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Page 7 of 16

Steps to follow for filing a SICKNESS & ACCIDENT (S&A) Claim

Employees that go on sick leave must call 1-800-810-2271 to report your absence 30 minutes prior to the start of your shift and get a call-in number for the first day of absence. Employees should also call Sedgwick at 1-888-322-4462 to get your S&A claim started. Your S&A claim must be called in within 20 calendar days of the date your disability commenced. Your doctor must also call Sedgwick at 1-888-322-4462 to report your medical information within 90 days of your release date. Claims will not be paid unless you and your doctor call Sedgwick within the above time limits and meet eligibility requirements. An S&A claim will start with the first day you were physically treated by your doctor. When an injury occurs, your S&A pay will begin from day one as long as you are TREATED WITHIN 24 HOURS BY A DOCTOR OR HOSPITAL; all others will be required to serve a 3-day waiting period. For example:

S&A Claims with a 3-day waiting period

  • Inpatient hospitalization.
  • Outpatient.
  • Inpatient observation.
  • Illness.
  • Injuries or accidents NOT treated within 24 hours.

S&A Claims that pay from day-1

  • Injury or accident treated within 24 hours by a doctor or at a hospital.

Sick leave is only payable on Monday through Friday and does not include Saturday or Sunday even if you are scheduled to work. Sedgwick may send you to a doctor of their choice for a second opinion. If you are sent for a second opinion you will be notified by a letter from UPS or a phone call. Please make sure that your contact information is up to date with the plant HR Department. Failure to show up or to be late for your second opinion exam, will cause Sedgwick to discontinue your S&A pay.

If the second opinion doctor says you are able to work, you must report to the plant doctor for a third opinion. Failure to follow any of these steps will result in termination of your S&A benefits.

In order for you to receive S&A pay, you and your doctor must call Sedgwick and meet the eligibility requirements. If you or your doctor miss the Wednesday deadline, your claim will be processed the following week. Checks are processed on Thursday and mailed or EFT on Friday. S&A pay is based on your rate pay.

If your sick leave needs to be extended, you must be physically treated by your doctor prior to your original sick leave end date and have your doctor call Sedgwick and you must call the Absentee call-in number: 1-800-810-2271 to extend your return to work date.

In order to continue your Optional Life Insurance while on sick leave, you must call Benefit Express at 1-888-456-7800 within 30 days to request payment coupons. Your monthly deductions are taken ONLY from your payroll checks not from your S&A checks. You may also ask Benefit Express how long your Medical/Dental coverage will stay active based on your seniority.

You are required to reinstate through the HR Department the day before your return to work date. You can pick up a reinstatement form from the HR Department.

Reporting Your Absence

1. Get a call-in number call 1-800-810-2271.
2. Record your call-in number.
3. Call in 30 minutes prior to the start of your shift.

Applying for S&A

1. Call Sedgwick 1-888-322-4462.
2. Record your call-in number.
3. Have your Doctor call Sedgwick 1-888-322-4462. (select option 4)

Eligibility

To be eligible for S&A Benefits you must:

  • Be totally disabled and unable to work with restrictions.
  • Be unable to perform all duties of your occupation.
  • Be under the continuous care of a legally licensed physician who certifies your total disability.
  • Furnish written notice of claim and satisfactory proof of disability on a timely basis.

Appealing Denied Sickness and Accident (S&A) Claims Procedure

If your S&A claim is denied, we will need the following information within (45) days to file an appeal, on your behalf, to the International Union.

  • A letter from your doctor stating that you are/were unable to work.
  • All Doctor notes pertaining to your S&A claim.
  • If you were injured, have your doctor give the date of injury and how it occurred.
  • A list of all medications and the directions on how you take the medication.
  • All treatment dates.
  • An estimated return to work date from your doctor.
  • Have the Doctor list his treatment plan and any procedures you have had (MRI, X-rays, physical therapy etc.) You must submit the results of the procedure/s or if you had physical therapy, you would need a letter describing your progress or a copy of the medical notes describing the therapy.
  • If you are treated or admitted to the hospital, you must provide a copy of your E.R. report indicating the duration and reason for the hospitalization.
  • If more than one Doctor treated you, please have all the Doctors call Sedgwick and provide all the information that is listed above.
  • A written statement from you requesting to Appeal the Decision of Denial for your S&A. In your own words explain why you were off work and applying for S&A.

Appeals may take 2-3 months for reconsideration. You will receive notice by mail as soon as the appeal has been met on by the Company and the International Union and a decision has been reached.

 

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