The PERA Disability Program — Unum Insurance
Employees of most Colorado governmental agencies and public entities receive disability and other benefits by virtue of their participation in the Public Employees’ Retirement Association (PERA). These claims are administered by PERA’s disability program administrator, which is currently Unum Life Insurance Company of America (“Unum”). The program was previously administered by Standard Insurance Company, until January 1, 2011, and they continue to handle STD claims made before that date. The attorneys at McDermott Law are experienced in assisting Colorado PERA Members pursue their claims through all stages of the internal appeal process and into litigation, if necessary.
When a member of PERA becomes mentally or physically incapacitated from working, a disability claim should be immediately submitted to PERA. After eligibility for such benefits is confirmed, the claim is submitted to Unum for a determination whether the PERA member is medically eligible to receive either short-term disability or PERA disability retirement.
From 1999 through 2010, the designated Disability Program Administrator (DPA) of the PERA disability program was Standard Insurance Company. Unum Insurance Company took over the role as DPA commencing with all claims filed on or after January 1, 2011. Unum Insurance also replaced Standard Insurance as the insurer of the short-term disability (STD) benefit. As the new DPA, Unum renders all decisions on claims submitted after January 1, 2011.
The PERA disability program provides two separate disability benefits: short-term disability and disability retirement.
In order to qualify for STD, an employee must demonstrate an inability to perform his or her prior occupation. The insurance policies issued by Standard and Unum also require an individual to demonstrate an inability to perform any other occupation in which he or she could earn 75% of pre-disability earnings. We believe this second requirement violates law, and therefore, are currently pursuing a class action on this issue. You can read more about our efforts in that matter here. The maximum duration for STD benefits is 22 months. The amount of the benefit equals 60 percent of an employee’s pre-disability earnings. Short-term disability benefits are paid by Unum pursuant to an insurance contract.
Alternatively, Unum could determine an individual is entitled to disability retirement benefits. In order to qualify for PERA disability retirement, an employee must demonstrate total and permanent inability to engage in any employment in which he or she would earn at least 75 percent of his or her pre-disability earnings. If Unum Life Insurance Company of America agrees that this requirement has been met, the employee is entitled to receive disability retirement benefits for life, or until the employee is no longer disabled. The disability retirement benefit is paid by PERA, through its own funds and the member’s contribution account.
The amount of the PERA disability retirement benefit is determined by performing a complicated set of calculations, which are based on the employee’s earned and purchased service credit with the PERA employer and the “highest average salary” earned by the employee.
Depending upon the employer, some PERA members are offered additional or supplemental long-term disability (LTD) coverage under a separate long-term disability insurance policy. This additional policy is meant to supplement the PERA disability retirement program and compensate the employee up to 60 percent of the employee’s pre-disability income.
The Denver disability lawyers at McDermott Law have considerable experience pursuing PERA disability claims (both for STD and disability retirement) through all stages of the appeal process and into litigation. If either Standard or Unum has denied your claim for PERA disability retirement or short-term disability benefits, please contact our office for an assessment of your case.