How To Apply For Long Term Disability
You apply for long-term disability benefits by filling out forms. In other words, you are submitting an application or claim. Then, you simply send the completed forms to the insurance company. After that, they assign an insurance representative to review your claim.
There are three forms you must fill out, or arrange to be filled out:
- Notice of Claim You fill this out
- Employers Report Your employer fills this out
- Medical Report Your doctor fills this out
You can get these forms from your employer. If you are already dealing with the insurance company, then they may give them to you. But, its up to you to arrange for everyone to fill out the forms.
What to learn more about applying for long-term disability? Check out our 7-Step Guide on How to Apply for Long-term Disability
Benefits Of Private Disability Insurance For Federal Employees
Disability benefits through FERS are typically barebones and donât provide the tailored coverage that many people might need. A private disability insurance policy, on the other hand, can be customized with additional benefits such as:
Rehabilitation riders help pay for vocational training after a disability.
Partial or residual coverage gives partial benefits if your hours are cut back or you otherwise canât work to your full potential to receive the same income as you previously did.
Future purchase options allow you to increase your coverage in the future without going through the underwriting process again.
Even though federal employees are eligible for their own benefits and supplemental coverage might be less than you originally assumed, there are still benefits to getting a private policy that shouldnât be ignored.
Apply For Benefits Online
You should apply for disability benefits as soon as you become disabled. Follow these easy steps to apply online for disability:
- To start your application, go to our Apply for Benefits page, and read and agree to the Terms of Service. Click Next.
- On that page, review the Getting Ready section to make sure you have the information you need to apply.
- Select Start A New Application.
- We will ask a few questions about who is filling out the application.
- You will then sign into your mySocial Security account, or you will be prompted to create one.
- Complete the application.
You can use the online application to apply for disability benefits if you:
- Are age 18 or older.
- Are not currently receiving benefits on your own Social Security record.
- Are unable to work because of a medical condition that is expected to last at least 12 months or result in death and
- Have not been denied for disability in the last 60 days.
Note: If your application was recently denied, our application is a starting point to request a review of the determination we made.
You may be able to file online for SSI at the same time that you file for SSDI benefits. Once you complete the online process above, a Social Security representative will contact you if we need additional information.
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Who Is Eligible For Long
Not everyone is eligible for long-term disability benefits, however. The eligibility criteria are unique to each insurance policy, but generally, you must:
When Do My Benefit Payments Start
If you become totally disabled, benefits will be paid once you have used all of your sick leave, providing a minimum elimination period of 13 weeks has been met. In most cases, the elimination period consists of a complete absence from work for a minimum period of 13 weeks. In certain circumstances, however, periods of absence due to the same condition for which you are claiming benefits, which occurred within the year immediately prior to the initial date of total disability, can be used in calculating the elimination period. These are special circumstances which must be referred to the Insurer for a decision on an individual basis.
If you are a seasonal employee, the elimination period is applied in a slightly different way because of your special terms and conditions of employment. You should, therefore, consult your departmental Compensation services or the Public Service Pay Centre for details.
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Disability And Leaving The Public Service
You should immediately notify your manager if your physician has certified that your illness is continuing and you are unable to return to work. Your manager may grant you leave without pay for a period sufficient to enable you to make the necessary adjustments and preparation for separation from the public service.
Refer to Appendix B of the Directive on Leave and Special Working Arrangements for additional information.
The Disability Application Process
Whether you apply online, by phone, or in person, the disability benefits application process follows these general steps:
- You gather the information and documents you need to apply. We recommend you print and review the . It will help you gather the information you need to complete the application.
- You complete and submit your application.
- We review your application to make sure you meet some for disability benefits.
- We check whether you worked enough years to qualify.
- We evaluate any current work activities.
- We process your application and forward your case to the Disability Determination Services office in your state.
- This State agency makes the disability determination decision.
To learn more about who decides if you are disabled, read our publication .
Once You’ve Applied
Once we receive your application, well review it and contact you if we have questions. We might request additional documents from you before we can proceed
Look For Our Response
Youll receive a letter in the mail with our decision. If you included information about other family members when you applied, well let you know if they may be able to receive benefits on your record.
Check The Status
You can check the status of your application online using your personal mySocial Security account. If you are unable to check your status online, you can call us 1-800-772-1213 from 8:00 a.m. to 7:00 p.m., Monday through Friday.
