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Disability Coverage - UTB

Full-Time Salaried Employees

Short-Term Disability
A short-term disability absence is:

  • an absence of four or more consecutive calendar days due to pregnancy or a non-occupational illness or injury.  For example, you might have a five calendar day absence due to a surgery.  Also, a case in which you are absent on a Friday and the following Monday is a short-term disability absence.
  • an absence of less than four calendar days due to a reason that is related to a previous short-term disability absence of four or more days.  For example, you might return to work after a five calendar day absence for a surgery and later have a two calendar day absence that is related to the surgery.  Both absences would be considered short-term disability.

A sick leave absence is an absence of less than four calendar days due to pregnancy or a non-occupational illness or injury.  For example, you might be absent for two calendar days due to a cold. 

Also, sick leave absences include absences that are less than four consecutive calendar days for a chronic condition that has not resulted in a short-term disability absence of four or more days.  For example, you might periodically be absent for a period of less than four days due to diabetes, but you have not been absent for four or more days for this condition during the one-year period before your absence.  See “Successive Disabilities” for more information about absences for chronic conditions. 

Approved sick leave absences are paid at 100 percent of Pay, are not part of the short-term disability plan, and are not counted against the maximum short-term disability benefit duration.

Successive Disabilities

Periods of disability are treated as separate occurrences if they are:

  • due to unrelated causes and are separated by your return to active work for at least one full regularly scheduled workday (normally eight consecutive hours for a full-time employee)
    or
  • due to related causes and are separated by a return to active work of at least 520 hours or three calendar months, whichever is longer
    or
  • due to related causes and are separated by a one-year period from the initial date of disability.

If related short-term disability absences of less than four consecutive calendar days continue after a one-year period from the initial date of absence and you have not exhausted your maximum short-term disability benefits eligibility within the one-year period:

  • The cause of these absences will be considered to be a chronic condition
  • The chronic condition must be certified by a physician in order for you to receive Pay for the absences
  • These absences will not be counted against your maximum benefits eligibility, will be paid at 100 percent of Pay, and will be considered sick leave absences rather than short-term disability absences as long as you are not absent for four or more consecutive calendar days.  If you are absent four or more calendar days for the same reason as your initial absence, this is considered a short-term disability absence.  You must contact the claims administrator to receive short-term disability benefits.

“Hour of Work” and “Disability” are defined in the Glossary.

Benefit Duration and Amount
If you are unable to work due to pregnancy or non-occupational illness or injury, the short-term disability plan provides continuing pay for up to 180 calendar days of disability.  The short-term disability benefit payments you receive depend on your length of service and the duration of your disability.  If you have been employed for six months or more, the following three tiers of benefit payments apply:

  • Tier 1:   100 percent of Pay for the first 42 calendar days (six weeks) of disability
  • Tier 2:   80 percent of Pay for the next 42 calendar days (six weeks) of disability
  • Tier 3:   60 percent of Pay for the remaining 96 calendar days (14 weeks) of disability.

If you have been employed for less than six months, the plan provides continuing pay for 30 calendar days for each month of service you completed as of the first day of your disability, limited by the percentages above.  Time you are absent for short-term disability does not count toward additional short-term disability eligibility.

The following examples show how the tiered benefit works (in each example, “day” means calendar day):

  • Example 1:  If you have worked six months, you will receive 100 percent of Pay for days one through 42 of the short-term disability absence (six weeks).  Beginning on day 43 of the absence, you will receive 80 percent of Pay through day 84 of the absence (the second six weeks).  Beginning on day 85, you will receive 60 percent of Pay through day 180 of the absence (the remaining 14 weeks). 
  • Example 2:  If you have worked two and a half (2 ½) months, you will have completed two months of work, for the purposes of determining your short-term disability benefit.  You will receive 100 percent of Pay for days one though 42 of the short-term disability absence (six weeks).  Beginning on day 43 of the absence, you will receive 80 percent of Pay through day 60 of the absence at which time short-term disability benefits will end based on your amount of Company Service as of your initial date of disability, i.e., two months times 30 calendar days.

“Pay” is defined in the Glossary.

Supplementing Tier 2 and Tier 3 Benefit Payments with Vacation Pay
You may supplement the Tier 2 (80 percent) and Tier 3 (60 percent) benefit payments with vacation pay, up to the maximum amount of vacation available to you, to reach 100 percent of Pay by completing an authorization form after a short-term disability claim is initiated.

  • The amount of vacation required to reach 100 percent of Pay is six days for the 42 days of benefit payments at Tier 2 (i.e., one day of vacation per week of disability) and 28 days for the 96 days of benefit payments at Tier 3, i.e., two days of vacation per week of disability.
  • Current year, banked and deferred vacation may be used to supplement the benefit payments.  If you accrue vacation, you may supplement the benefit payments with vacation pay up to the amount you have accrued at the time of the payments.  Additional supplementation may continue as additional vacation is accrued.
  • To have benefit payments supplemented with vacation pay, you must complete a Vacation Supplement Authorization form and return the completed form to the ORNL Disability Administration Office (DAO) at the address on the form.  You will receive the form from the third-party claims administrator for the Company after you file a short-term disability claim.  The form is also available on the ORNL Benefits Forms webpage.
  • Vacation may be used to supplement the benefit payments in one-hour increments.
  • If you do not complete and return the Vacation Supplement Authorization form or do not have vacation available to supplement the benefit payments, you will receive only the amount of the tiered benefit.