Long-Term Disability

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.

After you have been disabled for a period of at least 180 days and file a claim, you will be paid 60% 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:

  • During the 180 days of continuous disability before your long-term disability benefit begins and 36 months following that period, you are unable to earn more than 80% of the salary that you earned before your disability (in the same job); and
  • After the 36-month period, you are unable to earn more than 80% of the salary that you earned before your disability occurred in any job for which you are reasonably qualified based on your training, education, experience and former salary.

Your long-term disability benefits are paid according to the chart below.

Your Age on the Date Your Disability StartsBenefits 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 the Medical Compliance Department of METRO 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:

  • proof of your continuing disability
  • proof that you are under the appropriate care and treatment of a doctor throughout your disability
  • information about other income benefits
  • any other material information related to your disability that is requested, including the date the disability started, the cause of the disability and the prognosis of the disability.

Contact your LTD administrator for more information.

FAQs Icon

FAQs

I am on Workers’ Compensation. Can I get disability benefits, too?

While you are collecting Workers’ Compensation, you are not eligible to receive short-term disability benefits from the Plan. However, you are eligible to apply for long-term disability benefits six months after your injury. Any long-term disability benefit you receive will be reduced by your Workers’ Compensation and other forms of income. For many reasons, it is to your advantage to apply for long-term disability benefits. Call the Health & Welfare Plan office if you have any questions.

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