Benefits Plans - Long-Term Disability Plans: Expanded Long-Term Disability -
Claims

How do I apply for disability benefits?

Contact WorkConnections as soon as possible after you are disabled and are no longer actively at work, or anticipate an absence from work for a period of 10 consecutive days. You will work with WorkConnections staff to determine the appropriate time to apply for LTD benefits.

The Benefits Office, in partnership with WorkConnections, is the only office authorized to release and process an application for Expanded Long- Term Disability benefits.

To apply for benefits, you will need to complete the following forms:

In addition:

  • Your supervisor will need to provide a job description, and
  • Your physician will need to complete a Health Care Provider Statement (HCPS), and
  • Your physician will need to complete a Functional Abilities Form (FAF), and
  • You may be required to participate in independent medical evaluations and/or meetings with vocational rehabilitation specialists or nurse case managers.

For further information, refer to the Long-Term Disability (LTD) Application Claim Process Checklist below.

Will I be required to provide medical evidence or documentation?

Yes. You must provide proof of disability that is satisfactory to the Claims Administrator. This proof is referred to as “medical evidence” based on objective clinical findings. The medical evidence must show that the disability prevents you from engaging in any occupation or employment for which you are reasonably suited by education, training, or experience, and qualifies you for benefits according to the terms of this Plan.

To determine the nature and extent of your disability, you may be required to be examined by physicians, psychologists, or psychiatrists, and/or be interviewed by vocational rehabilitation specialists or nurse case managers.

Will I have to provide medical evidence more than once?

Yes. If your disability continues, you will be required to submit medical evidence on an ongoing basis. This means that you may be required to be regularly examined by physicians, psychologists, or psychiatrists, and/or be interviewed by vocational rehabilitation specialists or nurse case managers.

To continue receiving Expanded Long-Term Disability benefits, your treating physician will be required to complete and return a Health Care Provider Statement (HCPS) and a Functional Abilities Form (FAF) (and any other evidence specified by the Claims Administrator) proving that you continue to be disabled according to the terms of this Plan. You must do so at your expense and as often as the Claims Administrator determines is reasonably necessary.

What if my claim is denied?

If your claim for benefits from this Plan is denied, either in full or in part, the Claims Administrator will promptly send you a written notice indicating the reason(s) for denial. Upon written request, you may appeal the decision within 180 days of the date of denial. Detailed instructions for submitting an appeal will be included in the written notice from the Claims Administrator.

LTD Application Claims Process Checklist

What to do When to do it
  1. Contact WorkConnections at 734-615-0643 or toll free at 1-877-869-5266, or visit their website at: workconnections.umich.edu
As soon as possible after you are disabled and are no longer actively at work or anticipate an absence from work for a period of 10 consecutive days.
  1. Fully cooperate with WorkConnections and provide medical information and documentation as requested.

As directed by WorkConnections.

  1. Complete all the LTD application claim forms you receive from the Benefits Office.
Within 30 days from the date of the cover letter included with the forms that are mailed to you.
  1. If requested by the external Claims Administrator, meet with a nurse case manager and/or a vocational rehabilitation specialist.
As directed, by appointment.
  1. If requested by the external Claims Administrator, attend one or more independent medical evaluations.

As directed, by appointment.
  1. Contact the Social Security Administration (SSA) to apply for Social Security Disability Income (SSDI) benefits for you and your eligible dependents. Contact SSA by calling 1-800-772-1213 or visit their website at ssa.gov

Immediately upon approval of LTD benefits, if not already done.

You will be notified in writing once the Benefits Office has all the necessary documentation from WorkConnections and your completed LTD application claim forms. The external Claims Administrator at ManageAbility will make the determination that will result in the approval or denial of LTD benefits. The Benefits Office will notify you by phone and in writing if your LTD claim is approved. The Claims Administrator will notify you in writing if your LTD claim is denied.

 

Next: Vocational Rehabilitation and Return to Work

 

Limitations
The University of Michigan in its sole discretion may modify, amend, or terminate the benefits provided with respect to any individual receiving benefits, including active employees, retirees, and their dependents. Although the university has elected to provide these benefits this year, no individual has a vested right to any of the benefits provided. Nothing in these materials gives any individual the right to continued benefits beyond the time the university modifies, amends, or terminates the benefit. Anyone seeking or accepting any of the benefits provided will be deemed to have accepted the terms of the benefits programs and the university's right to modify, amend or terminate them.