If you work for Vanderbilt University, below is helpful information from
Vanderbilt regarding ERISA long-term disability coverage for their employees.
Long-term disability insurance (LTDi) is administered by Unum and is a benefit for faculty and staff that pays 60 percent of your annual base benefits rate, up to a maximum monthly benefit of $33,000, if you ever become disabled and are unable to work for six months or longer. The LTD benefit also includes a 10% monthly contribution to your retirement account if you are a participant in the Vanderbilt University Retirement Plan.
Automatic enrollment in LTDi occurs on the first of the month after your one-year anniversary for faculty and staff and immediately for house staff, so no enrollment is necessary. You may be able to waive the one-year wait if you had group LTDi coverage within 90 days prior to coming to work at Vanderbilt. Complete and submit the Long-Term Disability Certification of Prior Coverage Form within 90 days of your hire date to waive the one-year wait. If approved, full long‐term disability coverage must be effective on your hire date. Any missed LTDi premiums will be collected from future paychecks.
Vanderbilt pays for basic LTDi which covers the first $24,000 of your annual base pay. You pay for full coverage between $24,000 and your annual base pay. You can waive full coverage at any time (above the $24,000 that Vanderbilt pays) on the My VU Benefits website.
How to File a Long-Term Disability Claim
If you expect to be out of work for six months or more you should begin the LTDi application process within 30 days after the disability begins or as soon as possible so that a claim decision can be made in a timely manner. Generally, the application process may take two to three months. There is a six-month period between the onset of the condition constituting a disability and when benefits are payable1. However, the LTDi application should be submitted within 12 months of the onset of the disability for consideration for this benefit.
To file a claim with Unum, call the Office of Benefits Administration at 615.322.8977. A claim will be set up on your behalf. When the disability carrier is in receipt of the completed application, they will notify you and the Office of Benefits Administration if your claim is approved as eligible for LTDi benefits.
Receiving Long-Term Disability Benefits
What is Provided:
Long-term disability insurance provides two standard payment benefits. Those benefits include:
- an income payment of a percentage of covered monthly earnings exclusive of overtime pay, bonuses and other types of extra compensation, and
- a contribution of 10% of retirement eligible salary to your Vanderbilt University Retirement Plan account(s).
When Benefits Begin:
Benefits begin on the first day following six (6) consecutive months of total disability as defined by the plan and determined by Unum. LTDi payments continue for as long as the disability lasts or up to age 65, whichever occurs first. If disability occurs after age 60, the maximum period of LTDi payments is based upon the following schedule:
|Age When Disabled||Benefits Payable|
|Prior to Age 60||To Age 65, but not less than 5 years|
|Age 60 – 64||5 years|
|Age 65 – 69||To Age 70, but not less than 1 year|
|Age 70 and over||1 year|
Unum Defines Disability When:
- you are limited from performing the material and substantial duties of your regular occupation due to your sickness or injury; and
- you have a 20% or more loss in your indexed monthly earnings due to the same sickness or injury; and
- during the waiting period, you are unable to perform any of the material and substantial duties of your regular occupation.
Use of Leave Accumulations
During the six-month period, you must use all accrued leave available, grandfathered sick time, flexPTO, vacation and/or personal, before going into an unpaid status. In cases of a delayed application for LTDi benefits, the approval may happen after the six-month waiting period ends. Because of this, part of the LTDi payment may be made retroactively given the following considerations:
- If the LTDi payment is approved and flexPTO/leave accumulations have been used, no LTDi payments will be made for the period covered by the flexPTO/leave time.
- If no flexPTO/leave time was available following the six-month leave of absence, the approved LTDi payment will be paid once the six-month elimination period has been satisfied.
- If the LTDi company denies the claim and you have not been out beyond six months (maximum leave available under our policy), and remain under the care of a physician, you can continue the leave for the balance of the six months.
- If the LTDi company denies the claim and you have been out beyond six months, you may be either returned to work or terminated.
NOTE: If an application has been submitted to Unum for LTDi payments, but the approval takes longer than six months, the staff member who has flexPTO/leave time available may continue to remain in a paid status until one of two things occurs: approval/denial is given for the benefit or accruals are exhausted. This is an exception to the use of grandfathered sick time accruals and the maximum leave time available under the Family and Medical Leave Act (FMLA) and Tennessee Maternity Leave Act (TMLA) policy.
