What is the maximum number of weeks I can collect disability?
There is a 28-week maximum period of continuous disability. In addition, the following rules apply:
1. Benefits shall be payable commencing with the first day of disability following the expiration of the unpaid waiting period as defined above but only if the member is on an authorized sick leave without pay. This leave must commence immediately following the member’s removal from the Department of Education Payroll. The Department of Education must have granted the member either:
a. an authorized Leave of Absence Without Pay for Restoration of Health; or
b. an authorized FMLA Leave for Personal Illness.
Regularly Assigned Substitutes not eligible for FMLA Leave will require a letter from their Principal stating that they would have been regularly assigned for the term had it not been for injury or illness.
2. Benefits will end when you are no longer disabled, as determined by the Fund, or have been paid for 28 weeks, whichever occurs first.
3. All periods of disability due to the same or related sickness or injury followed by a recovery and a return to work for periods of less than forty (40) successive work days, will be considered one continuous period of disability. No benefits will be payable for more than 28 weeks for all such periods combined. * See NOTE below.
4. A member who has returned to work for at least forty (40) successive work days after a period of disability shall be entitled to begin a new period of disability of not more than 28 weeks. *See NOTE below.
5. Benefits for all periods of disability due to the same or related sickness or injury shall not exceed one hundred (100) weeks.
6. Disability benefits for maternity related illness have a maximum of six (6) weeks for normal deliveries, and eight (8) weeks for Caesarean sections. These are considered routine pregnancies. The Fund will issue payment only once; after the six (6) or eight (8) weeks.
7. Complicated pregnancies have a maximum of 28 weeks, as determined by the Fund’s Medical Advisor. The member should apply for an authorized Leave of Absence without Pay for Restoration of Health.
*NOTE: During the school year, any paid holidays or recess periods that occur within this return to work period shall be deemed a “work day” for purposes of counting the forty (40) successive work days.
How are benefits obtained?
1. When you have been disabled for a period of 28 consecutive days (14 days for Non-Pedagogues and Paraprofessionals) or if you know that you will be disabled for a period of 28 consecutive days (14 days for Non-Pedagogues and Paraprofessionals) or longer, you should request a disability claim form from the Fund Office 212-539-0539.
2. There are two types of claim forms in connection with this benefit. One is white and marked in the upper right hand corner, “DBL-1- Initial Application.” The other is blue and marked in the upper right hand corner, “DBL-2- Supplemental Application.” Each form has three parts with a Certification section on the bottom.
It is your responsibility to:
a. complete the Member’s portion (Section A)
b. make sure that your Principal or Payroll Secretary completes Section B
c. make sure that your Physician completes Section C
d. sign and date the Certification on the bottom
e. ensure that all the necessary documentation has been attached to the claim form and is forwarded to the Fund Office.
Photocopies of the DBL-1 and DBL-2 claim form are not acceptable.
3. Your first claim (DBL-1- Initial Application) must be filed no later than thirty (30) days following your waiting period, or thirty (30) days following the issuance of your Leave, whichever is later. Failure to file within this period may result in the loss of benefits for the period between the 29th day of disability (15th day for Non- Pedagogues and Paraprofessionals) and the date the claim is received by the Fund Office. Physical inability, or delays in obtaining the required documentation necessary to file within this period, may be considered an exception and will be given consideration.
4. Upon receipt of a properly completed and signed
form, with necessary documentation (See
#7 on
the next page), the Fund will have the claim reviewed by its Medical Advisor,
as described in the “Disability Defined” Section above.
5. After having received your initial disability benefit payment from the Fund, and if you are eligible for further disability benefits, the blue “DBL-2 Supplemental Application” form (which will be mailed to you by the Fund) must be completed. It must be completed in the same manner as the DBL-1, as described above. A DBL-2 will not be sent when:
a. the maximum benefit has been paid; or
b. the Medical Advisor has determined that no additional benefits are payable; or
c. you have returned to work; or
d. you were paid for a routine pregnancy.
6. You should submit your DBL-2 Supplemental Application no later than thirty (30) days following the last date of the previous UFT Welfare Fund disability payment.