What is the deadline to file a Long-Term Disability (LTD) claim?
The LTD claim form must be submitted to Fort Dearborn Life at the address shown on the claim form within 12 months of the date your disability began.
What is required to file a LTD 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. The insured employee must complete the Employee's Statement and have the attending physician fully complete the Attending Practitioner's Statement. The benefits coordinator will forward the fully completed claim form along with any other required documents directly to the Fort Dearborn Life claims office.
What is the appeal process if my claim is denied?
The letter you receive from Fort Dearborn Life 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 Fort Dearborn Life Claims Department. Any additional information submitted for reconsideration will be reviewed. If Fort Dearborn Life determines that your claim warrants a second denial, you will be notified in writing of the decision and Fort Dearborn Life 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 Fort Dearborn Life in order to review your grievance. ERS will notify you in writing of their decision.
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When does LTD become payable?
If you are disabled, you may be eligible to receive LTD benefits after you have completed the waiting period of your sick leave, extended sick leave, and sick leave pool or 90 consecutive days whichever is greater. LTD benefits are issued monthly at the end of each 30 day benefit period. To check the status of your claim, contact Fort Dearborn Life Customer Service at 800-778-2281.
What is the maximum time frame I will receive LTD benefits?
Your age as of the date your disability began will determine the period for which you may be eligible to receive LTD benefits. The maximum benefit duration for receiving LTD is based on your age at the time your disability began:
- Under age 60: to age 65*
- Ages 60 to 64: 60 months
- Ages 65 to 69: to age 70*, or 12 months, whichever is greater
- Ages 70 and over: 12 months
*
The maximum benefit period for Mental and Nervous Conditions is 24 months unless you are totally disabled, under an approved practitioner's regular care, and confined in a hospital or institution specializing in the treatment you require.
Additionally, after 24 months of LTD benefit eligibility, the definition of total disability changes from performing the tasks of your own occupation to performing the tasks of any occupation for which your are reasonably qualified by training, education or experience.
What happens if I am receiving other sources of income?
LTD benefits are reduced by other sources of income to which you may be entitled such as STD benefits, Worker's Compensation, Employees Retirement System or Teacher Retirement System disability retirement benefits, Social Security Disability benefits for you and any of your eligible dependents and other group disability benefits. This reduction is called integration with other sources of income.
The maximum LTD benefit payable is the lesser of 60% of your insured monthly salary or $6,000; and if you are approved for this coverage, your minimum LTD benefit would be 10% of your insured monthly salary for up to 12 months.
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Is pregnancy or childbirth covered under my LTD coverage?
If you are disabled from any covered condition, including pregnancy or childbirth, it is considered to be an illness/sickness covered under your LTD coverage.
Is my LTD benefit taxable?
If your employing agency pays any portion of your LTD insurance premiums, that portion of LTD benefits paid are taxable for the duration of the claim.
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