Employment Status While on Long-Term Disability
Once disability benefits are approved, the Benefits office will process a Personnel Action Form terminating your employment.
You may consider the following options to gain access to health care:
- You may be eligible for Medicare. TN SHIP (Tennessee State Health Insurance & Assistance Programs) offers free Medicare information and counseling: Call 877.801.0044 (Office hours 8 am – 4 pm).
- The new state health exchanges may be an option to consider. Visit https://www.healthcare.gov/ for more information.
- If you want to continue your Vanderbilt health care benefits, you must complete the COBRA which will be mailed to your home. Your first monthly payment will be due within 45 days of electing COBRA.
Returning to Work
If you return to work as an active, full-time employee for 6 month(s) or more, any recurrence of a disability will be treated as a new disability. A new disability is subject to a new Elimination Period and a new Maximum Duration of Benefits. Please notify the Office of Benefits Administration when you anticipate returning to work at email@example.com or 615.322.8977.
You may return to work so long as you have been released by your physician and there is an available position in your department. Long-term disability benefits are a protection of your income. Please refer to your department for the status of a vacant position.
Making Changes to LTDi Coverage
You can waive full coverage at any time (above the $24,000 that Vanderbilt pays) on the My VU Benefits website.
If you have waived Full Long-term Disability and wish to reenroll at a later date, you must submit Evidence of Insurability satisfactory to Unum.
What is Evidence of Insurability?
If you are required to submit Evidence of Insurability, you must:
- complete and sign a health and medical history form provided by Unum;
- submit to a medical examination, if requested;
- provide any additional information and attending physicians’ statements that Unum may require; and
- furnish all such evidence at Your own expense.
Unum will then determine if you are insurable under the plan.
If you are involved in a long-term disability claim and need a qualified attorney to review your case at no charge, please call the legal professionals at Cody Allison & Associates, PLLC (615) 234-6000. You can also visit our website LTDanswers.com. At Cody Allison & Associates, PLLC we fight denied long-term disability claims everyday. It’s what we do. If you believe you have been wrongfully denied your ERISA, or non-ERISA, long-term disability benefits, give us a call for a free consultation. You can reach Cody Allison & Associates, PLLC at (615) 234-6000. We are lawyers based in Nashville, TN; however, we represent clients in many states (TN, KY, GA, AL, MS, AR, NC, SC, FL, MI, OH, MO, LA, VA, WV, just to name a few). We will be happy to talk to you no matter where you live. You can also e-mail our office at firstname.lastname@example.org. Put our experience to work for you. For more information go to www.LTDanswers.com.
Chronic pain can have a devastating affect on the life of anyone it touches. RSD (“Reflex Sympathetic Disorder”) /CRPS (“Complex Regional Pain Syndrome”) is a chronic neuro-inflammatory disorder which causes extreme pain. It is classified as a rare condition by the United States Food and Drug Administration. This pain disorder is difficult to diagnose and is often seen as “exaggerated” by those not experiencing it first-hand. RSD/CRPS can affect daily life activities and the ability to work.
At Cody Allison & Associates, we see many denied long-term disability insurance claims related to this disorder. In many cases we spend a great deal of time going over the client’s medical records to determine if the documentation related to these claims is sufficient. Many times the insurance company will not thoroughly discuss your condition with your treating doctors, if at all, before denying the claim. Our job is to make sure that we locate and dissect the documentation that does exist, then contact your doctors to supplement any deficiencies in documentation before the claim advances. Time is of the essence. If you are suffering from chronic pain and a long-term disability insurance company doesn’t believe your pain is real, or severe, we can help. Our team of dedicated legal professionals fight long-term disability insurance companies every day.
If you believe you have been wrongfully denied your ERISA, or non-ERISA, long-term disability benefits, give us a call for a free lawyer consultation. You can reach Cody Allison & Associates, PLLC at (615) 234-6000. We are based in Nashville, Tennessee; however, we represent clients in many states (TN, KY, GA, AL, MS, AR, NC, SC, FL, MI, OH, MO, LA, VA, WV, just to name a few). We will be happy to talk to you no matter where you live. You can also e-mail our office at email@example.com. Put our experience to work for you. For more information go to www.LTDanswers.com.