NNEBT

WEEKLY DISABILITY INCOME BENEFIT

[A-1 Plan Only]

Benefit

The Trust will pay a Weekly Disability Income Benefit to a covered member who is “totally disabled,” as defined below, as a result of an illness or injury that is not work related, and who also meets the eligibility criteria set out below. The weekly benefit is 66% of the member’s basic weekly earnings to a maximum of $250 per week. The weekly benefit is payable from the first day of disability after the member satisfies a 7-day waiting period. The weekly benefit is payable for a maximum period of 26 weeks.

All periods of disability due to the same or related cause or causes that are separated by less than 2 weeks of continuous, full-time, active employment shall be counted against the maximum benefit period of 26 weeks. Any period of disability that is preceded immediately by a period of at least 2 weeks of continuous, full-time, active employment will be considered a new disability, for purposes of calculating the maximum period for which benefits will be paid, no matter what the cause or causes of the disability.

Eligibility

To be eligible for a Weekly Disability Income Benefit you:

1. must be a covered employee when the disability arises and at all periods of time thereafter for which benefits are sought or must be a disabled employee who is a member of a new group so long as such employee meets the other weekly disability benefit eligibility requirements;
2. must be “totally disabled,” which means that you are unable to perform your job or any other job to which you have access to under the terms of your collective bargaining agreement;
3. must be “totally disabled” as a result of a “medically determinable physical or mental impairment,” which means an impairment that results from anatomical, physiological or abnormalities which can be shown by medically acceptable clinical and laboratory diagnostic techniques and not only by the individual’s statement of symptoms;
4. must be actively receiving treatment by a doctor for the disabling medical condition or, in the case of a mental health related disability, be actively receiving treatment from a licensed mental health professional;
5. must not be performing any work or service, of any kind, for wages or profit; and
6. must submit a claim for benefits within sixty (60) days of the date of your disability or, for disabled employees of new groups, within sixty (60) days of the commencement of the new group with the Trust.

How To File For Weekly Disability Income Benefits

You must obtain a claim form from the Trust or download the form by clicking here, complete the member’s portion of the form and send or take the form to your doctor. Your doctor will complete the medical portion of the form and send it directly to the Trust.

There is a separate form for claims for a mental health related disability, which must be completed, by the member and either the member’s primary care physician or treating psychiatrist.

Revised: September 2002