Disability Claim Form

Request Disability Benefit Plan Description

 

 

Disability Insurance Benefit

 

 

 

A short term disability insurance policy is paid for by the company.  This insurance provides a benefit of $200.00 per week to employees meeting disability criteria defined as total disability for off-the-job illness or injury. The duration of the insurance is 13 weeks.

 

When you are off work on short term disability, it is the employee's responsibility to make monthly payments to keep their portion of health, dental and life programs current.

 

A summary plan description of your disability benefit is available upon request from Human Resources. 

 

 

Total Disability

 

 

  You, the eligible employee, are totally disabled if you cannot perform the duties of your own occupation or any other work for wage or profit.  Two periods of disability are separate if they are separated by return to active work for a period of six consecutive months or they arise from totally unrelated causes.

For more information regarding the disability insurance program, contact Human Resources for further assistance.