How the Plan Works
You may receive benefits from the plan if you are a member and become totally or partially disabled while you are covered under the Long-Term Disability Plan. No benefits are provided for any disabilities commencing before you were covered under the Plan or after your coverage under the Plan terminates.
“Totally disabled,” for purposes of the plan, means that, because of medically determinable illness or injury:
- You cannot perform each of the material duties of your own occupation for which you are reasonably fitted by training, education, or experience during the elimination period and the next the twenty-four months, and thereafter, unable to perform the material duties of any occupation.
“Partial Disability;’ for purposes of the plan, means that, because of your medically determinable illness or injury:
- While unable to perform all the material duties of your regular occupation on a full-time basis because of injury or illness, you are:
- Performing at least one of the material duties of your regular occupation or another occupation on a part-time or full-time basis; and,
- Earning currently at least 20 percent less per month than your pre-disability earnings.
Note: either or both of these can satisfy the elimination period.
“Elimination period,” for purposes of the plan, refers to the six-month period during which you must continuously have a total disability or partial disability before you can begin receiving benefits from the plan
You must be totally disabled or partially disabled and suffering a 20% earnings loss for at least six consecutive months before you can begin receiving benefits. Benefit payments will begin on the date you complete 180 days of continuous total and/or partial disability.
After completing the elimination period, you will receive monthly disability benefit payments while you remain totally or partially disabled.
Note: Your Health Plan coverage and Dental Plan coverage continue for the duration of your disability.
Subrogation and Reimbursement
The Boston University Long-Term Disability Plan also has a subrogation and reimbursement rule. If another party is legally responsible to pay lost earnings resulting from an illness or injury inflicted on you, the Long-Term Disability Plan is entitled to reimbursement out of any recovery from the responsible party (or from any insurer) for the amount of Long-Term Disability benefits paid by the plan. The covered individual must cooperate with the Long-Term Disability Plan to recover such amounts. If the covered individual received payment from the responsible party (or any insurer) before the Long-Term Disability Plan receives amounts paid as Long-Term Disability benefits, the covered individual must hold any amount recovered from the responsible party in trust for the benefit of the Long-Term Disability Plan to the extent of the Long-Term Disability benefits paid by the Long-Term Disability Plan, and must repay the Long-Term Disability Plan from the amounts recovered.