- How do I know if I am disabled?
- How do I report a disability?
- Can I report a disability to Concordia Plan Services in advance?
- Do I need to satisfy the waiting period before reporting a disability?
- What information will I be expected to provide when I call Concordia Plan Services about a disability?
- What happens to my claim after it goes to Liberty Mutual?
- How long should I expect to wait before my first contact by Liberty Mutual?
- Is a Medical Authorization Form required?
- Where do the income benefit payments come from?
- How does submitting a disability claim affect my other benefits with Concordia Plan Services?
- If I have submitted a maternity disability claim, when can I add my baby to the Concordia Health Plan?
- Who decides if I am disabled and eligible for a benefit? How much is my doctor involved?
- Liberty Mutual has notified me that I need to contact my doctor to get medical information. Why is this my responsibility?
- What if my doctor’s office charges for medical records?
- How long will Liberty Mutual typically approve a benefit?
- Is there a possibility that Liberty Mutual might discontinue my benefit before my doctor releases me to return to work?
- What is a pre-existing condition limitation and who is subject to this limitation?
- If I am an active worker receiving an in-service retirement benefit, may I file a claim?
- How is my disability income benefit calculated?
- Is there a minimum disability income benefit that the CDSP will pay?
- Is it acceptable for my employer to supplement the 70% disability income benefit paid to me by the CDSP?
- What is the Medicare Part B Premium Reimbursement Benefit?
- Are my benefits subject to Social Security and Medicare taxes?
- Are my benefits subject to federal and state income taxes?
- Are my disability benefits reported to the Internal Revenue Service (IRS)?
- What are my options if my claim is denied by Liberty Mutual?
- How does Liberty Mutual handle an appeal?
- Would I be able to return to work part-time, and continue to receive a benefit after being totally disabled but before I am allowed to return to my full-time job?
- What is expected of disabled workers receiving benefits through the Concordia Disability and Survivor Plan (CDSP)?
- When should I apply for Social Security disability benefits?
- When do my disability income benefits end?
- What conditions are subject to the lifetime maximum on disability benefits?
- Am I eligible for these benefits if my disabling condition is job related?
- Am I subject to subrogation?
- Whom do I call if I have questions?
1. How do I know if I am disabled?
The Concordia Disability and Survivor Plan (CDSP) defines disability according to the following:
NOTE: Pregnancy is eligible for consideration as a disabling condition. Impairments that are not eligible for disability include those that result from an injury or illness sustained while serving in the armed forces; committing a felony; willfully and illegally participating in a fight, riot, or civil insurrection; or those sustained after you cease to be an eligible worker.
- You must be absent from work for a period of 14 consecutive days because of a medically determinable physical or mental impairment and must be under the regular care of a licensed physician. Your doctor(s) must provide documented, objective medical evidence of your disabling condition.
- During the first two years of disability, you must be unable to perform the essential duties of your occupation because of your disabling condition or be unable to earn at least 80% of the compensation you were earning prior to the onset of your disabling condition.
- After the first two years of disability, you must be unable to engage in any substantial, gainful activity for which you are qualified by training, education, or experience because of your disabling condition.
2. How do I report a disability?
All disability claims should be reported directly to Concordia Plan Services at 888-927-7526. A disability benefits representative will forward your claim information to Liberty Life Assurance Company of Boston (“Liberty Mutual”) the same day. As the benefit administrator and disability case manager, Liberty Mutual is responsible for determining the initial and ongoing approval for disability benefits. A disabling condition should be reported after the last day worked if it appears that you will be unable to work for at least 14 calendar days. You must apply for disability benefits within 90 days from the date your disability commenced. You must be actively employed at the time your disability began.
Refer to the New Baby Basics brochure if you will be reporting a maternity claim. 3. Can I report a disability to Concordia Plan Services in advance?
No. You should call Concordia Plan Services only when you can report the last day worked and you will be off work due to a potentially disabling condition even though you may not have satisfied the 14-day waiting period. (See Question #4.) 4. Do I need to satisfy the waiting period before reporting a disability?
