Stroke victim suffers disability insurance set back

FREMONT, Neb. (WOWT) -- Life suddenly changed for a healthy middle-aged couple when one of them suffered a stroke. But then came the after shock while collecting disability insurance. Their story is an eye opener for anyone expecting full coverage for the premiums they paid.

Married 27 years the Rydels must communicate like they just met.

Carla provides speech practice for husband Mike, "Say my name, Carla. Carla, good."

Last fall, 53-year-old Mike Rydel suffered a stroke.

"I can't go and work because he needs me the whole time," said Carla.

A longtime Applebees manager, Mike has disability insurance and Cigna started to send $2,700 a month.

"It strapped us down big time, we just get by," Carla told Six on Your Side.

They thought recently approved Social Security checks would be a financial boost. Instead, Cigna deducted the government amount from its monthly payment catching the couple off guard.

"Yes he should get it all. I don't understand why it's offset other than that is how Cigna has it set up in their policy and I didn't read it," said Carla.

Attorney Steve Lathrop, who specializes in disability insurance says most of his clients don't realize their monthly check will be cut when social security benefits kick in.

"No its not fair because the representation they make is we'll be there for you and in reality the fine print is but we're going to subtract from what we owe you the amount you are getting from social security disability," said Lathrop.

Mike and Carla Rydel found that out. Mike is approved in April but the first government check came in May. Cigna claims its April check is an over payment and wants the money back garnishing $300 from an already reduced monthly disability check.

"You think you are going to get this and social security and that's gong to sustain you. But it isn't because its offsetting and gives us hardly anything," Carla said.

A Cigna spokesman sent at statement to Six on Your Side:

" Although I cannot speak specifically about Mr. Rydel’s claim due to privacy laws, I can say that in providing individuals with long-term disability (LTD) insurance coverage, Cigna’s goal is to ensure that each person promptly receives all of the benefits to which he or she is entitled under his or her particular disability plan. Coordination of long-term disability benefits with SSDI benefits is a long-standing practice; one that both private industry and the federal government have followed for many years.

We also encourage individuals to apply for other benefits – in addition to their LTD benefits -- to which they may be entitled, such as workers’ compensation, state disability programs, vocational rehab programs, and SSDI. Eligibility for these programs is entirely separate from Cigna’s LTD coverage decisions.

The SSDI application process can be complex, often benefiting from the assistance of experts. For this reason, Cigna refers individuals to several third-party vendors that specialize in helping people apply for SSDI benefits. If an individual is approved for SSDI benefits and begins receiving SSDI payments, it is standard industry practice to offset the person’s long-term disability payments by the amount received from the government. If he or she has been finally denied SSDI benefits, there are no offsets of any kind.

We have established claims practices that are fair, customer-oriented, and consistent with industry practice and comply with applicable federal and state laws. Our customer service team will reach out to the Rydel family directly to answer any questions they may have about coordination of their benefits. "

The Rydel family does have a website set up for anyone wishing to make donations while Mike recovers.