The STD elimination period is waived for a Recurring Disability, but the maximum benefit period as to STD benefits within any rolling 12 month period shall continue to apply. The STD Policy will not cover any Disability due to cosmetic surgery unless such surgery is in connection with an injury or sickness sustained while the individual is eligible for this policy.
This time period may be extended by an additional 10 business days if the FMLA Administrator determines that such an extension is necessary. If the employee delivers the requested information within the time specified, any extension period will begin after the employee has provided that information.
If the employee fails to deliver the requested information within the time specified, the FMLA Administrator may decide the claim without that information.
The employee will have 45 days from the receipt of notice of an adverse benefit determination to file an appeal. The employee may file a written request for appeal of an adverse benefits determination with the FMLA Administrator. A decision on any appeal will be made by the FMLA Administrator not later than 30 days following receipt of the written request for appeal. If the FMLA Administrator determines that circumstances require an extension of time for a decision on review, the review period may be extended by an additional 30 days 60 days in total.
The claims administrator will notify the employee in writing if an extension is needed. If the employee delivers the requested information within the time specified, the extension of the appeal period will begin after the employee has provided that information.
If the employee fails to deliver the requested information within the time specified, the FMLA Administrator may decide the appeal without that information. The employee will have access to all relevant documents.
The review of the adverse benefit determination will take into account all new information, whether or not presented or available at the initial determination.
No deference will be afforded to the initial determination. In the case of an appeal based on medical diagnosis or medical determination, the FMLA Administrator will conduct the appeal review, after consulting with such medical professionals as the FMLA Administrator deems necessary, and will communicate the final appeal decision to the employee.
In the case of an appeal based on any other reason such as eligibility, calculation of benefit or offset , the FMLA Administrator will conduct the appeal review, after consulting with such legal or Human Resources professionals as the FMLA Administrator deems necessary which may include professionals employed with the University , and will communicate the final appeal to the employee. The employee also may file a second appeal directly to the University of any denial of appeal based on grounds other than medical diagnosis or medical determination.
University staff members who are covered by collective bargaining agreements should refer to the appropriate contract article. The benefits and policies for University of Pennsylvania staff members who work in locations outside of the Commonwealth of Pennsylvania may be different from the benefits and policies set forth in this policy.
Staff members working outside the Commonwealth of Pennsylvania should contact Human Resources for more information. Dealing with issues relating to Short-Term Disability can be challenging and returning to work following a Disability leave can be stressful. For these and other matters, the University offers the Employee Assistance Program EAP for free, confidential, one-to-one support at any time.
EAP counselors can be reached 24 hours a day, 7 days a week to help you manage the issues at hand and prepare for a successful return to the workplace. Additional useful information may also be found on the EAP website. Human Resources. Skip to Main Content Policy Manual. Long-term disability coverage can last from one year to the age of retirement — usually However, some plans differ or have exceptions for mental illness; consult the summary plan description to verify the number of years covered by the insurance policy.
STD is not a form of job-protected leave with rights to continued health coverage and job reinstatement. STD is merely a wage replacement benefit that employees may receive when they are unable to work for certain reasons. If you have long-term disability LTD insurance and you become unable to work, the insurance company will pay you part of the salary or wages that you earned before becoming disabled. However, employers and employees should understand the tax consequences of paying these benefits premiums on a pre-tax basis.
This is because leave under a disability plan, such as STD, is not unpaid leave. FMLA is a federally backed job protected leave from work. Eligible employees can take up to 12 weeks of unpaid leave each year. To summarize, STD benefits are wages the employee may be eligible for while on leave. It may or may not be accompanied by a payment amount for the portion of your STD coverage for which you are responsible.
Short-term disability insurance pays a portion of your salary in the event you become temporarily disabled, such as in an extended illness or after a surgical procedure. Disability coverage, both Short Term and Long Term, is a benefit program designed to provide income replacement in the event you become disabled due to an injury or illness and cannot perform the duties of your normal occupation.
After a claim is approved, benefit payments begin once the insured. Short Term vs. Long Term Disability Insurance.
STD provides crucial income replacement when a person is unable to work and bring in an income. Ask yourself — could your family pay all their bills and maintain their current lifestyle if you were unable to work for up to 26 weeks?
Employment Insurance EI is a federal benefit that operates very similarly to STD, providing income replacement in the event an accident, illness, or injury prevents you from working. EI is not usually as comprehensive an employer-sponsored STD plan, often having longer waiting periods and lower weekly payments. Both STD and LTD benefits can be set up as taxable to the employee employer pays the premiums or non-taxable to the employee employee pays the premiums.
STD serves as income replacement for employees unable to work, beginning from the onset of the disability. However, employees on STD who are making progress towards recovery can work with their employer to arrange for an early return to work or an accommodated work schedule.
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