Advocate Health Care
Benefits
Disability

 
Resources    Forms   

Dental HMO    Dental HMO Copayment Schedule    MetLife PDP    MetLife Dental ID CARD    Rates   
Disability Certification    Disability Council    Eligibility Requirements    Long Term Disability Plan    Restricted Duty    Short Term Disability Plan    Social Security Disability Benefits   Vocational Rehabilitation Services   
Dependent Coverage    Eligibility    Enrollment Process    Estimated Imputed Income Chart    Paying for Benefits   
Account Rules    Eligible Dependent Day Care Expenses    Eligible Health Care Expenses    Reimbursement Process    Tax Advantages   
ActiveHealth®    Healthe Actions    Healthe Eating    Healthe Breathing    Healthe Care    HealthMedia    Healthe TRENDS    Know Your Numbers    Questions & Answers   
FAQs  
Special Features    Beneficiaries    Optional AD&D Insurance    Optional Life Insurance   
HDHP   HMO   HMO Physician Search   HSA   Medicare Part D   Non-Duplication of Benefits   PPO   PPO/HDHP Covered Services   PPO Physician Search   Rates   Woman's Health and Cancer Rights Act of 1998  
PTO Sharing/Donation  
Auto and Homeowners' Insurance    Long Term Care Insurance    Universal Life Insurance   
Retirement Savings Plan    Portable Pension Plan   
Primary Benefits   Secondary Benefits   Rates  

   expand  |  collapse

   

Long Term Disability Plan
When coverage starts
You’ll be covered under the long term disability plan when:

You have been certified as disabled, and
You have received short term disability benefits for five months

What the Long Term Disability Plan pays
The plan pays 60% of your base pay at the time you became disabled. Base pay doesn’t include overtime, shift differential, or any other premium pay. Payments will start on the first day of the sixth month of your certified disability.

Payments are made on a bi-weekly basis to coincide with Advocate’s payroll schedule.

Long term disability benefits are subject to federal, state and local taxes. The first 30 days of long term disability benefits are subject to FICA taxes. Benefits paid after the 30th day will be exempt from FICA taxes.

How long your benefits continue
The length of time you will continue to receive long term disability benefits depends on your age at the time you become certified as disabled.

Age at which you’re eligible for long term disability benefits: Your long term benefits continue until the earliest of when you’re no longer certified as disabled, you die, or you:
61 or younger reach age 65
62 receive benefits for 3 years and 6 months
63 receive benefits for 3 years
64 receive benefits for 2 years and 6 months
65 receive benefits for 2 years
66 receive benefits for 1 year and 9 months
67 receive benefits for 1 year and 6 month
68 receive benefits for 1 year and 3 months
69 receive benefits for 1 year

If your disability results from a behavioral health, mental or nervous condition, you’ll be eligible to receive long term disability benefits for up to 24 months.

Offsets to your disability plan benefit
You may have other sources of income (such as Social Security disability or Social Security retirement benefits or income you receive from restricted duty) that will reduce the amount you may receive from the plan.

Claiming your benefits––what you need to know
At the beginning of your third month of certified disability under the short term plan, the Disability Council will provide you with the application forms for the long term disability benefit.

1.   All long term disability application forms must be completed and returned to the council within 30 days. You won’t receive any long term disability benefits until you return all of the completed forms.
2.   Contact your local Social Security administration office to apply for Social Security disability benefits. You must provide proof of your application for Social Security benefits to the council at least 30 days before your long term disability payments are scheduled to start. If you don’t provide this documentation, your long term benefits cannot be paid.

Remember, it is the Disability Council––not your physician––that determines your eligibility and certifies benefits under the plan. The council will notify you of your long term disability benefits after reviewing the above information. If the council doesn’t certify disability benefits, you’ll get a letter that explains why you were denied and the appeals process. If your appeal is denied, you’ll be considered to have voluntarily resigned as of the date your appeal was denied.

If you become disabled again
If you become disabled again and your certified disability results from the same illness or injury, you’ll receive benefits under the disability plans as follows:

If the disability happens within six months after you’ve returned to work following a long term disability, you’ll immediately begin to receive long term disability benefits.
If the disability happens more than six months after you’ve returned to work in a full duty capacity following a long term disability, you’ll first receive benefits under the short term plan. If your illness or injury continues beyond the short term disability period and you qualify, you’ll then receive long term disability benefits.

If you become disabled again and your certified disability results from a different illness or injury, you’ll first receive benefits under the short term plan. If your illness or injury continues beyond the short term disability period and you qualify, you’ll then receive long term disability benefits.