Life Events: Short Term Disability
If you become disabled, you must call the Benefit Fund within 48 hours of the date your physician informs you that you are disabled, and in no case more than 5 working days after the onset of your disability. If you do not begin the claim process within the specified time period, the Fund will assume that you became disabled on the date the Fund receives your claim.
If you qualify, disability payments will be made until you recover, or have received benefits for 26 weeks – whichever occurs first. You may not receive benefits for more than 26 weeks in any 52-week period for any reason.
How Your Other Benefits Are Affected
Coverage for hospital, medical, dental prescription drug, and death, (as applicable) will continue for the length of time that you receive disability payments – up to a maximum of 26 weeks.
Note: If you are injured at work, and qualify for Workers Compensation benefits, you must Supply proof of receipt of Workers Compensation Benefits on a monthly basis. If you are injured in an auto accident, and are receiving benefits for lost wages from your Auto insurance, you must supply proof of payment for lost wages from auto insurance.
Pension Plan – Your participation continues until you recover or until you have received 26 weeks of extended benefit coverage, whichever occurs first. You may be eligible to receive a pension benefit from the Fund if:
- You are permanently disabled and
- You qualify for a Social Security disability pension.
Contact the Benefit Fund office for more detailed information.
Address/Personal Information – Be sure to update your address and personal information, including beneficiary designation, to reflect any changes.
Maternity: Special rules apply for Maternity disability.
For a normal pregnancy, you may receive disability benefits for up to 4 weeks before the delivery date and up to 6 weeks after the delivery date. (Benefits actually start as of the 8th day of the disability.)
If you become disabled more than 4 weeks before your delivery date, the benefit period may be extended if medical necessity has been established to the satisfaction of the Benefit Fund.
However, if the Fund determines that you were not disabled before this 4-week period, then you will not receive disability benefits, and your medical coverage will end 30 days after your last day at work. This means you would not receive disability benefits before or after delivery. You would not have any medical coverage for the hospital admission or other medical expenses (unless you had applied and paid for COBRA continuation coverage).
What You Need To Do
Call the Benefit Fund office at 215-735-5720 or 1-800-531-1199 within 48 hours of the date your physician informs you that you are disabled. When you call, make sure you have your doctor’s name, address and telephone number. The Fund will send the necessary forms to you, your doctor and your employer.
Complete and return the form (Part A) that you receive. Follow up with your employer and doctor to ensure that they return the forms they received (Parts B and C). If your doctor is not sure when you will return to work, ask the doctor to estimate this date.
Remember!
Your claim will not be processed until the Fund receives Parts A, B, and C of the claim form.
If you do not return all required information and all parts of the form to the Fund within 14 days of the date you notify the Fund of your disability, your claim will be denied. You will then have to file an appeal.