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Long-Term Disability Plan

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Claims

The Benefits Office has all the necessary forms and can provide help with claims for Plan benefits. View the section Applying for and Receiving Disability Benefits for the steps you should follow in claiming disability benefits.

When should I apply for benefits?
You should apply for benefits as soon as it appears you may be eligible for disability benefits so that rehabilitation efforts can begin as soon as possible. You will work with Work~Connections staff to determine the appropriate time to apply for LTD benefits. Refer to the section Applying for and Receiving Benefits for steps you should follow. You should also apply for Social Security disability benefits at the same time you apply for benefits under this Plan. See When must I apply for Social Security disability benefits for more information.

How do I apply for disability benefits?
Contact the Long-Term Disability Coordinator in the University's Benefits Office. The Benefits Office is the only office that is authorized to release and process an application for Expanded Long-Term Disability.

To apply for benefits, you will need to complete the following forms:

  • Request for Participation Form
  • Reimbursement Agreement
  • Social Security Administration Release Authorization
  • Medical Release Authorization

In addition:

  • Your supervisor will need to complete a Departmental Disability Claim Form, and
  • Your physician(s) will need to complete a Healthcare Provider Statement of Disability, and
  • You may be required to participate in independent medical evaluations and/or meetings with vocational rehabilitation specialists or nurse case managers.

Will I be required to provide medical evidence or documentation?
Yes. You must provide proof of disability that is satisfactory to the Claims Administrator. This proof is referred to as "medical evidence" based on objective clinical findings. The medical evidence must show that the disability prevents you from engaging in any occupation or employment for which you are reasonably suited by education, training, or experience, and qualifies you for benefits according to the terms of this Plan.

To determine the nature and extent of your disability, you may be required to be examined by physicians, psychologists, or psychiatrists, and/or be interviewed by vocational rehabilitation specialists or nurse case managers.

Will I have to provide medical evidence more than once?
Yes. If your disability continues, you will be required to submit medical evidence on an ongoing basis. This means that you may be required to be examined on an ongoing basis by physicians, psychologists, or psychiatrists, and/or be interviewed by vocational rehabilitation specialists or nurse case managers.

To continue receiving Expanded Long-Term Disability benefits, your treating physician will be required to complete and return a Medical Update Form (and any other medical evidence specified by the Claims Administrator) proving that you continue to be disabled according to the terms of this Plan. You must do so at your expense and as often as the Claims Administrator determines is reasonably necessary.

What if my claim is denied?
If your claim for benefits from this Plan is denied, either in full or in part, the Claims Administrator will promptly send you a written notice indicating the reason(s) for denial.

 

 

Every effort has been made to ensure the accuracy of the benefits information in this site. However, if any provision on the benefits plans is unclear or ambiguous, the Benefits Office reserves the right to interpret the plan and resolve the problem. If any inconsistency exists between this site and the written plans or contracts, the actual provisions of each benefit plan will govern. The University in its sole discretion may modify, amend, or terminate the benefits provided with respect to any individual receiving benefits, including active employees, retirees, and their dependents. 

©2002 University of Michigan Human Resources and Affirmative Action | Benefits Office | Wolverine Tower - Low Rise G250, 3003 South State Street, Ann Arbor MI 48109-1278 |Fax (734) 763-0363