Additional Employee Benefits Disability Questions and Answers
Additional Employee Benefits Disability Questions and Answers
EB Disability Q&A
Q. If I have both short-term and long-term disability insurance with American United Life (AUL), am I required to submit a claim for long-term disability if I have already submitted a claim for short-term disability?
A. No, however additional information may be required. We will contact you to discuss:
- Your claim
- Your prognosis
- Your ability to return to work
- Your policy’s provisions and limitations; as well as
- Any additional information needed
Q. What should I expect after filing a claim?
A. Your claim examiner will communicate with you via the telephone and in writing throughout the claim review process to keep you informed.
Q. How long will it take to make a decision after my short-term disability claim is filed?
A. Short-term disability claim decisions are generally made within five (5) days from the receipt of all the necessary claim requirements and documentation.
Q. How long will it take to make a decision after my long-term disability claim is filed?
A. A long-term disability claim decision will generally be made within 45 days from the receipt of all necessary claim requirements and documents.
Q. How will I be notified when a claim decision has been made?
A. Your claim examiner will notify you via a telephone call and mail.
Q. When will benefits start?
A. If your claim is approved, your benefits will begin after the elimination period end date as defined by your policy.
Q. What is an Elimination Period?
A. An elimination period is a period of time beginning on the first date of disability that must be satisfied before benefits are payable. The elimination period is stated in the “Schedule of Benefits” section of your policy.
Q. Will my disability benefit replace all of my income?
A. Your policy is designed to replace a portion of your regular pay. Please review your policy for details and terms of the specific coverage for which you may be eligible.
Q. When am I considered disabled?
A. The definition of disability is defined in your policy. Information will be requested from you, your employer, and your physician(s) to determine your abilities, restrictions and limitations. This information will aide in determining if you are disabled, as defined by your policy.
Q. How frequently will my short-term disability benefit checks be issued?
A. Approved short-term disability benefits are paid on a weekly basis, for the prior week. As a service to you, benefits for routine maternities and some surgeries are paid via a lump sum benefit payment.
Q. How frequently will my long-term disability benefit checks be issued?
A. Approved long-term disability benefits are paid on a monthly basis, for the prior month, after the elimination period has been satisfied. For example, if the elimination period is satisfied on May 15, the monthly benefits will be issued on June 15 for the benefit period of May 16 through June 15. Benefits will continue to be issued on the 15th of each month, subject to policy provisions and limitations.
Q. What benefit payment options are available?
A. The following two payment options are available:
- Check; and
- Electronic Funds Transfer (EFT) to a bank account designated by you.
Q. Are my disability benefits taxable?
A. Disability benefits may have taxes withheld if your employer contributed premiums on a pre-tax basis.
Q. Will my disability benefit be reduced by income and other benefits I receive while disabled?
A. Other benefits and other income you're eligible to receive could reduce your benefit amount. Please review your policy for a list of other income and benefits that may reduce your disability payment.
Q. How are work-related injuries handled?
A. Most short-term disability policies do not insure and cover work-related injuries. You should review your policy’s limitations and exclusions sections to determine if work-related injuries are covered.
Most long-term disability policies cover work-related injuries, but reduce the monthly benefits by Workers’ Compensation benefits received. A lump sum Workers’ Compensation benefit is prorated to determine long-term disability benefit reductions. Please review your policy’s limitations and exclusions sections to determine if work-related injuries are covered.
Q. How many weeks of benefits are paid for a maternity claim?
A. Up to six (6) weeks of post-partum disability is allowed for routine pregnancies and up to eight (8) weeks of post-partum disability is allowed for C-section deliveries. Please note that the elimination period still applies and therefore, the six (6) and eight (8) week disability periods are reduced by the elimination period when determining the time period for which benefits are payable. Your disability period may be less or greater in length depending on your individual medical and vocational factors.
Q. What will happen if my employment is terminated while I am disabled?
A. If employment ends during a period of disability for which benefits are approved, benefits may continue in accordance with your policy’s “Extended Benefits” provision.
Q. If I return to work on a part-time basis, what information is required from my employer to calculate my partial disability benefits?
A. Your employer is required to submit your earnings statements on a weekly basis for a short-term disability claim and a monthly basis for a long-term disability claim. Your employer will also be required to submit the number of hours you work each week and your rate of pay. The partial disability benefit will be calculated upon receipt of this information.
Q. What should I do if I return to full-time work early?
A. You should notify the claims department immediately regarding your return to work in order to prevent an overpayment of benefits.
Q. What if I return to work after receiving disability benefits and then go out again for the same reason, do I need to file a new claim?
A. You will not need to re-satisfy the elimination period if you return to work and the same disability recurs within the recurrent period outlined in your policy. In this situation, your claim is a continuation of your previous claim and benefits may be payable.
A new disability claim elimination period would be required when:
- You recover from your disability, return to work, and a new disability occurs; or
- The same disability recurs outside the recurrent disability period outlined in your policy.