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Sterling Employment Law

Filing a claim for long-term disability benefits in Michigan

Many Michigan employers provide a long-term disability insurance program as part of their employee benefits package. A good example of such a program is the one available to Michigan state employees. Employees of the State of Michigan have the right to enroll in a long-term disability income protection plan which is funded by the state and which provides support through an extended period of disability. In the private sector, long-term disability benefits are typically provided through an insurance company.

In Michigan's state employee program, employees may enroll within 31 days of the beginning of employment or during the state's annual group insurance open enrollment period. Claim filing information can be obtained from the State of Michigan Human Resources Department, the Civil Services Disability Management Office or the LTD Plan Third-Party Administrator.

The state employee LTD plan does not cover pre-existing medical conditions during the first year of coverage. A pre-existing condition is defined as a condition for which the state employee was seen by a doctor or obtained medical treatment or medication within the six months before enrollment. However, after the employee has been enrolled in the plan for more than a year, the pre-existing condition rule no longer applies.

The state employee LTD plan provides that full-time employees receive gross payment equivalent to two-thirds their monthly base earning. Employees who are not employed full-time are paid based on the number of hours paid in the previous fiscal year. Additional payments, such as bonus and overtime, are not included when calculating LTD payments. Payment under the LTD plan is subject to a monthly maximum.

Filing a long-term disability claim, either with the state's self-funded plan or with a private insurer, does not ensure the claim will be paid. Failing to provide the proper documentation or evidence of disability can result in a denial of benefits. Working with an experienced employees' rights attorney through the claim and appeal process can increase the odds of a claim being approved.

Source: , Michigan.gov, "Long Term Disability Income Protection Plan," Accessed on Feb. 20, 2015

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