What is the deadline to file a Short-Term Disability claim?
The Short-term Disability claim form must be submitted to Dearborn National at the address shown on the claim form within 12 months of the date your total disability began.
How do I file an Short-term Disability claim?
A completed Disability claim form is required. All claim forms require information to be provided by three parties: the insured employee, the benefits coordinator, and the attending practitioner. You must complete identifying information in the Employee's Preliminary Statement and forward the form to your benefits coordinator who will complete the Employer's Statement and return the form to you. When you receive the form, have your doctor complete the Attending Practitioner's Statement. Then, complete, sign and date the claim form and forward with all attachments to Dearborn National at the address shown on the claim form. Dearborn National must receive the form within 12 months of the date your total disability began.
When do Short-term Disability benefits become payable?
If you are totally disabled, you may be eligible to receive Short-term Disability benefits after you have completed the waiting period of your sick leave, extended sick leave, and sick leave pool, or 30 consecutive days, whichever is greater. Short-term Disability benefits are issued monthly at the end of each 30 day benefit period. To check the status of your claim, contact Dearborn National Customer Service at 1 (855) 377-5433.
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What is the time frame for processing my Short-term Disability claim form?
Your Short-term Disability claim will be assigned to an Examiner upon receipt of the completed claim form. The Examiner will review the claim and determine whether the information submitted substantiates your eligibility for Short-term Disability benefits. The review process could take up to ten calendar days. If it is determined that additional information is required, a request will be issued appropriately.
What is the appeal process if my claim is denied?
The letter you receive from Dearborn National will explain your appeal rights.You may ask for reconsideration of the decision by submitting a request in writing along with any additional information to the Dearborn National Claims Department. Any additional information submitted for reconsideration will be reviewed. If Dearborn National determines that your claim warrants a second denial, you will be notified in writing of the decision and Dearborn National will provide you with instructions for filing a grievance with ERS.
Grievances must be submitted in writing to ERS within the time stated in your denial letter. Upon receipt of your appeal, ERS will provide you with notification of receipt and obtain all information regarding your claim from Dearborn National in order to review your grievance. ERS will notify you in writing of their decision.
How long will I receive Short-term Disability benefits?
The maximum benefit period for receiving Short-term Disability benefits is five months.
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What happens if I am receiving other sources of income?
Short-term Disability benefits are reduced by other sources of income to which you may be entitled such as Worker's Compensation, Employees Retirement System (ERS) or Teacher Retirement System (TRS) disability retirement benefits, and other group disability benefits. This reduction is called integration with other sources of income.
The maximum Short-term Disability benefit payable is the lesser of 66% of your insured monthly salary or $6,600. However, if your Short-term Disability benefits are integrated with other sources of income, Short-term Disability benefits will be 70% of your insured monthly salary, minus other income. If you are approved for this coverage, your minimum Short-term Disability benefit is 10% of your insured monthly salary.
Is pregnancy or childbirth covered under my Short-term Disability coverage?
If you are disabled from any covered condition, including pregnancy or childbirth, it is considered to be an illness/sickness covered under your Short-term Disability coverage.
Is my Short-term Disability benefit taxable?
If your employing agency pays any portion of your Short-term Disability insurance premiums, that portion of Short-term Disability benefits paid are taxable for the duration of the claim.
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