Short/Long Term Disability
Completing a Leave/Irregular Workweek Form
When do I need to fill out a Leave/Irregular Workweek Form?
When an injury/illness lasts more than 10 days, a Leave/Irregular Workweek Form must be completed. The LIWF is completed in order to properly code sick leaves and Long Term Disability leaves. In most cases, you will submit several LIWFs as an employees moves through this process.
In addition to completing the LIWF, is there anything else I need to do?
YES! Keep detailed records of hours worked. It is very important to keep detailed records if an employee is able to work modified hours during their salary continuance period, since all hours worked will extend the salary continuance period.
If you need assistance calculating a salary continuance period please contact the Benefits Department at extension 85562. Benefits Administration will request confirmation of the first day sick and any hours worked since the first day sick in order to calculate their salary continuance period. This information will then be relayed back to the department.
If you need assistance calculating a salary continuance period please contact the Benefits Department at extension 85562. Benefits Administration will request confirmation of the first day sick and any hours worked since the first day sick in order to calculate their salary continuance period. This information will then be relayed back to the department.
Coding Examples for a Leave/Irregular Workweek Form
To record the commencement of a sick leave:
To return an employee from a sick leave that did not exhaust the 15 consecutive weeks:
To record the commencement of a sick leave and to return an employee from a sick leave that did not exhaust the 15 consecutive weeks:
For an employee that exhausts the 15 consecutive weeks and is not working any modified hours and transitions to a LTD leave:
For an employee that exhausts the 15 consecutive weeks and is working modified hours and transitions to a LTD-Rehab leave:
To return an employee from a LTD leave that will begin working a modified rehabilitation schedule:
To return an employee from a LTD leave to full-time hours:
To return an employee from a LTD-Rehab leave to full-time hours:
Long Term Disability (LTD) Application Process
(Start 8 weeks prior to end of employee's salary continuance period (STD))
What is the Supervisor's role in the LTD application process?
In application for Long Term Disability benefits is made through Manulife Financial.
The application consists of four statements listed below:
Benefits Administration will send the Employee Statement and Physician Statement directly to the employee with a guide and letter outlining their next steps. Benefits Administration will complete the Employer Statement.
All statements should be submitted approximately 8 weeks prior to the anticipated expiration of their salary continuance period.
The application consists of four statements listed below:
- Employee Statement - completed by employee
- Physician Statement - completed by employee's Physician (arranged by employee)
- Supervisor Statement - completed by employee's Supervisor
- Employer Statement - completed by Benefits Administration
Benefits Administration will send the Employee Statement and Physician Statement directly to the employee with a guide and letter outlining their next steps. Benefits Administration will complete the Employer Statement.
All statements should be submitted approximately 8 weeks prior to the anticipated expiration of their salary continuance period.
