Disability Benefits
  My Disability Benefits
  Check a Claim
  Glossary
  FAQs
  Contact a Disability Benefits Specialist
 
Frequently Asked Questions
The content of these frequently asked questions and answers is provided for your information and convenience. If you are covered or become covered for benefits, the terms and conditions of your coverage are determined by the applicable benefit plan documents and/or MetLife insurance policy, contract, or certificate. In the event of any conflict with the content of these frequently asked questions and answers, the applicable benefit plan or MetLife insurance documents shall be controlling. You can obtain copies or instructions on how to obtain copies of those documents from MetLife or your employer.
 
Disability Questions 1-10 Disability Questions 11-25
FMLA Questions
 
Before Filing
1) What are Disability Income benefits?
2) How do I know what benefits I am eligible to receive?
 
 
How to File
3) How do I file a claim for disability benefits?
4) When should a disability claim be filed?
5) How do I know what kind of claim to file?
6) What information do I need to have available before I report my disability claim to MetLife?
 
 
After You File - Explanation of Processes
7) What can I expect after reporting a disability claim to MetLife?
8) Once my claim is approved, how long will it take for disability benefits to begin?
9) How frequently are disability benefits paid?
10) When is my disability benefit taxable?
 
 
Answers
 
Before Filing
1) What are Disability Income benefits?
 

Generally, Disability Income benefits provide partial income protection or replacement if you are unable to work due to a sickness or accident, as defined by the plan. The benefits can be paid on a short or long term basis depending on your employer's plan.

Back to top

2) How do I know what benefits I am eligible to receive?
 

Please contact your employer for information regarding the specifics of your disability coverage.

Back to top

 
How to File
3) How do I file a claim for disability benefits?
 

MetLife offers a number of different ways to file claims for disability benefits: downloading and mailing a form, calling to a customer service center and using the Internet for some employers. MetLife's customers are given the option to choose the method(s) of their choice. Please contact your employer for the options available to you and specific instructions on how to report your claim to MetLife.

Back to top

4) When should a disability claim be filed?
 

A disability claim should be filed when you become ill or suffer an injury and are unable to work for the number of days specified by your plan.

Back to top

5) How do I know what kind of claim to file?
 

The type of claim you file is based on your coverage eligibility and your reason for absence. You can refer to the glossary for descriptions of the coverage options. Contact your employer for specific information regarding your disability coverage and instructions on how to file a claim.

Back to top

6) What information do I need to have available before I report my disability claim to MetLife?
  When reporting your absence from work, you will be asked to furnish information about:

Yourself
- Name
- Address
- Telephone number
- Social Security number, employee identification number
- E-mail address for contact purposes during your period of disability

Your job
- Business unit or segment
- Location and address
- Payroll classification (hourly, salary, union, non-union, etc.), salary amount and frequency
- Department number
- Supervisor's name, telephone number, and e-mail address
- Job classification — sedentary, light, medium, etc.

Your illness/injury
- Last day worked
- Date of disability
- Reason for absence or your diagnosis — including the specific diagnostic ICD-9 code(s) and CPT-4 (procedure) code(s) — when available
- If applicable, information regarding your accident/injury including when, how and where the injury occurred
- Date of medical treatment after your last day worked
- Location of medical treatment — including hospitalization or outpatient service information
- Prognosis date or actual/anticipated return-to-work date

Your physician(s)
- Names, addresses
- Telephone numbers
- Fax numbers

Your other income sources
- Benefit amount(s) from each income source
- Frequency of payment, including start date and end date

Back to top

 
After You File - Explanation of Processes
7) What can I expect after reporting a disability claim to MetLife?
  After you report your disability claim, a MetLife case management specialist may contact you to discuss:
· The information you provided
· Your medical condition, including the impact it has on your ability to do your job, and your treatment plan
· The evaluation procedures under the disability program based on your specific disability plan


Your physician may be contacted to discuss your medical information, treatment plan, prognosis, and functional abilities. To assure timely processing of your claim, please contact your physician and authorize the release of medical information to MetLife.

Your employer may be contacted to discuss your specific job duties. Confidential medical information will be protected based on current privacy legislation. Your physical abilities, as they relate to your job requirements, will be discussed.

Once all pertinent information has been obtained, MetLife will make an initial determination regarding your disability benefits based on several factors, including:
· Your Disability Plan's definition of disability
· Your medical information
· Activities you can and cannot perform
· The circumstances of your condition, treatment plan and prognosis
· The requirements of the job and your ability to perform the job. Disability benefits may be payable as determined by MetLife, based on your plan.

MetLife will advise you and your employer of its decision to approve or deny your disability claim. If approved, a MetLife case management specialist may contact you to:
· Discuss your expected return to work
· Inform you of how frequently your claim will be re-evaluated and when to expect follow-up calls

As appropriate, the case management specialist may also provide you with information about applying for Social Security benefits.

If your claim is not approved, a MetLife Case Management Specialist will:
· Inform your employer of the claim denial
· Send you a formal letter that documents the reasons for the denial and explains applicable appeals procedures.

Back to top

8) Once my claim is approved, how long will it take for disability benefits to begin?
 

Once your claim is approved, your disability benefits/payments will begin immediately — excluding applicable waiting periods, offsets, etc. — per your plan.

Back to top

9) How frequently are disability benefits paid?
 

Short Term Disability benefits are usually paid weekly. Long Term Disability benefits are usually paid on a monthly basis. In some cases, your employer may choose to continue paying your benefits. In these instances, your benefits will be paid per your employer's regular payroll schedule.

Back to top

10) When is my disability benefit taxable?
 

(A) Your disability benefits will generally be 100% taxable if: (1) your employer paid for your disability coverage and did not include the premium paid for your coverage in the taxable wages that were reported to you on Form W-2 in the year the premiums were paid, or (2) you paid for your disability coverage with pre-tax wages (i.e., the premiums for your coverage came out of your wages before they were subjected to tax).

(B) Your disability benefits will generally be 100% tax free if: (1) your employer paid for your disability coverage and included the premium paid for your coverage in the taxable wages that were reported to you on Form W-2 in the year the premiums were paid, or (2) you paid for your disability coverage with after-tax wages (i.e., the premiums for your coverage came out of your wages after they ware subjected to tax).

(C) Your disability benefits will be partially taxable and partially tax free if: the premiums for your disability coverage are partially paid under one of the methods described in (A) above, AND partially paid using one of the methods described in (B) above. A very simple example of how this might work would be as follows: if your employer pays for 50% of your disability coverage, and does not include the employer-paid premium in taxable wages on your W-2, and you pay for the other 50% of your disability coverage with after tax wages, then roughly 50% of your benefits will be taxable, and roughly 50% of your benefits will be tax free, when paid.

The statements above are meant to provide a very general overview of when your disability payments will be taxable. The statements above are based on the law at the time that they were drafted and may not reflect recent legal developments. To the extent that the facts of your situation are unique, these general answers may not apply to you. Please consult with your employer and your tax advisor to determine if your disability payments will be subject to tax.

Back to top


My Disability Benefits | Check a Claim | Glossary | FAQs | Contact a Disability Benefits Specialist