DC 37 Health & Security Plan Benefits
Disability Benefit (Active employees only)
The weekly disability income benefit for full-time per annum employees is 66 2/3% of their weekly salary but no more than $200 per week (7 day week). The benefit is paid for up to a maximum of 26 weeks but not longer than the member remains totally disabled. The weekly disability benefit for part-time or hourly employees is 66 2/3% of their weekly salary but no more than $98 per week. The benefit is paid for up to a maximum of 13 weeks but not longer than the member remains totally disabled.
Disability Payments begin when the member has used up all sick days, Section 3.5, and/or Donated/Dedicated Sick Leave Grant, but not before the end of 8 days of total disability at home. If the member is hospitalized, however, the benefit begins as soon as he/she has exhausted his/her sick days. In order to assist us in expediting the processing of the disability claim form, the following suggestions should be followed:
- Be sure that the member completes the claim in its entirety and have his/her physician answer all relevant questions (i.e cause of disability, dates of treatment, and or hospitalization, anticipated return to work date, etc.). Remember, claims must be signed by both member and physician.
- Indicate on the claim form the telephone number of the timekeeper, personnel officer, payroll secretary (depending on the agency).
- If the accident occurred on the job, the member must file for Workers’ Compensation with his/her employer and also notify the Workers’ Compensation Board.
- If the disability was due to a car accident, the member must file for No-Fault Insurance with his/her own auto insurance carrier. If the member is injured by an uninsured vehicle, then he/she must file with the Motor Vehicle Accident Indemnification Corp. [M.V.A.I.C. (646) 205-7800].
- In these situations, the member will not receive disability benefits. However, he/she is eligible for other Health & Security Plan benefits for a maximum of 26 weeks (or 13 weeks if he/she is a part-time or hourly employee) measured from the last day on active payroll status. If the member remains on active payroll status, receiving either sick leave, vacation pay, Section 3.5 or Section 7.2 leave pay, the eligibility period for Health and Security Benefits is measured from the last day on active payroll status. In order to maintain eligibility for these Health and Security Benefits during the period of disability, a disability claim form must be filed with the Plan. Further documentation will be necessary to extend benefits to the maximum allowable period.
The Disability Unit of the Health and Security Plan utilizes a list of Reasonable and Customary convalescent periods associated with each illness. If a member is out on disability for more than the Reasonable and Customary period of convalescence, the Plan will require an evaluation be performed by a doctor selected by the Health and Security Plan at no cost to the member. Failure to keep the evaluation appointment will cause the denial of any further disability payments, until another evaluation appointment is made and kept.
The Disability Unit periodically forwards requests for medical statements to the member, to be completed by the treating physician. Claims processing could be delayed if the medical statement is not furnished quickly.
The disability claim form must be filed within 15 days from the onset of the disability, regardless of the amount of sick time, vacation time or annual time available. If the claim is filed beyond the 15 days filing limitation, a letter of explanation must be attached to the claim. Complying with the above-mentioned instructions, will permit us to process the claim within 10 working days. However, other problems may cause processing delays (information not received from the payroll department, etc.).
Disability Benefits As They Relate To Workers’ Compensation
According to the rules and regulations governing the administration of the Disability Benefit, no benefits are payable if a member is receiving or eligible to receive Workers’ Compensation. However, there are instances where a member can turn to the Plan for assistance when his/her case is being controverted and payments for Workers’ Compensation benefits will be delayed until after a hearing. Therefore, if the following criteria are satisfied, the Plan will extend Disability Benefits to a member who is in dire need of financial assistance:
- The member applied for Workers’ Compensation and received a letter from the Law Department indicating that the case is being controverted.
- The member has exhausted all accrued sick and annual leave.
- The member has made application, if eligible, for but does not qualify for a Section 3.5 or Section 7.2 paid sick leave grant or similar provisions provided by other Agencies.
Once the above criteria are met and Disability Benefits are released, the Disability Unit will send a Compensation Lien Form directly to the Compensation Board. The lien becomes part of the Workers’ Compensation Case so that if or when the member is awarded Compensation benefit the Workers’ Compensation Board will pay the Plan directly.
Disability Benefits As They Relate To Substance Abuse
We are now able to pay benefits for alcoholism and drug dependency for both in-hospital and out-patient care. For out-patient care coverage, the individual must be in a rehabilitative program that is recognized by the Plan and verification of the care must be supplied to the Plan upon request. This benefit has a maximum coverage of 26 weeks for full-time employees and 13 weeks for part-time employees.
DISABILITY AND THE NEW YORK PUBLIC LIBRARY TRUST
The members of the New York Public Library Trust receive their short-term disability payment from the State while getting their ancillary benefits from the New York Public Library Trust. If the member is still disabled after receiving New York State disability, he/she will be eligible for a second six months of short-term disability payments. The member, however, will not be eligible for an additional six months of ancillary benefits.
Should you have any general questions relating to the disability benefit, contact the Inquiry Unit at (212) 815-1234.