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W E L F A R E
Weekly Disability Benefits
Introduction
The Accident and Sickness Disability Benefit for active employees provides you with a weekly benefit when you are absent from work due to illness, including pregnancy, or nonjob-related injury. You must be under a doctor's care to receive benefits.
How The Accident and Sickness Disability Benefit Works
If you become disabled while covered by the plan, you'll receive a weekly benefit. You're considered disabled if you're not able to work your regular job because of an injury or an illness.
Effective January 1, 2008
Benefits Overview
Weekly Benefit Amount |
$500 |
Date Benefits Begin |
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Maximum Time Benefits
May Be Paid |
52 weeks |
When Coverage Begins
Coverage begins when your welfare fund plan coverage begins. See the Eligibility and Membership section for more information. There is one exception: If you are hospitalized on the date your accident and sickness disability coverage would otherwise begin, coverage will be delayed until you are released from the hospital and have returned to active work.
Weekly Accident Benefit
If you are disabled because of a non-work-related accident, you may receive a disability benefit of $500 a week for each week you are disabled, up to a maximum of 52 weeks for each accident. Benefits begin on the first day of disability.
Weekly Sickness Benefit
If you are unable to work because of an illness or disease not covered by Workers' Compensation, you may receive a disability benefit of $500 a week for each week you are disabled, up to a maximum of 52 weeks. Benefits begin on the first day of your disability.
Extending the Maximum Time Benefits May Be Paid
If you have been eligible for benefits under this plan for at least five consecutive years and you are still disabled after receiving 52 weeks of benefits, you may be eligible to receive accident and sickness benefits for an additional 52 weeks.
Doctor's Care Required
To receive benefits, the employee must be under the regular care of a legally qualified doctor and be seen by the doctor at least once each 60 days during your period of disability.
How A Period of Disability Is Determined
If you return to work after a disability and then become disabled again, the disability will be considered one period of disability unless:
- you return to full-time active work for two full weeks, or
- the causes of the disabilities are different and you have worked one full day between the disabilities.
What the Plan Does Not Cover
Benefits are not provided for:
- injury and/or illness covered by Workers' Compensation
- employees who are becoming eligible for the first time on any January 1, or for employees who are reestablishing their coverage on any January 1 after having failed to qualify for coverage for one year or more, if they are confined in the hospital on January 1.
Claiming Your Benefits
If you become disabled, contact the Welfare Fund Office for a claim form and complete and sign the front side of the form. Your doctor should complete the back side of the form and return it to the Welfare Fund Office as soon as possible so that you will be able to receive your benefits promptly. You and your doctor should complete and date a claim form for each period that you receive disability payment. Claim forms cannot be pre-dated.
See the Important Information section for information on appealing a denied claim.
When Coverage Ends
Your coverage for weekly accident and sickness benefits will end on the earliest of:
- the date the plan terminates;
- the date the plan terminates coverage for the class of employees to which you belong;
- for employees employed in the Manager's Office, the Georgia Stevedore Association Office, Container Inspectors, and the local unions of the International
Longshoremen's Association for whom contributions are required, the last day of the calendar month in which contributions stop or your employment ends; or
- for all other employees, the December 31 following a plan year - October 1 through September 30 - in which you work less than 700 credited hours.
If your coverage ends for reasons other than the plan terminating or the plan terminating coverage for the class of employees to which you belong, however, benefits can be paid for up to the 52 week maximum for any injury or illness that began or occurred while you were covered.
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