If you become disabled, contact your Plan Administrator ASAP who will provide information concerning Weekly Disability benefit claims and required documentation. Satisfactory written proof of claim must be submitted within 6 months of the date you become disabled.
The plan provides you with income to replace income lost because of a disability due to disease or injury. Benefits begin after the waiting period is over and continue until you are no longer disabled or until the end of the benefit period, whichever comes first. Check the Benefit Summary for the benefit amount, waiting period and benefit period.
Members insured for weekly disability coverage are eligible to apply for benefits related to pre-delivery and post-delivery complications or other medical conditions as a result of pregnancy and that prevents the Member from performing their job duties. Members who are pregnant, meet the working criteria for disability coverage, and are unable to work due to medical or safety reasons, are eligible to apply for weekly disability benefits prior to giving birth.
Eligible Members are entitled to weekly disability benefits for the health related recovery period following a delivery. The recovery periods are as follows:
If on weekly disability, once the baby has been born, it is the responsibility of the plan member to contact the disability claims manager to inform them of the baby’s date of birth. Disability benefits will continue as noted above. Members who worked right up to the birthdate, may apply for either the 4 or 6 week disability coverage, as noted above.
The 14 day waiting period and all eligibility requirements will apply. The Member is responsible for providing the medical information to identify the medical and functional restrictions that support their inability to work. The Member is also responsible for contacting the disability claims manager to confirm the date of birth.
If the Member experiences post-delivery medical complications that do not resolve within the 4 to 6 week recovery periods, they may be eligible for continued benefits. The Member will need to provide medical to support this.
Your weekly disability benefit is reduced by other income you are entitled to receive while you are disabled. Other income includes:
Earnings received from an approved rehabilitation plan are not used to reduce your weekly disability benefit unless those earnings, together with your income from this plan and the other income listed above, would exceed your weekly earnings before you became disabled. If it does, your benefit is reduced by the excess amount.
Vocational rehabilitation involves part-time work with your employer that is intended to help you return to your job or other gainful employment with your employer on a full-time basis. A plan will be approved if it is appropriate for the expected duration of your disability and it facilitates your earliest possible return to work.
Medical coordination is a process of early involvement to ensure that you are diagnosed quickly and receive appropriate treatment on a timely basis. The goal is to enable you to return to work as early as possible and to prevent the disability from becoming long term or permanent.
No benefits are paid for:
Depending on the severity of the condition, you may be required to be under the care of a specialist.
This does not apply to any portion of a period of maternity leave during which you are disabled due to pregnancy.