No. You are encouraged to call Concordia Plan Services as soon as you feel reasonably certain that your illness or injury is going to keep you out of work for more than 14 consecutive days. Any claim for disability benefits under the plan must be submitted as soon as is reasonably practical but in any event, not later than ninety (90) days after the disability began. 5. What information will I be expected to provide when I call Concordia Plan Services about a disability?
Your name, address and phone number, your Social Security number, your last day worked, the first full day you were unable to work, your job title, the nature of your condition, your employer’s phone number/contact information, and your doctor’s name and phone number. (It would be helpful, when leaving a message with the information, to spell the member’s and doctor’s last names.) NOTE:
Liberty Mutual will not accept a claim directly from a member. You must first call Concordia Plan Services.
If someone is calling on your behalf, he/she will need to provide the same information. For your protection, after your initial claim for disability is made, Concordia Plan Services and Liberty Mutual will only speak directly to you regarding the administration of your disability claim. If you wish to designate a representative to assist you further, you must complete the form entitled “Nomination of Benefit Plan Representative
” and return it to Concordia Plan Services. 6. What happens to my claim after it goes to Liberty Mutual?
The initial claim information first goes through Liberty Mutual’s Screening and Creation Unit and then your claim is assigned to a Disability Case Manager.The Disability Case Manager will contact you about your disability, obtain medical information from your doctor, and make a claim determination. If your claim is approved, your Case Manager will continue to make periodic reviews of your disability status. Regular updates are procured at various levels to ensure appropriate claim/medical management. Throughout the process, evaluations are performed in consultation with peer advisors (with an appropriate specialty) when necessary.
Your Disability Case Manager may ask you or your nominated representative for assistance in obtaining medical information (See Question #13).
If your disability claim is denied you will be notified of the reason and be provided with steps to take for reconsideration. (See Questions #26.) 7. How long should I expect to wait before my first contact by Liberty Mutual?
Your Disability Case Manager will be in touch with you to review your claim. If you do not receive initial contact from Liberty Mutual within 5 business days of reporting your claim, please call Concordia Plan Services at 888-927-7526. 8. Is a Medical Authorization Form required?
Yes. You will be asked to complete a Medical Authorization Form, which allows medical information to be released to Liberty Mutual. The form will be mailed to you by Concordia Plan Services. You may also be asked by your doctor to sign your doctor’s authorization form - just be sure to notify your Liberty Mutual Disability Case Manager that you have done so. Otherwise, if you have an upcoming doctor’s appointment scheduled, you can request that your Concordia Plan Services Disability Representative fax the Medical Authorization form directly to your doctor’s office for you to sign. Please note that any delays in providing a signed authorization to your doctor will result in delays in making a determination on your claim. 9. Where do the income benefit payments come from?
The majority of income benefit payments paid by the self-funded Concordia Disability and Survivor Plan are processed and mailed by the Plan’s benefit administrator, Liberty Mutual. After the first 14 days and upon approval from Liberty Mutual, you will be eligible to start receiving disability income benefits. There are two different payment schedules depending on the duration of your disability:
- The first 26 weeks of your disability: Liberty Mutual will issue weekly benefit checks to members who are on an approved disability of 26 weeks or less. Each Wednesday, checks will be printed and mailed for the prior approved weekly benefit period.
- Disabilities that exceed 26 weeks: Liberty Mutual will issue monthly benefit checks to members who are on an approved disability that exceeds 26 weeks. On the 27th of each month, checks will be direct deposited or printed and mailed for the prior approved benefit period.
If the 27th falls on a weekend, checks will be printed and mailed on the next business day. 10. How does submitting a disability claim affect my other benefits with Concordia Plan Services?
Concordia Health Plan (CHP):
If you are a member of the CHP, your employer is required to pay the contributions for your health benefits in the CHP option you were enrolled in during the period of time your initial claim for disability benefits is being reviewed.
If your claim is approved and while your disability continues, CHP coverage continues and the contributions will be waived effective beginning with the third calendar month following the start of disability benefits. Your employer may be reimbursed for any contributions paid before your disability was approved and after the waiver of contributions becomes effective.