Appeal A Decision
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Filing A Private Short
To apply for short-term disability benefits from the insurance company, you’ll need to follow a few steps:
- Get a copy of the claim form from your employer’s HR department or your insurance carrier . The claim form will ask you for details about your medical condition and the date you last worked, as well as some personal information.
- Ask your employer and doctor to fill out their portions of the claim form. Your employer will need to provide your job description, salary, and history with the company. Your physician must certify that your medical condition keeps you from working. The insurance company’s claims administrator will then review your medical records to make sure they support your claims of disability.
- Appeal if denied. If you’re denied for short-term disability benefits, it’s a good idea to appeal. Many claims that are eventually approved are turned down initially hire a lawyer to give yourself the best chance.
Leave Without Pay For Illness Or Injury
If you wish to request leave without pay for illness or injury, you must provide a medical certificate from your physician. With this certificate, and the indication of a likely return to work within a reasonable period of time, your manager will consider granting you leave without pay for illness or injury.
Once your leave without pay is approved, your manager will notify your departmental human resources. They will then notify the Pay Centre through a pay action request form. The Pay Centre will take the appropriate action to temporarily stop your salary.
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Enquiries About The Di Plan
Employees with questions about their coverage under the DI Plan should contact their compensation advisor.
Should you have any questions regarding this notice, please contact Treasury Board of Canada Secretariat, Pensions and Benefits Sector at .
Bayla Kolk Assistant Deputy Minister Pensions and Benefits Sector
Joyce: Do You Know How Many Claims Are Submitted Each Year For This Program And How Often They Are Approved Also About How Long Does It Take To Get Approved
Cheri: There are no statistics that we can find on approval rates. The OPM statistics on this programs use, however, are interesting. In 2016, OPM reports that there were 136 CSRS disability applications and 6486 FERS applications, for a total of 6622. OPM also reports that for that fiscal year, approximately 6.7% of all retirements among federal employees were taken for reasons of disability.If you would like to see how OPM reports this data, go to this website:
The fact is that it could take up to a year or more for OPM to act on your claim from when it is fully completed and submitted, so you will need to plan accordingly. Remember that you can apply while you are employed, but you do have one year post separation to apply for disability retirement. If you miss that deadline, you are ineligible.
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Do Retroactive Salary Increases Affect The Calculation Of My Disability Insurance Benefit
In accordance with the Disability Insurance Contract, the retroactive salary increase provision applies only to claimants whose disability commenced on or after March 1, 1993.
Any retroactive salary increase approved after the commencement date of your Disability Insurance benefits will affect your insured salary and benefit level only when the effective date of the increase precedes the date your DI benefits began. Therefore, a retroactive salary increase approved in April, to take effect from February 10, would only be used to adjust benefits if your DI benefits commenced February 11 or later
What To Consider When Buying Disability Insurance
If you’re considering disability insurance, make sure you:
- check with your employer to see if you already have group disability coverage with your employer’s plan
- shop around, especially if you’re considering private disability insurance
Consider group insurance offered through a union, guild, or professional or alumni association. Premiums for this type of coverage usually increase as you get older. You’ll need to renew your insurance every few years.
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Regular Or Own Occupation
The definition of “regular or own occupation” plan means you’ll receive benefits if you’re unable to perform the main duties of the job you had at the time the disability started.
You’ll still receive benefits even if you can work in a different job from the one you had before your disability, based on your training, experience and education. Some policies don’t allow you to get benefits, or may reduce your benefits, if you begin working in a different job.
In group policies, it’s common that policies have regular or own occupation plans for a specified period of time. At the end of the specified period of time, usually after the first 2 or 5 years, the disability policy will often change to the any occupation definition.
Own occupation plans that never change in definition are often purchased individually and usually cost more than any occupation plans.
You may want to consider an own occupation plan if you have a specialized occupation that would require you to take a significant pay cut in order to work in another field.
