When an employee becomes disabled due to illness or injury, they are eligible to apply for long term disability benefits, which if approved, will continue to age 65, so long as the employee continues to satisfy the definition of disability in the contract. Your disabled employee may also be eligible to apply for waiver of life premium and waiver of accidental death & dismemberment premium. If these provisions are contained in your contract, and the claims approved, the life and accidental death & dismemberment coverage will remain in force, without premium payment, to age 65, again so long as the employee continues to satisfy the definition of disability in the contract.
This leaves the matter of how to manage your disabled employee’s employment position and the balance of benefits, mainly health and dental benefits. Without a formal policy in place outlining to your employees exactly what will occur in the event of a disability, employees could assume that employment and benefits will be provided to age 65, when the disability and waiver claims will terminate.
The Leslie Group strongly recommends publishing a formal policy and applying it consistently in all situations of disability. An employer has a duty to accommodate a disabled employee. As a result, we suggest that you maintain employment, and therefore the health and dental benefits, for a period of 24 months from the date of disability or the last day actively at work. Conversely you may wish to implement a tiered policy where the employment and benefits are maintained depending on years of service. It is also important to communicate the termination of
employment and benefits with the utmost care and consideration for your disabled employee. The termination should be communicated, in writing, well in advance, and should include information, and any necessary forms, regarding the disabled employee’s eligibility to convert terminating benefits to individual products. You should also include contact information for your company and the insurance company should the employee have any questions about what will transpire.
It’s important to remember and reassure your disabled employee that the termination of their employment, will not affect the status of their long term disability, life and/or ad&d waiver of premium claims. These benefits will remain in force so long as the employee continues to satisfy the definition of disability in the contract, regardless of the status of employment.
The Leslie Group would be pleased to assist you in drafting a formal policy, however, our recommendations are reflective of our experience with these situations and do not constitute a legal opinion. We strongly recommend that an employment lawyer review the policy we help you draft before publishing it to your employees.
In addition, we also suggest that you review the specifics of any given situation with an employmenlawyer before you terminate the employment, and therefore the benefits, of a disabled employee. In certain situations, there may be extenuating circumstances that a lawyer can help you address.
Publishing a formal policy governing disability, and applying it consistently, will not necessarily protect you from a lawsuit. But, it will lessen the probability of one, as all of the players knew what was going to happen from the beginning. In the event that you do find yourself faced with a lawsuit from a terminated, disabled employee, having a formal policy in place will certainly help prove to a judge or mediator that you genuinely tried to accommodate your disabled employee, which will help to mitigate any damages that may be awarded.
Please contact your Leslie Group consultant or service representative at (416) 510-8966 should you wish to discuss this issue further or develop a formal policy.