by Molly Friedman, Attorney
Most federal employees are covered by the Federal Employee Retirement System, known as FERS.
FERS-covered employees may qualify for disability retirement benefits if they can prove they are medically unable to do their job. Federal employees may have the ability to supplement this coverage by purchasing long-term disability benefits (LTD) policies administered by private insurance carriers. If you are potentially eligible for both LTD and FERS Disability Retirement (FDR)benefits, it’s essential to know the difference in the application process, requirements, and impact on payment.
First, the application process for both benefits is different.
The documentation required to apply for FDR benefits is standard for all FERS employees. For private LTD policies, the application forms vary by plan and provider. An important document to have for your reference is a copy of your LTD policy. You should reach out to your Human Resources department to obtain the correct documentation, including contact information for your insurance carrier.
For both your LTD and FDR benefits, the most important information will always be documentation of your medical condition and resulting restrictions and limitations.
LTD applications generally require that one or more of your medical providers complete a form, usually called an Attending Physician Statement (APS), detailing the length and nature of their treatment and abilities to perform specific activities. There is no specific form required for your physicians to complete for the FDR application process. Even without a required form, you should be actively treating and discussing the impact of your medical condition on your ability to work and ensuring that your medical records reflect this information.
Generally, the process for approval of LTD benefits and going into pay status is far shorter than the FDR process.
There are many reasons for this. The LTD carriers focus solely on administering these disability benefits plans and require less information from your employer upfront. The FDR process requires review and input from different offices in your agency. You shouldn’t necessarily be concerned regarding the strength of your FDR case if it is taking longer than the LTD claim to be approved.
If you are approved for both FDR and LTD, in a typical policy, your LTD carrier will offset your LTD benefits by your gross FDR benefit. It is vital to keep your LTD provider updated regarding your approval for FERS benefits and the benefit amount you receive. The same goes for any other benefits you may receive, such as Social Security Disability (SSD) or Veterans Disability Benefits. Most LTD policies include a minimum benefit. Even if the offset resulting from other benefits you receive is higher than your LTD benefit amount, you will still likely be eligible to receive some compensation.
As noted above, central to obtaining both your LTD and FDR benefits is proving that you are medically unable to work.
Approval for LTD benefits can strengthen your FDR application and vice versa. The definition of disability that you must meet for eligibility for your LTD plan can vary from policy to policy. Unlike the universal eligibility requirements for the approval of FDR applications, definitions differ between LTD carriers and policies. It’s important to review your policy for the exact definition.
Another difference in eligibility is based on the nature of your disabling condition.
For your FDR benefits, the nature of your disabling condition does not matter, whether it is based on physical injury, mental health, or a combination of both. Unfortunately, the same cannot be said for most LTD plans. Many LTD plans limit eligibility for benefits for claims based on mental and emotional health to 24 months or less. However, this should not discourage you from applying for both benefit systems.
The choice to supplement your FERS disability retirement with a Long Term Disability (LTD) policy is a complicated one.
Navigating the impact of both benefit systems on each other can be complex. When filing for these benefits, our recommendation is to obtain an attorney to help you strategize for one or both benefits and ensure you are receiving the maximum possible benefits you are eligible for. At Andalman and Flynn, we have over 20 years of working with Federal and private sector employees to obtain disability retirement benefits. Please call us or visit our website any time to request a free consultation.
Founded in 1998 in downtown Silver Spring, Maryland, Andalman & Flynn has forged a distinguished reputation for legal excellence. The Firm practices family law, estate planning, and probate throughout Maryland and the District of Columbia, and represents individuals seeking disability benefits throughout the country. The Firm focuses on cases that impact the rights of everyone and is there for clients when responsive legal help is most critical. The Firm has provided legal analysis on national and local television and radio, and its attorneys often testify before legislative bodies and are routinely invited to contribute to prominent legal publications. For more information about Andalman & Flynn, please visit the website at andalmanflynn.com or call 301.563.6685.