Informing The Pay Centre
Your manager will have the departmental leave system updated with any additional approved leave. They will provide notification of your separation from the public service to your departmental human resources, who will subsequently provide the necessary information to the Pay Centre. The Pay Centre will, in turn, provide you with the information relative to your situation and separation from the public service
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Joyce: What Happens If You Recover Once You Are On Fers Retirement Disability
Cheri: If you recover, you will lose your benefits. OPM will periodically ask you and your physician to re-certify your disability status and you will need to provide proof of on-going disability when you are asked. This request could come annually or more or less often. Irrespective of when you are asked by OPM for information, you need to proactively advise OPM when you are no longer disabled, as to continue to receive federal funds for a disability you no longer have, could be considered fraud.
Returning To Work With Changes To Your Schedule
You should immediately notify your manager if your physician has certified that you are able to return to work, but that you are:
- no longer able to carry out the duties of the position
- in a rehabilitation program
- recommended for a reintegration process
- not able to return to work on a full time basis
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Canada Pension Plan Disability Benefits
The Canada Pension Plan provides monthly payments to people who contribute to the plan during their working years.
You may be eligible for CPP disability benefits if:
- you contributed to the CPP for a certain number of years
- you’re under 65 years old
- you have a severe and prolonged mental or physical disability
- your disability prevents you from working on a regular basis
The benefits include payments to children of a person with a disability.
Apply as early as possible if you think you’re eligible for CPP disability benefits. Quebec residents may be eligible for a similar program called the Quebec Pension Plan . It may take several months to process your application.
If you applied for CPP or QPP disability benefits and were told that you’re not eligible, you can ask to have your application reviewed or considered again.
Once you reach age 65, your CPP disability benefit will automatically change to regular CPP payments. Your regular CPP payments may be less than the CPP disability payments you got before.
If so, consider:
What Are My Obligations With Respect To My Claim
While you are receiving benefits, you must be under the regular care of a licensed physician and following a course of treatment, which, in the opinion of the Insurer, is appropriate. You must also make every reasonable effort to comply with recommended treatment modalities which may facilitate your return to your employment during the first 24 months of disability or to obtain employment in a commensurate occupation at the end of the 24 months of disability.
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Workplace Wellness And Productivity
The Government of Canada plans to modernize this outmoded and inefficient disability management system in order to provide seamless coverage and active case management. The Government plans to introduce, for the first time, a short-term disability program to support employees through illness while the long-term program will be overhauled and integrated with the short-term disability program.
A revamped plan would strengthen support for ill and injured employees, including addressing new and emerging illness like mental health, which today represent more than half of all disability claims among employed Canadians. Active case management will tackle high rates of absenteeism in the public service, ensuring a timely return to work and improved productivity.
Disability Benefits For Veterans
You may be eligible for disability benefits if you’re on disability from your service in the Canadian Armed Forces or Merchant Navy.
You may get social assistance payments from:
- your province or territory
- your First Nation
These payments will depend on your household income, savings and investments.
You may also be eligible for health-related benefits from your province or territory. These benefits may include benefits that help cover the cost of:
- medical aids or devices
Effects Of Leave Without Pay On Benefits And Employment
Your leave without pay will have an impact on:
Once the Pay Centre receives the necessary documentation from your departmental human resources team, it will provide you with a benefit letter outlining the impact your period of leave without pay will have on your benefits.
The Pay Centre will also explain:
- how your sick leave benefits are impacted
- how to complete and submit disability and long term disability insurance forms
Features Of Disability Income Programs :
- Benefits available on the 15th day. Covers both sickness and accidents. 1st day coverage if hospitalized for sickness.
- Benefits available from $600 to $3,000 per month.
- 24-hour coverage. Group rates. No medical exam needed to qualify.
- Pre-existing conditions covered after the first year.
- Pays 100% in addition to any other benefits or disability insurance you may have.
- Pays 50% in addition to worker’s compensation.
- Maternity covered the same as any other sickness.
- Many other outstanding benefits also available.
NO ELIGIBLE FEDERAL, POSTAL OR DC GOVERNMENT EMPLOYEE CAN BE TURNED DOWN.
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What Are My Responsibilities Related To The Rehabilitation Program
You are required to make every reasonable effort to facilitate recovery from your disability. This includes your full participation in an approved Rehabilitation Program and your acceptance of any reasonable offer of modified duties that your employer can put in place. You must also try to retrain for employment in a commensurate occupation where it is apparent that you will not be able to return to your regular occupation within the first 24 months that you receive disability benefits. The Insurer may withhold or discontinue your benefits if you do not comply with the above conditions.