Long Term Disability FAQs
What is long term disability?
Long term disability provides income if you cannot perform the major functions of your job after becoming disabled from a non-work related accident, illness or pregnancy/childbirth. Long term disability kicks in when an employee has been disabled for at least 180 days. Benefits can replace up to 60 percent of income lost due to illness or injury.
Am I eligible for long term disability insurance coverage?
Employees working at least 20 hours per week (except for temporary employees) are eligible for long term disability as shown:
- Exempt employees become eligible for long term disability on the first of the month after 30 days of service.
- Classified employees may purchase long term disability coverage after one year of service. It is provided at no cost after completing five years of service.
When am I considered disabled?
For long term disability, you are considered disabled when both of the following conditions apply:
- You are unable to perform with reasonable continuity the material duties of your own occupation as a result of physical disease, injury, pregnancy or mental disorder.
- You suffer a loss of at least 20% of your pre-disability earnings when working in your own occupation.
You are not disabled merely because your right to perform your own occupation is restricted, including a restriction or loss of license.
When do benefits become payable?
If your claim is approved by UnitedHealthcare, benefits become payable at the end of the benefit waiting period. No benefits are payable during the benefit waiting period.
What is the benefit waiting period for long term disability?
The benefit waiting period is 180 days.
What is my benefit?
Benefits are based on your earnings from the County. The group insurance policy refers to these earnings as pre-disability earnings. Your group insurance certificate includes the complete definition of pre-disability earnings. Your long term disability benefits are 60% of your pre-disability earnings, reduced by deductible income.
How long can benefits continue?
The maximum benefit period is determined by your age when a disability begins, as defined in your certificate of coverage.
If I am disabled and return to work, can I continue to receive benefits?
The group long term disability (LTD) insurance policy includes a feature that offers you a financial incentive to return to work during a disability. During the first 12 months from the date you first return to work (after the benefit waiting period) your LTD benefit will be reduced by work earnings which, when added to your LTD benefit, cannot exceed 100 percent of your pre-disability income. Other deductible income can further reduce the LTD benefit payable. Frequently, claimants who return to work receive more total income than those who do not. The return-to-work incentive applies whether you are working for your employer or any other employer (including self-employment). You are eligible for the return-to-work incentive on the first day you work after the benefit waiting period, if LTD benefits are payable on that date. After the first 12 months from the date you first return to work, one-half of your work earnings are considered deductible income.
What happens if I have a relapse after initially recovering from a disability?
If your disability ends during the benefit waiting period and you become disabled again from the same cause within 30 days of recovery, then you will not have to serve a new benefit waiting period. However, you will have to serve the remainder of the prior benefit waiting period.
If your disability ends after serving the waiting period, and you become disabled again from the same cause within 180 days of recovery, then you will not have to serve a new benefit waiting period.
In either case, no benefits will be payable for the period of temporary recovery. Additionally, no benefits will be payable after you begin to receive payments from any other group insurance policy that began coverage during your period of temporary recovery.
What are some of the other features of this coverage?
- A Rehabilitation Plan provision may pay some or all of the expenses you incur in connection with the plan, including expenses for training and education, family care, job search and other job-related expenses.
- Insurance continues without payment of long term disability premiums while benefits are payable.
- If you are disabled and return to work in any occupation for any employer as a result of a reasonable accommodation made by the employer and UnitedHealthcare gives prior written approval of the accommodation before it is implemented, then UnitedHealthcare will pay the employer up to $25,000 for expenses incurred for the accommodation.
- If you die while long term disability benefits are payable, and on the date you die you have been continuously disabled for at least 180 days, then UnitedHealthcare will pay an a lump sum of three times your monthly disability benefit to any one of the following people:
- Your surviving spouse
- Your surviving unmarried children under the age of 25
- Any person providing care and support to the above people
When does my insurance coverage become effective?
Eligible employees must meet the active work requirement to perform the material duties of your own occupation at your employer’s usual place of business.
If you are incapable of meeting this requirement because of physical disease, injury, pregnancy or a mental disorder on the day before the scheduled effective date of your insurance, then your coverage will not become effective until the day after you meet the active work requirement for one full day as an eligible member.
When does my insurance coverage end?
Your coverage ends on:
- The last day of the last period for which you make a premium contribution
- The date your employment terminates
- The date the group policy terminates
- The date you cease to be a member
Are the long term disability plan documents available?
Visit Short and Long Term Disability for more resources, contact information and answers to other questions.
These FAQs are written in non-technical language and not intended as a complete description of the group insurance plan offered by UnitedHealthcare. You should refer to your plan documents which contain more detailed information. The controlling provisions are in UnitedHealthcare’s group policy. This information does not modify that document or the insurance in any way.