Claims Approval Process



Claims Approval Process

In order to be approved to receive benefits from the Plan, the employee must:
  • Have a minimum of six Plan payroll deductions prior to the beginning date of disability.
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  • Have been actively at work or using accrued leave on the working day prior to the beginning date of disability.
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  • Apply to receive Plan benefits within 12 calendar months of the beginning date of disability.
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  • Be unable to perform the essential functions of his or her job due to a documented disability.
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  • Be under appropriate and continuous care of a licensed health care provider, and provide the Short-Term Disability Claim form and other medical documentation to the Benefits and Leave Administration Office. All statements must include the extent of disability, including restrictions and treatment preventing the employee from performing their essential job functions, and the expected duration of the disability.

It is the employee's responsibility to inform Benefits and Leave Administration of any changes in the medical condition for which he or she is receiving Plan payments. This includes a change in providers and/or treatment. The employee must also provide updated information upon request of the Plan Administrator and/or designees(s).

Plan claims will be paid or denied following a review by the Plan Administrator and/or designee(s).