If you are age 65 or older when your disability benefits end, the health coverage available to you under the 15-month extension provision or post-retirement health, if eligible, is the CHP Medicare supplemental coverage.
As you approach age 65 you will need to become familiar with Medicare’s enrollment rules. It is suggested that you contact Social Security to enroll in Medicare two to three months prior to your 65th birthday.
If your disability claim is denied, CHP coverage ceases at the end of the month in which the initial denial occurs. If you not have returned to work at your LCMS employer, you will be offered the opportunity to extend CHP coverage by either (a) purchasing continued coverage for a period up to 15 months or (b) purchasing post-retirement CHP coverage if you meet the age and participation requirements. If you have returned to work at your LCMS employer, your CHP coverage as a worker will continue.
If you appeal a denied claim in writing within 60 days from the date of receipt of the denial letter, CHP coverage may be reinstated at the time the appeal is received and may continue during the First-Level Appeal Process.
If the appeal is not successful at the First-Level Appeal, CHP coverage will cease at the end of the month in which the first level of appeal decision is made by Liberty Mutual, but in no event beyond the end of the fourth month following the month in which the original denial by Liberty Mutual was communicated to the member. You will be offered the opportunity to extend CHP coverage by either (a) purchasing continued coverage for a period up to 15 months or (b) purchasing post-retirement CHP coverage if you meet the age and participation requirements.
Concordia Retirement Plan (CRP):
If your claim is approved, your membership in the CRP will continue. Your employer will be responsible for paying contributions on your behalf until the waiver of contributions becomes effective with the third calendar month following the start of disability benefits. If the disability claim is denied, your membership in the CRP terminates at the end of the calendar month of your last day worked, unless you have returned to work at your LCMS employer by that date.
Subsequent approval of the claim via the First-Level Appeal Process would result in the reinstatement of membership in the CRP retroactive to the initial denial.
Concordia Disability and Survivor Plan (CDSP):
If your disability claim is approved, your CDSP membership continues, including death benefits. Your employer will be responsible for paying contributions on your behalf until the waiver of contributions becomes effective with the third calendar month following the start of disability benefits. If the disability claim is denied, your membership in the CDSP terminates at the end of the calendar month of your last day worked, unless you have returned to work at your LCMS employer by that date.
Subsequent approval of the claim via the First-Level Appeal Process would result in the reinstatement of membership in the CDSP retroactive to the initial denial.
Concordia Retirement Savings Plan (CRSP):
If you were participating in the CRSP prior to filing for your disability benefits your salary deferral can continue while receiving salary continuation. If you have an outstanding CRSP loan and you are not receiving a continuation of your salary, you will need to send monthly payments directly to MetLife and continue to repay the loan in order to prevent a default on the loan.
Accident Insurance Program (AIP):11. If I have submitted a maternity disability claim, when can I add my baby to the Concordia Health Plan?
If you were participating in the Accident Insurance Program (AIP), participation must terminate at the end of the month following your last date of active employment because only those members employed on an active, full-time basis are eligible to participate. When you have recovered and returned to work on an active, full-time basis, coverage will automatically be reinstated on the first of the following month unless you supply written notice to the contrary.
Within 60 days of your child’s birth, you must complete a Newborn Enrollment
form or Important Notice form (sent to you by a Disability Representative upon the submission of your claim). If the form is not received by Concordia Plan Services within 60 days of your child’s birth, your child may not be eligible for health coverage. The child’s enrollment will then be subject to the provisions in effect at the time coverage is requested and may require having to satisfy special enrollment eligibility requirements or waiting until an open enrollment period is provided by the Plan.
If you are not enrolling your newborn into the Concordia Health Plan, you should still enroll your child in the Concordia Disability and Survivor Plan. Doing so will cover the child with a lump-sum death benefit, as well as include him/her in the calculation of your death benefit amount (calculated as two times your annual compensation, plus one times your compensation for each enrolled dependent up to a maximum of 6 times your annual compensation).12. Who decides if I am disabled and eligible for a benefit? How much is my doctor involved?
