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ELIGIBILITY
You are eligible if you are actively working 30 hours a week at your usual
place of employment and have satisfied your employer's minimum
service requirements.
WEEKLY BENEFIT AMOUNT
Short-term disability pays a specific weekly benefit if you become
disabled due to a non-job related injury or sickness. The weekly benefit
is based on a percentage of your basic weekly pay.
Basic Weekly Pay is defined as the weekly rate of pay from an employer
in effect the day before the total disability begins. It excludes bonuses,
overtime pay or other extra compensation. Commissions can be included
upon request. When included, commissions are averaged for the lesser
of the 12 month period of employment before the date total disability
begins, or the period of employment. (Ask your plan administrator if
commissions are included in your Basic Weekly Pay definition.)
To receive disability benefits, you must be totally disabled, under the
care of a physician and unable to perform any work for pay or profit due
to a non-job related injury or sickness. Benefits are not payable if you are
receiving benefits under Worker Compensation or a similar law.
Disabilities due to pregnancy are covered but will be subject to
pre-existing conditions limitations.
ELIMINATION PERIOD & BENEFIT DURATION
The elimination period is the number of days of continuous total disability
before the benefits begin. Depending upon your plan, benefits will begin
on the 15th or 30th day for an accident or sickness.
The benefit duration is the maximum number of weeks you may receive
disability benefits. Your plan's benefit duration is either 13 or 26 weeks.
Benefits will end on the date you fail to give required proof of continuing
total disability, your total disability ends, or the maximum benefit period
ends. If the group policy ends, this will not act to end the maximum
benefits. Ask your plan administrator for your plan's elimination period
and benefit duration.
PRE-EXISTING CONDITIONS
Benefits are not paid for an injury or sickness for which an employee has
incurred charges, received medical treatment, consulted a physician or
taken prescribed drugs within 12 months before becoming insured
under this plan. If total disability s due to a pre-existing condition and it
begins within 12 months of the date the employee has become insured
under this plan, no benefits will be paid.
Pre-existing conditions limitation periods may vary by state.
EXCLUSIONS
No weekly benefits will be paid for a disability due to:
- intentionally self-inflicted injury
- a war or an act of war
- committing a crime or an attempt to do so
- job-related sickness or injury.
REDUCTION OF INCOME BENEFITS
Each weekly benefit will be reduced by the sum of any
income received that week from:
- the Federal Social Security Act or the Railroad Retirement Act*
- non-job related disability sickness laws of any state
- a mandatory state auto reparation or indemnity act (no-fauly auto insurance)
- an employer or self-employment
Unless the insured notifies United States Life to the
contrary, it will be assumed that the maximum family
benefit is paid to the insured under these acts or plans.
The minimum weekly benefit is $25.00.
SUCCESSIVE PERIODS OF DISABILITY
Successive periods of disability will be considered one period and will
allow continuation of benefits if the insured returns to work for less
than two weeks if the disability begins before age 70 and less than six
months if the disability begins on or after age 70. A new elimination
period does not need to be satisfied. The maximum benefit duration continues
to accumulate from the date disability recurs.
INCOME INCREASE
If other income benefits are increased after the first week that benefits
are paid for a period of disability, such increase will not be used to
determine the weekly benefit reduction.
SUPPLEMENT TO STATE PLANS
Short-term disability can be used to supplement state plans in California,
Hawaii, New Jersey, New York and Rhode Island. Using this approach, United
Stated Life calculated the entire benefit and offsets it with the benefit
paid by the state plan.
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