Statutes, codes, and regulations
Delaware Administrative Code
Title 19 - LaborEmployee Benefits
Disability Insurance Program "DIP" Rules and Regulations
Section 2007-16.0 - LTD Benefit Payment

19 Del. Admin. Code § 2007-16.0

Download
PDF
Current through Reigster Vol. 28, No. 6, December 1, 2024
Section 2007-16.0 - LTD Benefit Payment
16.1 LTD benefits will be paid in an amount up to 60% of the claimant's creditable compensation as of the day before the onset of the disability.
16.2 As defined in 29 Del.C. § 5253(c)(3), LTD benefits will not include general salary increases during the period of LTD. LTD benefits may be increased annually by an amount approved by the SEBC.
16.3 A claimant who applies for LTD benefits must apply to the Social Security Administration for disability benefits. LTD benefits will be reduced by the disability benefits awarded to all family members by the Social Security Administration.
16.4 The amount of a benefit for loss of income provided to a claimant or to a claimant's family as a result of a period of disability for which the claimant is requesting LTD benefits will be an offset to the claimant's LTD benefit payment. This includes benefits for which the claimant or the claimant's family is eligible or is paid to the claimant, the claimant's family, or to a third party on behalf of the claimant. This includes the amount of a benefit for loss of income from:
16.4.1 temporary disability benefits under Workers' Compensation Law, the Jones Act, occupational disease law, similar law or substitutes or exchanges for the benefits;
16.4.2 governmental law or program that provides disability or unemployment benefits as a result of the employees job with the State;
16.4.3 plan or arrangement of coverage, whether insured or not, or as a result of employment by or association with the employer or as a result of membership in or association with a group, association, union or other organization;
16.4.4 mandatory "no-fault" automobile insurance plan;
16.4.5 disability benefits under:
16.4.5.1 the United States Social Security Act or alternative plan offered by a state or municipal government;
16.4.5.2 the Railroad Retirement Act;
16.4.5.3 the Canada Pension Plan, the Canada Old Age Security Act, the Quebec Pension Plan or a provincial pension or disability plan; or
16.4.5.4 similar plan or act, that the claimant, the claimant's spouse and children are eligible to receive because of the claimant's disability;
16.4.6 Disability benefit from the Veteran's Administration, or another foreign or domestic governmental agency:
16.4.6.1 that begins after the claimant developed a disability; or
16.4.6.2 if the claimant were receiving the benefit before becoming Disabled, the amount of the increase in the benefit that is attributed to the claimant's disability.
16.4.7 Payment for Rehabilitative employment by the State of Delaware or other employer. All Income received from the State of Delaware or other employer must immediately be reported to the DIP insurance carrier or third-party administrator.
16.4.7.1 disability benefit under the Employer's Retirement Plan;
16.4.7.2 permanent disability or impairment benefits under a Workers' Compensation Law, the Jones Act, occupational disease law, similar law or substitutes or exchanges of the benefits;
16.4.7.3 portion of a settlement or judgment of a lawsuit that represents or compensates for the claimant's loss of earnings;
16.4.7.4 retirement benefit from a Retirement Plan that is wholly or partially funded by employer contributions, unless:
16.4.7.4.1 the claimant was receiving it before becoming Disabled; or
16.4.7.4.2 the claimant immediately transfers the payment to another plan qualified by the United States Internal Revenue Service for the funding of a future retirement.
16.5 Claimants receiving LTD benefits are responsible for the accurate and timely payment of health care premiums. In accordance with 19 DE Admin. Code 2001, refer to the Group Health Insurance Plan Eligibility and Enrollment Rules for full details.
16.6 If the State of Delaware notifies the DIP insurance carrier or third-party administrator that a claimant receiving LTD benefits has been overpaid LTD benefits for any reason, the DIP insurance carrier or third-party administrator will recoup all overpaid LTD payments directly from the LTD beneficiary.

19 Del. Admin. Code § 2007-16.0

19 DE Reg. 78 (7/1/2015)
20 DE Reg. 70 (7/1/2016)
21 DE Reg. 234 (9/1/2017)
28 DE Reg. 57 (7/1/2024) (Final)