If you are unable to work because of a long-term disability (LTD), the disability policy purchased by the Health and Welfare Fund will pay monthly, 60% of your basic monthly earnings with a maximum monthly limit of $3,500.
- Eligibility begins on the date you become a member, in a position represented by the Philadelphia Federation of Teachers, provided you have completed one full day of active work.
- Basic Monthly earnings is gross salary before deductions shown on your last paycheck prior to the time the disability started. It does not include extracurricular, staff development, overtime or any other extra compensation.
Your monthly income under this benefit will be reduced by other income you receive or are eligible to receive while the LTD benefits are paid. An example of other income is Social Security disability (one-time offset) and your PSERS pension.
- LTD Benefit: 60% of the first $5,833 of your Predisability Earnings, reduced by Deductible Income.
- Maximum: $3,500 before reduction by Deductible Income.
- Minimum: $100
- Benefit Waiting Period: 365 days.
- Maximum Benefit Period: Determined by your age when Disability begins, as follows:
Age Maximum Benefit Period
- 61 or younger: To age 65, or to SSNRA*, or 3 years 6 months, whichever is longest.
- 62 ………………: To SSNRA, or 3 years 6 months, whichever is longer.
- 63 ………………: To SSNRA, or 3 years, whichever is longer.
- 64 ………………: To SSNRA, or 2 years 6 months, whichever is longer.
- 65 ………………: 2 years
- 66 ………………: 1 year 9 months
- 67 ………………: 1 year 6 months
- 68 ………………: 1 year 3 months
- 69 or older…..: 1 year
*Social Security Normal Retirement Age (SSNRA) means your normal Social Security retirement.
DISABILITIES EXCLUDED FROM COVERAGE
- War
You are not covered for a Disability caused or contributed to by War or any act of War. - Intentionally Self-Inflicted Injury
- Preexisting Condition
- Definition
Preexisting Condition means a mental or physical condition whether or not diagnosed or misdiagnosed:
- Definition
- For which you have done any of the following:
- Consulted a physician or other licensed medical professional;
- Received medical treatment, services or advice;
- Undergone diagnostic procedures, including self-administered procedures;
- Taken prescribed drugs or medications;
- Which, as a result of any medical examination, including routine examination, was discovered at any time during the 90-day period just before the date your insurance becomes effective.
- Exclusion
You are not covered for a disability caused or contributed to by a Preexisting Condition or medical or surgical treatment of a Preexisting Condition unless, on the date you become disabled, you have been continuously insured under the Group Policy for 12 months.
DISABILITIES EXCLUDED FROM COVERAGE
- Mental Disorders, Substance Abuse and Other Limited Conditions
Payment of LTD Benefits is limited to 24 months during your entire lifetime for a Disability caused or contributed to by any one or more of the following, or medical or surgical treatment of one or more of the following:
- Mental Disorders;
- Substance Abuse; or
- Other Limited Conditions.
However, if you are confined in a Hospital solely because of a Mental Disorder at the end of the 24 months, this limitation will not apply while you are continuously confined.
If you are the recipient of Long Term Disability payments, you are entitled to a prescription benefit. To receive this benefit, call the Health and Welfare Fund office.