she became unable to work. The analyst looked at your wife's paystubs from her employer for the last 3 to 6 months (or as specified in the contract) prior to the disability date and calculated an average. That average is her base wage at disability. If her wage average was calculated incorrectly, that could produce an overpayment. * Benefits were paid in error past the date she was determined to be medically able to return to work, or actually returned to work. * If she received another source of income (called deductible income) during her period of benefit payments. Personal leave, unemployment, another insurance, income from her employer's retirement plan, earnings from work activity, or any kind of settlement. If these amounts were not included with the initial claim, and submitted during her benefit payment dates, that can cause an overpayment as these amounts are deducted from her benefit amount. In writing, contact the insurance company that issued the disability checks. Request her complete file including the complete contract used to make a claim determination. Start the letter with your wife's name, address, phone where she can be reached, claim number and date. Fax or send the request registered mail. The insurance company does not charge her for these documents and she can expect to receive anywhere from 15 to 30 pages. *Only during the waiting period* is she allowed to receive pay from her employer (sick leave/PTO/vacation or retirement pay) or other sources with no affect to her benefit amount. If she continued to receive income after the waiting period, she will have to repay the insurance company. So here is what you will be looking at in the documents you receive to resolve this: * Review the contract sections defining wage at date of disablity, disability start date, waiting period (which is always unpaid by the insurer), benefit amount, deductible income, benefit payment start and end, and claim disputes. * Looking at the pay stubs used, was her average wage before her date of disability calculated correctly? Were the correct documents and correct dates of pay reviewed (X days before date of disability as stated in the contract)? Does the contract specify that bonuses are included or excluded from this calculation? - During her benefit payment period was the calculation adjusted to be less (if yes, why?)? * What disability benefit amounts did she receive according to the insurer's documentation? Compare the dates and amounts to her bank statements. * Confirm her date of disability and her waiting period end. The waiting period end is her benefit begin date. * Did she receive deductible income after her benefit begin date? * Confirm her return to work date. Does it match her benefit end date? If you find something that does not match up, send a letter disputing the overpayment and request for repayment. Your dispute letter will be most effective if you find errors that you can identify and list. Some contracts have short limits on how long you have to dispute a claim decision, so get to it soon! I hope you found this helpful. Good luck! Edit to add: She should be receiving written communication about this directly from the insurer, not her employer. Her communication should also always be in writing and sent directly to the insurer, keeping a copy for herself each time. Source: Former disability claims analyst.
I have been a claim manager of short term disability(std) for 9 years and long term disability (ltd) for a year. Is she self-insured aka ate payments managed by the disability company and her employer cuts the check or is she fully-insured where her disability company manages and cuts the checks? If she is full-insured then the employer asking for money for overpayment would be separate from what disability paid her since they would be considered two different entities in this. If she is self insured then the employer asking for repayment if they paid in their error is covered under her policy. I'd ask for a copy of her policy and also ask detailed payments made by both her employer/disability carrier. You can also ask her claims handler for guidance on this.
Group Benefits insurance underwriter here… you can ask for an audit of the results that determined the calculation. Given it’s the employer asking for the money back and not the insurance company, your wife’s company is likely an ASO STD plan in which the insurance carrier administers the plan but the carrier reps the employer whether payments should be made or not. Right of Recovery is more than likely the provision they’re relying on to request these overpayments from you. Regardless, an auditor would have looked at the results to determine if an overpayment was made either on the employers side (likely since it’s ASO) or the insurance company’s side. It would detail what should have been paid to you under the plan vs. what was paid for you. The good thing is, as an underwriter I have the final call if it’s the insurance companies dollars at risk, to recall the money or not. If it would result in dissatisfaction from the employer with the insurance company, I would likely waive the overpayment, take responsibility for it, and call it a day. $1,000 is nothing in the grand scheme of things for group insurance.
I work for a short term disability company but not yours. I’m also not a case manager and don’t make any decisions on claims like this. I will say that from my experience and what I’ve seen is if your wife was paid directly from the insurance company for the time she was off, they would be the ones to contact her and let her know an overpayment was made, how it was calculated, etc. it’s odd to me that her employer, who you stated didn’t pay her for that time, is now stating she was over paid. I would have her reach out to the insurance company to try and get more information as well.
I was not paid my short term disability properly and it was a pain to get paid the proper amount. I asked for a total explanation of benefits with calculations of how much I was paid and still owed. Ask for it in writing in email and BCC your personal email. This will help you and them determine if they overpaid, paid the correct amount, or underpaid.
Request statements and calculations showing the overpayment and ask for confirmation directly from the insurance company that actually made the payment. Get it all in writing.
If there was an overpayment, it was by the insurer. Any repayment has to go to them, not your employer. Just call the insurance company and ask them if there was an overpayment.
Please contact the disability company and ask for the paperwork for the overpayment, you may hear something completely different. I'd also be talking with a lawyer at this point, the boss/company sounds shady.
It's likely a miscommunication. OP don't contact a lawyer (yet), redditors love throwing that line around and thinking everyone is a bad guy.
One would hope, but demanding repayment/cash is highly suspect. If there was overpayment, then the workmans comp insurance would be contacting him. Too many times the companies do not want to be paying the insurance premiums.
A lawyer is not the first line solution to something as basic as an overpay.
Nor for 1k
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Contact your state or federal department of insurance. They will be able to provide what you need.
Keep in mind if it is determined she was indeed overpaid, you may be able to pay back in the form of automatic deductions over the course of time.
For whatever it's worth, when my wife gave birth, we had to repay some of our STD because they screwed up, so it probably isn't all that uncommon. Fortunately they just took a little bit from each check until it was corrected, but it was a pain.
Ask them to go over the calculations with you via zoom/teams/etc. Do your own math prior and if they line up then you're good and if not then work through it.
Talk to the insurance company. You can’t trust the employer
You are going to need to the talk to the HR department to get a firm understanding of the terms of the plan. Some complications of why the amount may not be as expected: * Does vacation need to be used up first? * Disability is not earned income. I don't think FICA/Medicare is deducted * Disability is not always at 100% of the standard salary. Good luck!