Comprehensive Long Term Disability (LTD) Coordinator Manual

The LTD Coordinator Manual is available on this website by selecting one of the sections.

Claim Filing Procedures
 

How Is A Long Term Disability Claim Filed?
Disability management and accurate, efficient payment of benefits are what employees expect as part of the disability program from Unum. So that we may provide our best service, please read this section carefully.

Because of the complexity of LTD claim reviews and the importance of a timely response, it is essential that all LTD claim forms be filled out completely and accurately.

PLEASE NOTE THAT ALL GIC COORDINATORS ARE REQUIRED TO PROVIDE CLAIM-RELATED INFORMATION TO UNUM WITHOUT EXCEPTION. UNUM SHALL DETERMINE THE MERIT OF ALL DISABILITY CLAIMS.
 

Claims to File Early - Early Intervention
Early intervention on disability claims is an integral part of any disability management program.
 

Filing an Early Intervention Claim
When an employee is disabled as a result of one of the conditions or procedures listed below, please have them call Unum (1-877-226-8620 option 1) as soon as possible after they cease working due to a disability.

  • Chronic Fatigue/Epstein Barr Syndrome
  • Mental/Psychiatric Disorders
  • Fibromyalgia
  • Multiple Sclerosis
  • Systemic Lupus Erythematosus (SLE)
  • Cardiovascular Conditions
  • Back pain that may lead to surgery
  • Repetitive Motion Injuries (such as Carpal Tunnel)

If the claim is found to be appropriate for Early Intervention, a Disability Specialist and Nurse Case Manager will immediately begin processing of the claim.

Filing a Claim
When an employee's disability (including disabilities caused by occupation related sickness or injury) is likely to continue beyond the 90-day elimination period, the following steps should be followed:

1) Approximately 45 days before the end of the elimination period, the employee should call Unum using the dedicated toll free number 1-877-226-8620 option 1 to request a claim submission packet.

Unum will send the employee a claim submission packet within one business day. The packet will contain:

  • Claim Submission Instruction letter
  • Employment Statement
  • Claimant Statement
  • Attending Physician Statement

2) The employee should:

  • Give the Employment Statement to the GIC Coordinator to complete and return to the employee.
  • Give the Attending Physician Statement to the Physician to complete and return to the employee.
  • Complete the Claimant Statement.
  • Return the Employment Statement, the Claimant Statement, and the Attending Physician Statement to Unum by faxing to 800-447-2498 or mailing to the address on the forms within 14 days.

Claim Processing
Initial Claim Processing. When Unum receives the LTD Claim Forms, they will assign a claim number and advise the employee of that number.

To qualify for benefits, an insured employee must:

  1. be disabled during the 90-day elimination period and beyond in accordance with the policy provisions; and
  2. meet all eligibility requirements as outlined in the policy

In addition, premium for the coverage provided under the policy must be paid to date.

Once the 90-day elimination period ends, claim payments are made in accordance with the policy provisions. Claim payments will be sent directly to the claimant unless otherwise specified.

If additional information is needed to make the initial evaluation of the claim, Unum will contact the GIC Coordinator, the employee, or the employee's physician to obtain this information.

After benefits begin, additional medical information will be necessary to support continued disability and to verify that the employee is under the appropriate regular care and attendance of a physician. The employee's condition and the physician's prognosis determine how frequently this information is needed.


This information provided by the Group Insurance Commission.