Disability Pension Claims for Benefits
In order to initiate a claim for monthly disability pension benefits, you must complete an application form, available from Retirement Services, including a copy of notification of a disability onset date issued by the Social Security Administration. You must promptly inform Retirement Services, preferably in writing, if you believe there is any error in either the information contained in your annual Pension Statement from the Plan, or in any pension payment that you receive.
Examinations
The Plan reserves the right and opportunity to examine, through medical professionals designated by the Trustees, a person whose disability is the basis of a claim, as often as the Trustees may reasonably deem necessary.
The Plan will make a benefit determination within a reasonable time, but not later than 45 days after receipt of the claim by the Plan. This 45-day period may be extended, if necessary, for reasons beyond the control of the Plan, up to an additional 30 days. If an extension is necessary, you will be notified before the end of the original 45-day period of the reasons and the date by which the Plan expects to render a determination. The first 30-day extension period may be extended, if necessary for reasons beyond the control of the Plan, up to an additional 30 days, in which case you will be notified before the end of the original 30-day extension period of the reasons and the date by which the Plan expects to render a decision. In case of an extension, the notice of extension will state the standards on which entitlement to benefits is based, the unresolved issues that prevent resolution of the claim, and the additional information needed to resolve those issues. If such additional information is not received within 45 days, the claim will be denied due to lack of information.
In the event of an adverse benefit determination on a claim for disability pension benefits, you will be notified in writing. The notice will include:
- The specific reason for the adverse benefit determination.
- The specific Plan provision on which the determination was based.
- A description of any additional material or information necessary to perfect the claim and an explanation of why this information is necessary.
- A statement of the claimant’s right, upon request and free of charge, to access and to receive copies of documents, records and other information relevant to the claim for benefits.
- An explanation of the Plan’s appeal procedures, including applicable time limits, and a statement of the claimant’s right to bring a civil action following an adverse benefit determination on appeal.
- Information as to whether an internal rule, guideline, protocol or other similar criterion was relied on in making the determination, and if so, a statement that the claimant may obtain a copy of the rule, guideline, protocol, etc. free of charge upon request.