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How Do I Leave Work on Disability—2013

Jacques Chambers, CLU,
Benefits Consultant

Posted June 18, 2013

There are new treatments for liver disease coming, as this site frequently reports. Despite these promised advances, most people dealing with HBV and HCV realize that there may come a time that they will have to stop work. However, it’s usually just a vague idea that they don’t need (or want) to deal with now. 

However, waiting until that time arrives without doing any preparation or understanding the process can lead to costly errors and even cause people to try to continue working far longer than is healthy.

Learning the process of leaving work is a good step, which will make the actual decision easier if and when it happens. There is a lot that can be done now, even if leaving work is not in the near future. Below is a summary of the entire process.

Assemble Your Plan Documents – You need to obtain current copies of all the “rulebooks” for all the employee benefits that you are covered by, even the ones you won’t be needing immediately. They are formally called “Summary Plan Descriptions” and there should be one for:

  • Health, Vision, Dental benefits

  • Short Term and Long Term Disability benefits

  • Leave of Absence Policy (This will tell you how long you will be kept as an employee once you leave work on disability)

  • Group Life Insurance Policy

  • 401(k) or Other Pension Plans under which you are covered

These are not skimpy outlines of a few paragraphs or pages. The health booklet alone is usually over 30 pages and disability booklets almost as along. There should be a schedule of benefits in them, a list of covered items and exclusions.

They all should also have a series of statements often labeled “ERISA Provisions” or “ERISA Information.” This will list the Plan name, the Plan number, the type of administration, and the Agent for Legal Process. If your document has those items, it is a Summary Plan Description.

These can be obtained from the Benefits Department, or Human Resources or whoever handles benefits in your company. You don’t have to tell them you are planning to leave. If you are concerned that they will suspect something, simply tell them that you are doing some estate planning and the planner said he/she needs to know all your current benefits to get a better idea of just what you may need in addition. Please note that you will NOT be able to get them directly from the insurance carrier. They will only refer you back to your employer.

Have at least an idea of your coverage – The main questions you need to know answers to are:

  • How long will you be on disability before your employment is terminated? This will tell you how long they will save your position and maintain your benefits; depending on the employer, it may be longer than the twelve weeks provided by the Family & Medical Leave Act.

  • What happens to your health insurance upon termination? COBRA, or will your company continue health coverage for a while before starting COBRA, or is your company one of the few that will cover you as long as you remain disabled?

  • What short term disability benefits are available from sick leave or short term benefits?

  • When do long term disability benefits start and what will it pay and for how long?

  • Is there a period between sick leave/short term and the start of long term that you will be without income?

  • Does the life insurance have a Disability Waiver of Premium benefit that will continue the coverage in force without premium payment?

Should symptoms become more severe, and you begin to think you should take some time off, then you may want to consider some more specific tasks.

First, I do not recommend you start out by telling your employer that you are leaving and will never come back. Not only would this cost you extended coverage under the Family & Medical Leave Act (FMLA), it is not necessarily true. Maybe you will respond to the medication without severe side effects and will want to return to work. Maybe new treatments will come out.

When it does come time to leave, you should notify your employer. Without going into any details at first, just state, “The doctor has said I must take some time off,” and ask what documentation you need to provide. It is recommended that you do this at the highest level in Human Resources with which you feel comfortable, not with your immediate supervisor.

You should not announce your intention more than a few days to a week before leaving, never more than two weeks. Remember, you are not leaving by choice. Your health problems require you to.

If pushed to give your diagnosis in the interview and you are not comfortable doing so, you can divert it by saying, “Won’t that all be in the paperwork from the doctor?” If they are persistent about a diagnosis, you may want to ask, “Who besides you will need to know my actual diagnosis? I really don’t want it spread all over.” If you are dealing with a high enough level in HR, they will know the confidentiality laws about disclosing your condition and be more likely to abide by them.

When asked when you plan to return, be vague: “The doctor says at least four to six weeks, possibly eight to ten weeks, maybe sooner.” (Keep it below the 12 week limit for the FMLA).

You will need some paperwork to start the process:

  • FMLA claim form (may be combined with STD form);

  • Short Term Disability claim form;

  • State Disability claim form if you live in New York, Rhode Island, New Jersey, California or Hawaii;

  • It is not necessary to request the LTD or other forms needed for a longer disability yet; remember you may be returning.

Confirm whether your payroll deductions that cover your portion of the benefits will be taken from the STD payment or must be paid by you directly to the employer. Note especially how to continue paying for the supplemental life insurance if you have it.

It is a personal decision whether to tell your immediate supervisor directly. If you feel you must tell him/her personally, I don’t recommend going into the diagnosis or actual time expected to be out.

Once you actually stop work, there are several things still to be done:

  • File for benefits – Complete claim forms and submit them, always keeping copies. If possible, have the employer and doctor return their completed portions of the form to you so you can file them in one package and track it to make sure it is received.

  • Pay for your portion of your continuing benefits – Make arrangements with payroll to pay your portion of insurance if they won’t be withheld from your short term check.

  • Stay in touch – Ask HR or payroll how often they need to hear from you while you are out.

  • Stay on the office grapevine – Not just to keep up with office gossip but to make sure no major changes occur that might affect you. It is not uncommon in smaller groups for an employer to change health insurance companies and “forget” to tell those who are off work.


As time goes by and you are still not able to return to work:

Extend Your Disability – Notify HR that the doctor does not feel you are able to return yet. Request:

  • Paperwork to extend Medical Leave to its maximum.

  • If asked about permanently leaving, simply tell them the truth, “I hope not, but my doctor can’t promise one way or another. My issues are clearly not resolved yet.”

  • Confirm how long you will be kept as an employee before being terminated (along with your benefits and job protection), “just in case” you are disabled that long.


Get additional claim forms –
Now is the time to collect all the claim forms you will need for the extended disability:

  • LTD Claim form (“just in case”) – This assumes a three to six month elimination period before LTD benefits start.

  • Claim form for Life Insurance Waiver of Premium.

  • Paperwork to access 401(k) funds (“just in case”).


File for long term disability benefits.
Complete claim forms and submit them.

File for Social Security Disability Benefits. This can be a major undertaking with a lot of paperwork. There is no need to rush into it. As long as you file for SSDI within the first twelve months of leaving work, you will not be losing any benefits or payments.

Sometime during this period your employment will be terminated. When that happens:

  • Confirm COBRA Notice and/or when COBRA notice will be sent.

  • File for Life Insurance Disability Waiver of Premium

  • Request disbursement of retirement funds if needed or roll them over into an Individual Retirement Account (IRA). Some people may prefer to postpone this since the fund continues to earn interest. Also, an award of Social Security disability benefits is generally considered to be sufficient proof to the plan administrator and IRS that you are exempt from any early withdrawal penalties or reduced vesting.


Making a plan of the steps you need to follow to transition from work to disability will make the whole process easier and reduce the stress that comes with such a major life change.

 

Confused about applying for disability? Click here

[Jacques Chambers, CLU, and his company, Chambers Benefits Consulting, have over 35 years of experience in health, life and disability insurance and Social Security disability benefits. For the past twelve years, he has been assisting people with their rights, problems, and other issues concerning benefits and disability. He can be reached at jacques@helpwithbenefits.com or through his website at: http://www.helpwithbenefits.com.]

 

Copyright June 2013– Hepatitis C Support Project - All Rights Reserved. Permission to reprint is granted and encouraged with credit to the Hepatitis C Support Project.

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