KPERS' long term disability plan provides financial protection by replacing part of the member's income if he or she is disabled by injury or sickness for a long time.
KPERS claim denial and appeal process
If the member's claim is denied, KPERS will send member written notice with an explanation. The member may request an administrative hearing to appeal the denial.
The member is disabled when, on the date of disability, he or she meets the following definition of total disability:
If an active member becomes disabled, report it on the EWP.
For approved claims, benefits will begin the later of:
No benefits are paid during the 180-day waiting period, and the member must be under the care of a physician. If a member attempts to work for up to 30 days during the waiting period and again becomes totally disabled from the same cause, the waiting period will be extended by the number of days worked.
As long as the member is receiving at least 50% of full pay, based on his or her KPERS-covered position, the member is considered on the payroll for KPERS purposes.
Full pay is based on the following:
Once the member is no longer earning at least 50% of full pay based on his or her KPERS position, go to the EWP and enter the employee’s end date. Use “leave of absence” as the reason code. Quick Vid: End Dates
The member may continue to receive Workers’ Compensation pay or small accumulated payments for sick leave and annual leave. However, do not deduct KPERS contributions. The member has essentially moved to a non-covered position
Example 1: An employee is injured and begins using sick/annual leave to pay 66% of his salary.
Report contributions from the salary and keep the employee on your pay report.
Example 2: An employee is injured and begins receiving Workers’ Compensation, which pays 66% of the employee’s salary. The employee uses sick/annual leave to pay 34% of his salary. The employee is off more than ten consecutive days.
Stop KPERS contributions and place the employee on a leave of absence.
Example 3: An employee is injured and begins receiving Workers’ Compensation, which pays 66% of the employee’s salary. The employee has no accumulated sick/annual leave.
If the employee is off more than ten consecutive days, stop KPERS contributions and place the employee on a leave of absence even if the employee continues to earn leave.
Example 4: An employee becomes ill and has no accumulated sick/annual leave. The employee begins receiving 70% of full pay from the employer’s sick-leave program.
Deduct contributions from the salary and leave the employee on your pay report for KPERS purposes.
Example 5: An employee becomes ill and is not at work. Employee has no accumulated sick/annual leave and there is no employer sick-leave program. The employer pays employee 70% of full pay.
If the employee is off more than ten consecutive days, stop KPERS contributions and place the employee on a leave of absence.
Once a member completes the waiting period, our long-term disability administrator, DMS (Disability Management Services, Inc.), will pay a monthly benefit as long as the member continues to be approved for disability benefits. The benefit amount will be:
If approved for disability, the following applies:
Member may continue optional life insurance coverage by continuing to make premium payments at the same rates paid during active employment. Member must complete and submit the Optional Life Insurance Continuation form (KPERS 79-C). The member will make premium payments directly to Standard Insurance Company.
Disability payments are paid monthly for as long as the member qualifies for benefits, but not to exceed the maximum benefit period.
|Disability Begins||Members Maximum Benefit Period|
|Before age 60||Until 65th birthday or until retirement, whichever is first|
|At age 60 or after||For five years or until retirement, whichever is shorter|
Benefit payments end if the member:
Following a period of total disability, a member may continue to qualify for disability benefits while engaging in rehabilitative employment.
Davie's Life & Health will:
Once it's determined that the member is a suitable candidate for rehabilitative services, participation is mandatory.
Davie's reserves the right to make the final decision regarding the member’s eligibility to take part in a rehabilitative plan. If the member does not participate in a rehabilitative plan without good cause, disability benefits will end.
Rehabilitative employment benefits
During a period of approved rehabilitative employment, the member's monthly benefit will be reduced by employment earnings as follows:
|Period of Rehabilitation||Reduction of Member's Disability Earnings|
|Months 1-12||↓ 50%|
|Months 13-24||↓ 75%|
|The maximum benefit period for rehabilitative employment is 24 months.|