Disability benefits coverage is designed to provide you with a source of monthly income and continued benefits if you become totally disabled and unable to work.
The Benefits Plan defines disability as the inability of a member due to sickness or bodily injury to perform substantially all of the material duties of his or her regular work, and after a period of 24 consecutive months of such disability, the inability of a member due to sickness or bodily injury to perform any type of work for which he or she is fitted by education, training, or experience, all of which conditions must be certified by the Board.
When you are approved for disability benefits, payments begin after a 90-day waiting period or when your salary or severance payments end, whichever occurs later.
If you become disabled during the first 12 months of participation in the Death and Disability Plan, and the disability is due to an illness or injury diagnosed or treated during the 12 months immediately preceding your plan participation, no benefits are payable and all other coverage (medical, pension, death, supplemental death, dental, and supplemental disability) also terminates.
Disability benefits coverage provides a monthly disability benefit generally equal to 60 percent of the greater of
The initial disability benefit will not exceed 100 percent of your effective salary at the time of disability. Disability benefits will be reduced by disability payments you receive from other sources, such as workers’ compensation and Social Security, or an imputed benefit if you have opted out of Social Security.
If you are enrolled in medical, death, or supplemental death benefits coverage through the Board of Pension at the time of disability, these benefits will continue during disability, subject to Benefits Plan rules.
You may also continue to accrue pension credits if participating in the Pension Plan immediately before disability.
If you were enrolled in dental benefits before becoming disabled, you may continue participating in the plan, but must pay the cost of this coverage.
Continued eligibility for a disability benefit depends on you
Disability benefits end when the Board determines that you are no longer disabled, fail to comply with plan requirements, return to work, or reach maximum benefit eligibility age.
If you become disabled at age 62 or older, the benefit is payable for these maximum periods:
|69 or older||1|
Once your employer enrolls you for disability benefits coverage, you do not need to take any action when first hired or during annual enrollment.
Your employer pays the cost of disability benefits coverage; you may not contribute. Your employer (or, in the case of transitional participation, you) continues paying the cost of coverage (dues) for you during the first 90 days of your disability.
You may apply for disability benefits if your physician states that you are unable to work for more than 90 consecutive days while recovering from an illness or injury. If you are otherwise eligible, and do not apply for the benefit when the disability begins, you may still apply if fewer than 12 months have elapsed since the disability began.
If your application for disability benefits is denied or disability benefits are terminated, you have the right to appeal. All appeals must be in writing and include the reasons for disagreeing with the decision and any supporting information. The Board offers two levels of appeal for disability benefits claims. The first appeal should be directed to Lincoln Financial at the address below within 180 days of receiving the decision. The final appeal should be submitted to the Board at the address below within 60 days of receipt of the first appeal decision.
Lincoln Financial and the Board aim to respond within 60 days, but it may take longer if additional information is required.
|First-Level Appeal (Disability claims)||Final Appeal (Disability claims)|
|Lincoln Life Assurance Company of Boston|
P.O. Box 7206
London, KY 40742-7206
|Appeals Board Secretary|
The Board of Pensions of the Presbyterian Church (U.S.A.)
2000 Market St.
Philadelphia, PA 19103-3298