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Disability Benefits: Decision Process
- If your claim is approved you must serve a mandatory 14* consecutive calendar day waiting period before you can receive disability leave benefits.
*Contract exceptions for length of waiting period - Attorney General, FOP 46 and FOP 48 - please refer to your contract.
- You may use your leave time (sick, personal or vacation) to receive pay during the waiting period. This time will not be restored.
- After the waiting period, benefits will be paid at 70 percent of your base rate of pay for the first three* months and 50 percent for the remaining nine* months of eligibility.
*Contract exceptions for length of lifetime maximum effective percentage paid at what month - Attorney General Office FOP 45, FOP 46, FOP 48; State Treasurer 55 - please refer to your contract.
- Disability benefits can last for a one* year life time maximum.
*Contract exceptions for length of lifetime maximum - Attorney General Office, FOP 45, FOP 46, FOP 48; State Treasurer 55 - please refer to your contract.
- You will receive your disability benefits in standard bi-weekly paychecks.
- Taxes and all regular deductions will be taken from your disability check.
- If you are eligible for FMLA (Family and Medical Leave Act), the first twelve weeks of the approved disability benefits, including the waiting period, will count concurrently as FMLA.
The disability leave benefit program is a temporary program designed to help you until you are able to get back to work. Your disability benefits will continue until one of the following happens:
- Your health care provider determines that you are able to return to work;
- The medical documentation of your injury or condition does not support your claim for disability benefits; or
- You reach the one* year life time maximum of benefits.
*Contract exceptions for length of lifetime maximum - Attorney General Office, FOP 45, FOP 46, FOP 48; State Treasurer 55 - please refer to your contract.
Disability Retirement
Ohio Administrative Code 123:1-33-02(D)
- If your disability is deemed permanent*, you will be required to file for disability retirement from a state employee retirement system.
*Contract exceptions for retirement application requirement - State Treasurer 55 - please refer to your contract.
- Disability retirement programs are totally independent and separate from the disability leave program provided by the state of Ohio.
- If you have less than five years of state service or are age 60 or older, you may not be eligible for disability retirement.
- If you are not eligible for disability retirement, you may still be eligible to receive disability benefits for up to the one** year life time maximum.
- Once you submit proof that you have filed for disability retirement, disability leave benefits may be approved on a month-to-month basis until a decision is reached by the disability retirement system.
- If your disability retirement is approved, you may receive disability leave benefits to supplement your disability retirement benefits.
- The supplement brings your benefits up to what you have received from the disability leave program and is only available until you reach the lifetime maximum**.
**Contract exceptions for length of lifetime maximum - Attorney General Office, FOP 45, FOP 46, FOP 48; State Treasurer 55 - please refer to your contract.
Childbirth / Adoption Leave and Disability
- If you are disabled prior to your delivery due to complications, you may receive disability benefits for two weeks beyond your actual delivery date.
- Your childbirth/adoption leave will begin the 15th day following delivery, as your waiting period is covered by disability leave.
- If you remain disabled after your childbirth/adoption leave, you may be eligible for a reinstatement of your disability leave benefits.
Denials - Appeals Process
Ohio Administrative Code 123:1-33-04
If you receive a denial notice from the Department of Administrative Services, you will have 30 calendar days to appeal that denial. It is very important that you submit your request for appeal by the deadline date indicated in the letter or your claim may be closed.
- If your claim is denied because of a medical issue, your claim will be reviewed by an independent third-party physician.
- The third-party physician will not examine you. The doctor’s decision will be based on a review of all medical information contained in your disability file.
- If the third-party physician denies your claim, you will automatically be scheduled for a Chapter 119 disability hearing.
- If your claim is denied because of a technical issue, you will be scheduled for a Chapter 119 disability hearing.
- You will be notified by certified mail of the date, time and location of your hearing.
- Failure to appear at the hearing may uphold the denial of your benefits.
Appeal Process - Hearings
At a Chapter 119 hearing:
- You may be represented by an attorney or by yourself.
- You may present evidence and examine witnesses.
- The employee and the state will have the opportunity to testify before the hearing officer.
After the hearing:
- The hearing officer will issue a report and recommendation based on the results of the hearing.
- All parties will have 10 calendar days to file objections.
- The director of the Department of Administrative Services will review the recommendation and objections, if any, and issue an Adjudication Order to all parties.
- If you disagree with the director’s order, you will have 15 calendar days to appeal to the Court of Common Pleas.
- If the denial of benefits is upheld, the employing agency will be notified to initiate all necessary steps to recover disability leave benefits or insurance premiums paid on the employee’s behalf.
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