Statutory Disability (DBL & TDB)

Employer’s may provide Long Term Disability protection to their employee’s on either a contributory, non contributory or voluntary basis. If an employee is in able to perform the material and substantial duties of his/her regular/own occupation due to sickness or injury and he/she has a 20% or more loss in monthly earnings due to the same sickness or injury Long term Disability protection is there to assist the employee with loss of wages he/she may incur during this hardship. As with Short Term Disability there are several plan designs such as 59%, 60%, and 70% to a monthly maximum as high as $10,000 per month. There is a waiting period for Long Term Disability such as a 90 day or 180 day, even longer. Usually an employee will be on Short Term Disability and then if needed the Long Term Disability will kick in after the STD is exhausted. There are several definitions of disability options. For example – Your Insurance Carrier will protect your employee with a 3 Year Own Occupation definition of Disability by continuing to pay benefits for 36 months as long as the employee is deemed disability. You can have an “Any Occupation Definition”. If there is a 36 month definition of disability an employee will continue to receive benefits beyond the 36 months is he/she is also working in any occupation and continues to have a 20% or more loss in monthly earnings due to his/her sickness or injury or not working and due to the same sickness or injury, he/she is unable to perform the duties of any gainful occupation for which he/she is reasonably fitted by education, training or experience. Long Term Disability is also payable to age 65 own occupation periods up to the maximum retirement age – ADEA and will be integrated with Social Security either by Primary or Family offsets.

Benefits maybe limited to Mental, Nervous, Drug and Alcohol illnesses. LTD policies offer a residual option – which means the employee must be totally disabled throughout the elimination period. The Residual Option allows an employee to begin partial disability employment during the elimination period. Partial disability employment is a program in which the employee engages in vocational training or a period of work for the purpose of rehabilitation, or part time or full time employment in any occupation.

Pre-Existing Conditions

Long Term Disability benefits will not be paid for any disability resulting from a pre-existing condition. A pre-existing condition is considered to be any injury or sickness for which the employee has received treatment as defined in the Employer’s Insurance Policy within 30 days prior to the beginning of the employee’s coverage under that Policy. This limitation is based on one of the following three options:

3/3/12 – benefits will not be paid for any disability which begins in the first 12 months after the employee is insured, which is due to or results from a pre-existing condition unless he has received no treatment of that condition for 3 consecutive months after the effective date of the insurance but prior to the disability
3/12 – benefits will not be paid for any disability which begins in the first 12 months after the employee is insured, which is due to or results from a pre-existing condition
5/30 – benefits will not be paid for any disability which is due to or results from a pre-existing condition unless he employee has preformed the material and substantial duties of his own occupation on a full time basis for a least 5 consecutive days after the effective date of his insurance.

Long term Disability policies can be created to suit your employee’s needs based on the demographics, occupation and salary. We can provide Long Term Disability in All States.