Your Liberty Mutual Disability Case Manager will make the necessary contacts with you and your doctor to gather information about your medical condition, the nature of your job responsibilities, and your work environment. In most cases, it is the Disability Case Manager who makes the initial decision to grant or deny a benefit. However, this is only after evaluating information acquired from your doctor. 13. Liberty Mutual has notified me that I need to contact my doctor to get medical information. Why is this my responsibility?
Following receipt of your initial claim information, and whenever further details or clarification are necessary, Liberty Mutual will attempt to contact your doctor. The first week, two attempts will be made. If there is no response from the doctor, a written request for information will be faxed to the doctor’s office and a letter will be sent to you advising you of the need for Liberty Mutual to obtain medical information. If no medical information has been received within 45 days of your initial claim, Liberty Mutual will follow up with you and your doctor. If Liberty Mutual is not able to reach the doctor, they may need to deny benefits because of incomplete information.
At times when Liberty Mutual recognizes that additional information may provide justification for authorizing benefits, your Disability Case Manager will ask you to exert your influence to get your doctor to respond. You as the patient, and the one to directly benefit by Liberty Mutual’s receipt of medical updates, can sometimes have more influence with the doctor’s office to get the needed information. 14. What if my doctor’s office charges for medical records?
If your physician’s office charges fees for the medical records necessary to apply for disability benefits, please be advised that neither Concordia Plan Services nor Liberty Mutual will pay for or reimburse expenses incurred by you from the physician for medical records. Keep in mind that it is important that Liberty Mutual receive all the supporting medical documentation.15. How long will Liberty Mutual typically approve a benefit?
The length of an approved benefit period depends on the nature of the disabling condition and the information supplied by your treating physician. Normally the first approval period (and possibly some of the subsequent approvals) will be for a fairly short period, typically until the next appointment with your doctor. If updated medical information provided from the latest appointment confirms your continued disability, your Disability Case Manager will be able to extend the benefit period.
If the disability continues for a longer period, the approval periods may be extended and may not be so dependent on the next doctor’s appointment. It is important to remember that just because Liberty Mutual approves a benefit for a specific time period, it does not automatically mean that no further benefits are available.
There could be a delay in receiving additional benefits if there is a delay in receiving up-to-date medical information from the treating physician. (See Question #13.)
There could also be a delay if Liberty Mutual is reviewing records for a pre-existing condition. (See Question #17.) 16. Is there a possibility that Liberty Mutual might discontinue my benefit before my doctor releases me to return to work?
Yes. Benefits are approved when there is sufficient medical information to demonstrate your inability to perform the essential functions of your occupation or earn at least 80% of your compensation. When all available information relative to your impairment, its ongoing treatment, and treatment plan is evaluated, it is possible that Liberty Mutual may determine that you are not totally disabled.
The goal of Concordia Plan Services, through Liberty Mutual, is to help you return to some form of gainful employment, most preferably with your present employer, or at least within the Synod. However, in certain cases, you might be required to accept a different type of position than the one you previously held. 17. What is a pre-existing condition limitation and who is subject to this limitation?
No disability benefits will be paid for any disability commencing during the first 12 months of plan membership that is caused by or resulting from a medical condition for which, during the three months prior to CDSP enrollment, the worker received medical treatment, consultation, care, or services, or had symptoms that would cause a reasonable person to seek consultation, care, or treatment. No waiver of contributions for the Concordia Plans will be applicable under these circumstances.
The pre-existing condition limitation will not apply for new graduates of LCMS seminaries, universities, and colleges when they are enrolled at their first assignment after graduation. Nor will it apply to ordained or commissioned ministers who are reenrolled in the CDSP within one year of a termination of their plan membership. 18. If I am an active worker receiving an in-service retirement benefit, may I file a claim?
Yes. A member can receive both disability benefits and in-service retirement benefits, as long as the in-service benefits commenced prior to the onset of the disability.
19. How is my disability income benefit calculated?
Disability income benefits begin on the 15th consecutive calendar day of disability. The income benefit you receive is a monthly benefit equal to 70% of monthly compensation at the time your disability began.
