DISABLED EMPLOYEES/WORKERS' COMPENSATION

Click here to view the section of the Active Health SPD covering Disability and Worker's Compensation.

Despite the efforts of staff of the Trust Funds Administrative Office to make known unique Health Plan benefits we have recently recognized after speaking with numerous Plan participants that the Plan provisions governing the crediting of hours for periods of time you are receiving Workers' Compensation benefits as a result of an occupational injury, which occurred while working for a signatory Employer to this Health Plan are not widely known. Therefore, please find below the provisions of the Health Plan that address this issue:

Establishing Eligibility for Crediting of Hours

If an eligible Employee is unable to work in Covered Employment, as a result of an occupational injury, which occurs while working for a signatory Employer to this Health Plan, he may be credited with hours toward eligibility. In order to be eligible for this benefit, you must meet all of the following requirements.

  1. You must have been eligible for Plan benefits in the month in which the occupational injury occurred, and had contributions paid to this Plan on your behalf by an Employer.
  2. You must give written notice of your disability to the Administrative Office, within 30 days from the date you cease to be eligible under the Plan.
  3. You must provide proof, satisfactory to the Board of Trustees, certifying your disability, and the time period of disability.
  4. You must provide proof that you are receiving Workers' Compensation benefits, or will be entitled to Workers' Compensation benefits.

Crediting of Hours & Maximum Credit

You will be given 40 hours of work credit for each week of approved Workers' Compensation disability, up to a maximum of 26 weeks per disability.

Hours will be credited toward your eligibility, in the same manner as described above, under the section entitled, "Eligibility". For example, if you are unable to work for three weeks in July, and have received 120 hours of disability credit, it will apply towards your November eligibility.

Solely for purposes of establishing eligibility for the crediting of hours under this provision, hours worked for which contributions are being reciprocated to the Health Fund under the I.O. Health Reciprocity Agreement shall be considered hours worked in Covered Employment and the employer generating those reciprocal contributions shall be considered a signatory Employer to the Heath Plan.

This section added by: Amendment 17.

Family Medical Leave Act

The Family Medical Leave Act enacted by Congress in 1993 provides that in certain situations certain employers are required to grant leave to employees and that in such situations the employer is required to continue medical coverage for the employees. The federal legislation specifically provides that more liberal provisions of state law are permitted and also provides that more liberal provisions contained within collective bargaining agreements are permitted.

It is not the role of the Trustees or Trust Fund to determine whether or not an individual employee is entitled to leave with continuing medical care under the federal statute, any state statute or the provisions of a collective bargaining agreement. Disputes as to the entitlement to leave with continuing medical benefits must be resolved by the employer, employee, and where applicable, the local union.

To the extent that the participants are entitled to leave with continuing medical coverage pursuant to the federal act, state legislation or provisions contained within a collective bargaining agreement, the Trust Fund will provide continuing medical coverage so long as required monthly contributions are received from the contributing employer. Rights under this section in no fashion affect rights under COBRA or rights to continuing medical care pursuant to the disability extension features contained within the Plan.

Click here to view the section of the Active Health SPD covering Disability and Worker's Compensation.

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