Long-Term Disability Insurance
Last Modified: 2017-02-09
- How to File a Long-Term Disability Claim
- Receiving Long-Term Disability Benefits
- Employment Status While on Long-Term Disability
- Returning to Work
- Making Changes to Long-Term Disability Coverage
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 LTDI 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 My VU Benefits.
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 Unum at 800.836.6900 or go to www.unum.com/claims. 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 grandfathered sick time and PTO 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 PTO accumulations have been used, no LTDI payments will be made for the period covered by the PTO time.
- If no PTO 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 PTO 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.
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 My VU Benefits.
If you have waived Full Long-term Disability and wish to re-enroll 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.
Frequently Asked Questions (FAQs)
What is long-term disability insurance?
Long-term disability insurance is a benefit for faculty and staff that pays 60 percent of your annual base pay, up to a maximum monthly benefit of $33,000. There is a six-month waiting period before you are eligible to receive benefit payments. Vanderbilt pays for basic long-term disability which covers the first $24,000 of your annual base pay. You can pay for full long-term disability, which covers the portion of your annual base pay above $24,000. If you make more than $24,000 per year, you are automatically enrolled in full coverage but can waive it at any time in My VU Benefits. You will still be covered by the base coverage Vanderbilt provides at no cost to you. Long-term disability also includes a 10 percent pretax monthly contribution to your Vanderbilt University Retirement Plan account if you participate.
How does long-term disability insurance work with PTO and short term disability insurance?
Long-term disability can work in conjunction with PTO and/or short-term disability insurance. If you have short-term disability, our insurance provider Unum will automatically start a long-term disability claim on your behalf when the short-term disability benefit period ends (24 weeks).
If you are not enrolled in short-term disability, you can use PTO during the six-month waiting period for long-term disability. You will need to contact Unum to begin your long-term disability claim.
If you are approved for long-term disability, your employment at Vanderbilt will end the last day of the month in which you are approved for benefits. Any PTO time you have remaining will be paid out at that time.
Am I immediately eligible for long-term disability insurance program?
No, there is a 12-month waiting period for newly-hired or newly benefits eligible staff before you can enroll in long-term disability coverage. The 12-month waiting period can be waived if you were covered by a group long-term disability policy at least 90 days prior to starting work at Vanderbilt and your former employer completes a Certification of Prior Coverage Form. This form must be submitted to Human Resources within 90 days of your hire date. This form can be found on the HR website under Tools & Forms.
Is there a pre-existing condition clause in the long-term disability insurance program?
Yes, there is a pre-existing conditions clause. Your condition will not be covered by long-term disability if:
- you received medical treatment, consultation, care or services including diagnostic measures, or took prescribed drugs or medicines in the 3 months just prior to your effective date of coverage; and
- the disability begins in the first 12 months after your effective date of coverage unless you have been treatment-free for three consecutive months after your effective date of coverage.
I waived the full coverage long term disability insurance on my one year anniversary date. Can I add it now?
If you waived the full coverage, you must submit Evidence of Insurability satisfactory to Unum. This can be completed by logging into My VU Benefits and creating a life change event. The system will prompt you to complete evidence of insurability. The information you provide will be reviewed by Unum and you could be denied coverage.
Do I have to wait a certain amount of time before the long-term disability benefit begins?
If you are unable to work for six months or longer, you may file for long-term disability. If you expect to be out of work for six months or more you should begin the long-term disability 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. If you are approved, benefit payments would begin after the six-month waiting period.
Can I use long-term disability insurance for my spouse or children?
No, long-term disability is only for your own covered medical condition.
If I have a workers' compensation claim and am receiving benefits from that do I also get LTDI?
Possibly. Workers' compensation is considered a deductible source of income. This means that the amount of any payments you receive from your workers compensation claim will be deducted from your long-term disability benefit payment. Additional deductions may be taken for payments you receive for Social Security disability and some other programs. (See the long-term disability summary plan description for a full list.) If your long-term disability benefit payment would be greater than the combined payments you receive from these deductible sources of income, you may receive the difference.
This information is not meant to replace the Summary Plan Descriptions, which are the governing documents for Vanderbilt benefits. For complete details on the long-term disability insurance benefit, refer to the Long-Term Disability Summary Plan Description.
Long-term disability insurance is a fully insured benefit and is administered by Unum.
1 Consistent with the Long-Term Disability Plan Document, the decision for approval of the benefit is made by the Third Party disability insurance company.