Disability benefits will be reduced by:
- 70% of any compensation, including part-time earnings, and earnings from self-employment, earned by the member while disabled;
- Beginning after six months of disability, the amount of any supplemental salary provided by the employer;
- Social Security benefits, including any dependent benefits, even if you are not participating in Social Security (ministers of religion or deaconesses who are participating on the full basis are excluded); and
- Any state-mandated benefit or other group plan benefit for which an employer paid, including worker’s compensation.
Regarldess of income payable from other sources, the minimum monthly benefit from the CDSP after all deductions, except those in the first two bullets above, is equal to 10% of the worker’s gross monthly benefit.
For rostered workers who remain in furnished residences during disability, the benefit will be 70% of compensation without allowance added for value of housing furnished. The above offsets and minimum benefit provisions apply.
*Compensation is defined as base salary, plus 25% of salary if housing is provided as the primary residence, plus any cash utility or housing allowance, as reported by the member's employer.20. Is there a minimum disability income benefit that the CDSP will pay?
The minimum monthly benefit from the CDSP after all deductions, except those in the first two listed items of Question #19
, is equal to 10% of the worker’s gross monthly benefit. 21. Is it acceptable for my employer to supplement the 70% disability income benefit paid to me by the CDSP?
Yes. Some employers are willing to pay a portion or all of the difference between a worker’s regular salary and the 70% income amount, often for a specified period of time, e.g., the first 26 weeks (or 6 months) of disability. This may be especially important if the normal salary amount for a worker is low to begin with.
However, after the first 6 months of such salary continuation, the CDSP disability income benefit will be reduced by the amount of any supplemental salary provided by the member’s employer. 22. What is the Medicare Part B Premium Reimbursement Benefit?
Members on an approved disability who are enrolled in both Medicare Part B and the Concordia Health Plan and who provide Concordia Plan Services with proof of Medicare Part B enrollment will receive an additional monthly benefit equal to the lowest monthly premium set forth by Medicare each year. This reimbursement will be included in the monthly disability income benefit check and is taxable to the member as income. Payment of this additional benefit cannot be made retroactively.
This additional CDSP benefit will end when your enrollment in Medicare Part B ceases, your CHP participation ceases, when you are no longer eligible to receive a CDSP benefit, or if sufficient proof is not provided when requested. 23. Are my benefits subject to Social Security and Medicare taxes?
Any disability benefits you receive during the first 6 months following the last calendar month in which you worked are subject to Social Security and Medicare taxes. After that, your disability benefits are exempt from Social Security and Medicare taxes.
If you are not considered self-employed for Social Security purposes, Liberty Mutual will withhold your portion of Social Security and Medicare taxes from each disability payment made during the first 6-month period. Liberty Mutual, on behalf of the CDSP, will pay the required employer portion of Social Security and Medicare taxes on your behalf.
If you are considered self-employed for Social Security purposes, you are required to pay self-employment taxes for the disability benefits received during the first 6 months following the last calendar month in which you worked. 24. Are my benefits subject to federal and state income taxes?
Disability benefit payments are subject to federal income tax and state income tax, if applicable. Liberty Mutual is not required to nor does it withhold federal income tax from a lay worker’s disability payments unless the worker has provided Liberty Mutual with a completed Federal W-4S, Request for Federal Income Tax Withholding from Sick Pay form. This form is available from Liberty Mutual, or on the IRS website
. To have Liberty Mutual withhold state income tax, visit your state’s government website to retrieve the proper forms.
Disability benefits paid to a rostered ordained or commissioned Minister of Religion are designated as “housing allowance.” This means that a disabled minister can exclude up to 100% of the disability benefits received from federal taxable income, to the extent that it is used to rent or provide a home (excluded amount may not exceed the annual fair rental value of the home furnished plus utilities). Qualified expenses include rent (if housing is rented) or principal and interest payments and real estate taxes (if a home is owned), as well as expenses for utilities, routine repair and maintenance, capital improvements, furnishings, and garage rent. 25. Are my disability benefits reported to the Internal Revenue Service (IRS)?
