2006 Utah Code - 49-21-401 — Disability Benefits -- Application -- Eligibility.

     49-21-401.   Disability Benefits -- Application -- Eligibility.
     (1) An eligible employee shall apply for long-term disability benefits under this chapter by:
     (a) completing an application form prepared by the office;
     (b) signing a consent form allowing the office access to the eligible employee's medical records; and
     (c) providing any documentation or information reasonably requested by the office.
     (2) Upon request by the office, the participating employer of the eligible employee shall provide to the office documentation and information concerning the eligible employee.
     (3) The office shall review all relevant information and determine whether or not the eligible employee is totally disabled.
     (4) If the office determines that the eligible employee is totally disabled due to accidental bodily injury or physical illness which is not the result of the performance of an employment duty, the eligible employee shall receive a monthly disability benefit equal to 2/3 of the eligible employee's regular monthly salary, for each month the total disability continues beyond the elimination period, not to exceed the maximum benefit period.
     (5) If the office determines that the eligible employee is totally disabled due to psychiatric illness, the eligible employee shall receive:
     (a) a maximum of two years of monthly disability benefits equal to 2/3 of the eligible employee's regular monthly salary for each month the total disability continues beyond the elimination period;
     (b) a maximum of $10,000 for psychiatric expenses, including rehabilitation expenses preauthorized by the office's consultants, paid during the period of monthly disability benefits; and
     (c) payment of monthly disability benefits according to contractual provisions for a period not to exceed five years if the eligible employee is institutionalized due to psychiatric illness.
     (6) If the office determines that the eligible employee is totally disabled due to a physical injury resulting from external force or violence as a result of the performance of an employment duty, the eligible employee shall receive a monthly disability benefit equal to 100% of the eligible employee's regular monthly salary, for each month the total disability continues beyond the elimination period, not to exceed the maximum benefit period.
     (7) (a) Successive periods of disability are considered as a continuous period of disability if the period of disability:
     (i) results from the same or related causes;
     (ii) is separated by less than six months of continuous full-time work at the individual's usual place of employment; and
     (iii) commences while the individual is an eligible employee covered by this chapter.
     (b) The inability to work for a period of less than 15 consecutive days is not considered as a period of disability.
     (c) If Subsection (7)(a) or (b) does not apply, successive periods of disability are considered as separate periods of disability.
     (8) The office may, at any time, have any eligible employee claiming disability examined by a physician chosen by the office to determine if the eligible employee is totally disabled.
     (9) A claim brought by an eligible employee for long-term disability benefits under the

Public Employee's Long-Term Disability Program is barred if it is not commenced within one year from the eligible employee's date of disability, unless the office determines that under the surrounding facts and circumstances, the eligible employee's failure to comply with the time limitations was reasonable.
     (10) Medical or psychiatric conditions which existed prior to enrollment may not be a basis for disability benefits until the eligible employee has had one year of continuous enrollment in the Public Employees Long-Term Disability Program.
     (11) If there is a valid benefit protection contract, service credit shall accrue during the period of total disability, unless the disabled eligible employee is exempted from a system, or is otherwise ineligible for service credit.

Amended by Chapter 240, 2003 General Session