What are the Disability benefits?
Duke Disability benefits are 60% of your base salary and are reduced by Workers' Compensation, and/or Social Security Disability, or any income from employment while you are receiving benefits. Disability benefits are subject to both federal and state taxes.
What is the application process?
If your treating physician indicates you will be out of work more than 120 days, the claim forms must be obtained from HR - Benefits, completed and returned within 180 days of your becoming disabled and/or your last day worked due to disability.
When all completed forms are received in Benefits, your claim will be sent to the disability administrator. They will acknowledge receipt of your claim and notify you if additional medical information is needed. Approval or denial of a disability claim, which generally takes three to four weeks, will be determined after all the necessary documentation is obtained for claim review. Please note that applying for Duke Disability does not guarantee that you will be approved.
Should I request a leave of absence also?
You should apply for a leave of absence, FMLA or medical leave, as soon as you know you will be out of work for any length of time. Please discuss with your immediate supervisor your need to apply for a leave of absence, complete the appropriate leave form and obtain your supervisor's signature. You may also contact the Human Resources Information Center at 684-5600 about leave of absence questions.
How do I submit a claim for the Hartford's Voluntary Short Term Disability benefits?
If you have purchased coverage, you should contact Hartford directly at 866-945-4558 to initiate a separate short-term disability claim.
Is there help available since I have exhausted all of my accrued sick and/or vacation time and I am without pay?
You may inquire about the Kiel Voluntary Vacation/PTO Donation Program which allows employees, who have experienced a catastrophic illness or injury and who have exhausted all accrued time, to receive donations of accrued vacation or PTO Short Term Bank (STB) hours from fellow employees. Please refer to the Kiel Program website to review eligibility, procedures and forms.
How do I pay for my Health Insurance and other benefits during the 120 day waiting period or while awaiting a decision on my claim?
While on Family Medical Leave (FMLA), you will be responsible for paying only the employee portion of your health insurance premium. If you continue receiving payroll checks for accrued sick/vacation/PTO time or donated Kiel time during the four-month waiting period, your payroll deductions will continue as usual.
If you are on an unpaid Family Medical Leave (FMLA) during the four-month waiting period, insurance premiums for health, dental, vision, personal accident, and basic life should be sent to Duke Benefits, 919-668-3918. In addition, direct billing arrangements should be made to continue payments for other optional coverage such as life insurance and personal casualty by contacting the benefit vendor(s) directly.
After the 12 weeks of FMLA or while on an unpaid personal/medical leave, you will be responsible for paying the total premium for health insurance. Health, dental, and vision insurance benefits may be continued under the provisions of the Consolidated Omnibus Budgeted Reconciliation Act (COBRA), which requires payment of the full staff premium plus two percent (2%).
What health insurance premium amount will I be responsible for if I am approved?
You will pay only the employee cost if your disability claim is approved.
What about my other benefits if I am approved?
Please refer to the Benefits While Disabled page for information about benefits if approved for Duke disability.
What happens to my Health Insurance if my claim is denied or my benefits under Duke Disability end?
Should your Duke Disability claim be denied, health insurance can be continued for 18 months under COBRA (Consolidated Omnibus Budget Reduction Act) with your paying the full premium plus a 2% administration fee. It is important to note that entitlement to 18 months of coverage begins after the end of your leave under the Family Medical Leave Act, or on the first day of an unpaid personal, medical, or maternity leave. (The above does not apply if you are on approved Workers' Compensation.) A COBRA notification will be sent after placement on an unpaid personal leave of absence or an approved Duke disability.
What are my employment reinstatement rights at Duke University or Duke Health System?
You have no employment reinstatement rights at Duke University and Health System after your approved 12-week Family Medical Leave ends. If your disability claim is denied (you have 180 days to appeal), contact Recruitment to reapply for employment at Duke. While you are on approved disability, vocational assistance is available from the disability rehabilitation case managers. However, if your disability benefit is terminated because you no longer meet the definition of disabled under the Plan, there is no guarantee of re-employment with the University or the Health System. You may contact Recruitment at 684-5600 so that your qualifications and skills can be compared to the requirements of current positions available at Duke.
What about Partial Disability?
Partial disability is an option for people who are experiencing a loss of income greater than 20% of their total earnings. If you are not totally disabled, but are unable to work your full work schedule due to a documented medical condition, you may qualify for partial disability benefits. Documentation of time worked from the onset of your partial work schedule must be submitted with your claim. Partial disability benefits are based on the percentage of income lost due to part time work.
When will I receive my first benefit?
After the completion of the 90 day (Health System) or 120 day (University/Medical Center) waiting period and following the approval of your claim, you should receive your initial benefit soon. Continuing monthly income benefits are paid around the 15th of the month for the current month. PLEASE NOTE: Your first benefit check may be offset by any Duke salary or accrued time that is paid out in excess of 40% of your salary beyond the benefit waiting period. Kiel donations used after the waiting period will offset any disability claim benefit, including retroactively approved claims.
Can I supplement my disability benefit with my accrued sick and/or vacation?
As a University or Medical Center employee, you may supplement your disability benefit with your accrued time. The amount should not exceed 40% of your gross salary (pre-disability) and you can take this action while on your approved long-term disability until your time is exhausted or decide to stop using the accrued time. If you are a Health System employee, you may supplement your disability benefit with your accrued PTO. The amount should not exceed 40% of your gross salary (pre-disability) and you can take this action for weeks 13 – 25 only of your approved disability.
Please Note: Kiel Voluntary PTO/Vacation Donation Hours are not to be used to supplement disability benefits. Kiel donations can be used during the disability waiting period and donations used after the waiting period will offset any disability claim benefit, including retroactively approved claims.
Must I apply for Social Security Disability?
The disability administrator will review your claim and, when appropriate, direct you to apply for Social Security Disability (SSDI). If Social Security Disability is awarded for yourself and/or your dependents, it is subtracted from the benefit paid by the administrator. Therefore, a signed Social Security reimbursement agreement must be submitted with your disability claim.
How long will I be able to receive disability benefits?
Benefits may continue for up to 24 months if you are disabled from your own occupation. After 24 months, you must be unable to work at any occupation you could reasonably be expected to do because of education, training or experience. Medical documentation will be required each year to verify disability. If you become disabled at age 61 or older, you will need to review the Maximum Benefit Period outlined in the Plan Booklet. When disability is due in whole, or in part, to Subjective Conditions (see Plan Booklet), the Plan limits monthly benefits to a maximum of 24 months. Disability benefits are payable to age 65 if you are totally disabled from gainful employment.
What rights do I have if I am denied?
If your claim is denied, you have the right to appeal the decision. A first level appeal must be filed with the disability administrator within 180 days of the receipt of the written or electronic notice of denial. A letter of appeal, with any additional medical documentation supporting your request, must be sent directly to the disability administrator. The disability administrator will review your request and provide you with a written decision regarding your claim. If you are still not satisfied with the response, a second level appeal must be filed with the disability administrator within 60 days of the receipt of the written or electronic notice of denial of the first level appeal.
Who do I call for questions?
To apply, you should contact Sonya Stewart (919) 681-4436. If you are unable to reach Ms. Stewart, call the Human Resources Information Center at 684-5600. After your claim is submitted, you will be assigned a Disability Case Manager who will be your primary contact for claim questions.
The benefits that you receive are based upon the plan's official plan documents, not this guide or any other written or oral statement. If there is a conflict between this guide and the official plan documents, the official plan documents will govern in all cases. Duke reserves the right at any time to change or terminate these plans.