If you are a lay worker and not a rostered ordained or commissioned Minister of Religion, Liberty Mutual will report the disability benefits to the IRS each year and will issue you a W-2 form by January 31 reporting the disability benefits paid during the prior year.
If you are a rostered ordained or commissioned Minister of Religion, Liberty Mutual will send you a letter on behalf of the CDSP by January 31 each year reporting the total amount of disability benefits paid during the prior year, as well as information regarding eligibility for the housing allowance. 26. What are my options if my claim is denied by Liberty Mutual?
If the Disability Case Manager determines that you are not or are no longer disabled, the decision is reviewed by a Liberty Mutual Claim Manager. The Claim Manager may make the decision final or implement a Peer Review Process if appropriate.
If the denial decision is upheld, you are notified by telephone, followed by written confirmation. The letter to you will include the reasons for the decision and explain your right to appeal. A description of the information that should be provided to Liberty Mutual for re-consideration is also included. If you disagree with the decision, you are required to submit a formal, written appeal to Liberty Mutual.
If your appeal results in the initial denial being upheld, you will again receive a letter containing the medical reasons and steps to take if you would like to submit a second-level appeal. Any new information should be submitted for consideration. Again, you are required to submit a formal, written second-level appeal to Liberty Mutual.
If you are dissatisfied with the second-level appeal decision, you have the right to appeal to the Appeals Review Committee (ARC) at Concordia Plan Services, the Plan Administrator. The appeal instructions will be included in your second-level appeal denial letter and is also described in the Concordia Disability and Survivor Plan (CDSP) Offical Plan Document. The ARC will further consider your claim on the basis of whether Liberty Mutual properly followed the provisions of the CDSP and the administrative policies in place. 27. How does Liberty Mutual handle an appeal?
When an appeal letter is received by Liberty Mutual, your Disability Case Manager will review any new evidence submitted to determine if the claim can be reopened. If your claim cannot be reopened, it is forwarded to the Appeals Review Unit, which is separate from and independent of the regular disability claims team. A letter is sent to you within 5 business days acknowledging receipt of the appeal. Following receipt of your initial claim, and whenever further details or clarification are needed, Liberty Mutual will contact your doctor.
All information available, including any new medical records, treatment notes, or therapy details submitted with your appeal, are reviewed and, if applicable, discussed with a Peer Advisor (a staff medical doctor (MD) with an appropriate specialty). The Appeals Review Unit makes a decision on the appeal within 45 days of receipt of the appeal letter. You will be given written notice of the decision, with an appropriate explanation. 28. Would I be able to return to work part-time, and continue to receive a benefit after being totally disabled but before I am allowed to return to my full-time job?
Yes. It is very desirable to have disabled workers return to productive employment as soon as medically possible. With your doctor’s permission, a partial return to work might be appropriate as healing takes place, allowing you increased strength for greater activity. There might also be a work phase as part of a professionally developed rehabilitation plan, intended to help you get back into the job stream. In either case, the normal benefit for total disability would be offset by 70% of the income earned from your partial return to work. It is important to notify your Liberty Mutual Disability Case Manager and Concordia Plan Services of part-time earnings so your benefit amount can be accurately calculated and paid. 29. What is expected of disabled workers receiving benefits through the Concordia Disability and Survivor Plan (CDSP)?
The disabled worker must be under the regular care of a physician whose specialty or experience is appropriate for the treatment of the disabling condition. The physician’s treatment must conform to generally accepted medical standards.
The worker may also be asked to submit to an independent Medical Examination and/or a Functional Capacity Evaluation.
The disabled worker may be required to participate in a professionally developed rehabilitation plan intended to help him/her get back into the job stream. A disabled worker must comply with treatment or rehabilitation plans or the disability benefit will not be paid.
A disabled worker will also be required to apply for Social Security Disability benefits when eligible. The Plan will provide you with assistance during the application process at no charge (See Question #30).
Disabled workers are also expected to promptly report any changes to income including:
30. When should I apply for Social Security disability benefits?
- Part-time income, including self employment
- Social Security disability (including dependent) payments and awarded funds
- Workers compensation funds
- State disability funds
- Settlement awards when the disability is a result of an act of a third party (See Question #34).
