If you are unable to work due to a disability that lasts longer than 180 days, you may be eligible for long-term disability coverage through the Health & Welfare Plan. Long-term disability coverage protects you against loss of income if you are totally disabled. Unlike short-term disability benefits, eligibility for Workers’ Compensation does not affect your eligibility for long-term disability benefits.
Effective September 1, 2020, after you have been disabled for a period of at least 180 days and file a claim, you will be paid 55% of your base monthly earnings, up to $5,000 per month, during your disability. However, the amount you receive will be reduced by any other income you receive, like Social Security, pension benefits and Workers’ Compensation.
When you begin receiving your Social Security disability benefits, your long-term disability benefits will be reduced by the amount of your Social Security disability benefits. If your Social Security disability benefits are retroactive, you will be responsible for paying back retroactive reductions to the LTD carrier.
You must be an active, full-time or part-time employee, a participating member of the Transit Employees’ Health & Welfare Plan and represented by the Amalgamated Transit Union Local 689 to be eligible for LTD benefits.
Definition of Disabled
"Disabled" or “Disability” means that, due to sickness, pregnancy or accidental injury, you are receiving appropriate care and treatment from a doctor on a continuing basis and:
Your long-term disability benefits are paid according to the chart below.
| Your Age on the Date Your Disability Starts | Benefits Are Paid |
|---|---|
| Younger than age 63 | To normal retirement age, or for 42 months if greater |
| 63 | To normal retirement age, or for 36 months if greater |
| 64 | 30 months |
| 65 | 24 months |
| 66 | 21 months |
| 67 | 18 months |
| 68 | 15 months |
|
69 and over |
12 months |
The Medical Compliance Department of METRO will send the Health & Welfare Plan a referral after you have been out of work for 13 weeks. The Plan will then ask if you want to apply for long-term disability benefits. If you have been out of work for four to five months and have not received an application for long-term disability, you can contact WMATA OHAW Medical Services at 202-636-7141 to ensure that they have sent the Plan a referral.
You should file your application for long-term disability as soon as possible.
You will need to provide your LTD administrator with:
Contact your LTD administrator for more information.
If you are on Workers’ Compensation, you must make monthly premium payments, at the rate paid by active employees, to stay covered under the Plan. Payments are not deducted from your Workers’ Compensation check, so it is your responsibility to send timely payments directly to the Plan.
