Short Term Disability

Information

Benefit Overview & Benefit Period

Recurrent Claims

UFH

Denied Claims

State Plans

Your Short Term Disability is based on years of service with The Cigna group at the time disability begins

All Active Employees
Less than 2 years of service
75% of earnings up to 25 weeks
More than 2 years of service 

100% of earnings up to 6 weeks

75%
of earnings 7 to 25 weeks

 

 

 

If an employee returns to work and then becomes disabled again, MetLife will review the details of the claim to determine if it is a recurrent claim or a new disability claim:

If Employees Returns to Work for... And The Disability Is Due to... Then...
Three months or less The same or a related disability
Will receive short-term disability benefits for the remaining balance of that 26-week period (i.e. 26 weeks minus any time already taken)
More than three months The same or a related disability
May qualify for up to 26 weeks of short-term disability benefits
Any period of time
A different, unrelated disability
May qualify for up to 26 weeks of short-term disability benefits

 

 

 

  • At the 20th week of STD, MetLife will discuss LTD with the employee and assist with initiating an LTD claim at the employee’s request. MetLife begins this process early to allow time for information gathering to provide qualifying employees a seamless transition from STD to LTD.
  • The employee will receive a packet of information including required paperwork to complete.
  • MetLife will use the medical information from the STD claim, but the eligibility standards for STD and LTD are different, MetLife will also reach out to the employee’s provider(s) for any additional medical information to support an LTD claim.
  • The LTD claims specialist will send the LTD acknowledgement packet and contact the employee to introduce themselves. They will explain the LTD process and packet contents in addition to the timeline for when information will be needed.
  • After 30 days from the packet being sent, the LTD claim specialist will follow up to confirm it has been received and continue their initial decision phase. 
  • Once a decision is made about LTD, MetLife will notify Cigna Group of the LTD claim determination.

 

 

 

  • The employee will be contacted via telephone, and through detailed written communication notifying the employee of the denial, the rationale for the decision, and applicable appeal information. A decision template will be sent to the employee’s location contacts.
  • If an employee’s STD or LTD claim is denied, they have the right to appeal. The appeal timeframe allows the employee 180 days to appeal the denial of their benefits in writing, including an opportunity to provide any additional information to substantiate their claim. 
  • If a claim denial is overturned, the claim will be reinstated and approved. MetLife will send the updated decision to the employee’s location contacts.

 

 

 

  • Please see your State Plan Coordination Resource