If your disability has continued for 5 months, and it is expected that it will continue for at least a year, you will be contacted by your Disability Case Manager about applying for Social Security disability benefits. The Plan will help you apply for Social Security benefits using the services of a company that specializes in assisting people to understand the Social Security disability process and obtaining benefits when appropriate. This service is provided for you at no charge.
The disability benefit that is paid through the CDSP is offset by Social Security disability benefits (including dependent benefits). If you do not participate in Social Security, your CDSP benefit will be offset by the estimated amount of Social Security disability benefits you would have received if you were participating in Social Security as outlined in the CDSP Official Plan Document, Section IV, 4.2,e) and f). (Ministers of religion or deaconesses who are participating on the full basis are excluded.)
Concordia Plan Services requires you to use the approved vendor, at no cost to you, to file for Social Security disability benefits. If you choose to use another vendor, or not to use any service, the Plan will offset your disability benefits by an estimate of your Social Security disability benefits beginning with the 6th month of your disability, which will continue until Concordia Plan Services is notified of the actual Social Security disability benefit awarded.
If you fail to apply for Social Security disability benefits, your CDSP benefit will be offset by estimated Social Security disability benefits (including dependent benefits). 31. When do my disability income benefits end?
If you become disabled before age 61, your benefits end when the first of the following occurs:
- you recover and return to full-time employment;
- the Liberty Mutual Disability Case Manager makes a determination that you are no longer disabled in accordance with CDSP provisions;
- you receive the lifetime maximum benefit;
- you die; or
- you reach age 65.
If you become disabled after age 61, your benefits end when the first of the following occurs:
- you recover and return to full-time employment;
- the Liberty Mutual Disability Case Manager makes a determination that you are no longer disabled in accordance with CDSP provisions;
- you receive the lifetime maximum benefit;
- you die; or
- after the specified number of months of receiving benefits as follows:
32. What conditions are suject to the lifetime maximum on disability benefits?
Workers who become disabled due to mental illness, substance abuse, or a self-reported or subjective-syndrome condition are subject to a maximum benefit period of 104 weeks during their lifetime. The lifetime maximum is only applicable if one of the conditions listed above is the primary disabling condition. The lifetime maximum will not apply in cases of mental illness caused by stroke or cerebral vascular accident, viral infection, Alzheimer’s disease, senility and/or dementia, organic brain syndrome, or closed head injury.
A “self-reported or subjective-symptom condition” is one that cannot be independently verified and measured using generally accepted standard medical testing, procedures, and practices (e.g., headaches, fatigue, pain).
If you are confined in a hospital or institution at the end of the 104-week maximum benefit period, disability benefits will continue during the confinement and, if still disabled when discharged, for a recovery period of up to 90 days. Your waiver of contributions for the Concordia Plans will also end when benefits end. 33. Am I eligible for benefits if my disabling condition is job related?
Yes. While disability benefits from the CDSP will be offset by workers’ compensation benefits, you should file for benefits under the Plan, with you and your employer indicating the job-related nature of the condition. 34. Am I subject to subrogation?
If your disability is the result of an act of a third party, for which the third party may have some legal liability (e.g., an auto accident caused by the other driver), you or your legal representative will need to agree in writing to repay the CDSP for the disability benefits paid (and those that will be paid in the future) in the case of a settlement. Your Liberty Mutual Disability Case Manager will assist you in getting the proper documentation signed as part of the disability benefit approval process. For more information see the CDSP Official Plan Document located on our website under Resources/Plan Booklets, or call Concordia Plan Services at 888-927-7526. 35. Whom do I call if I have questions?
The Concordia Plan Services disability representatives are available to answer questions and help you or your designated representative through the disability application process.
Call our office toll-free at 888-927-7526 (Monday–Friday, 7:00 a.m.–5:00 p.m., Central Time).
For information about your disability status, length of your benefit approval, the impact of your medical condition on your eligibility for benefits, or other issues involving your benefit approval, it is best to contact your Liberty Mutual Disability Case Manager.