FMLA, STD, and Vacation Time

[Village Idiot]

What is the name of your state?IL

I recently had a baby, and went into FMLA. At my place of work they require you to use your paid time, such as vacation, sick days, personal days, etc. before unpaid time during FMLA, so I actually got an advance on those days (what would add up to be 4 weeks of pay) right before the baby arrived to help cover costs. Anyhow, I'm also eligible for short term disability with up to 75% of my weekly pay for 7 weeks. I wasn't surprised that the disability pay didn't start until after what would have been the regular pay periods for the vacation time, but now my employer is saying that they actually overpaid my STD and want me to pay them back.

According to them the 7 weeks of STD included the 4 weeks I had been advanced (even though those were vacation/sick time). According to the STD plan they provided me the benefits would not be paid until all sick days were used. If their FMLA policy forces you to use paid leave before unpaid leave, doesn't that mean that my vacation time was basically sick days? Shouldn't STD have begun only after the 4 weeks of earned pay from vacation? Do I really need to pay them back because they think I should have only received the difference of 3 weeks in STD even though I'm eligible for 7? I haven't even been able to return yet because of symptomatic hypertension and edema and now they're wanting money from me. Shouldn't I be entitled to the full 7 weeks, vacation time aside?

 

[Beth3]

If their FMLA policy forces you to use paid leave before unpaid leave, doesn't that mean that my vacation time was basically sick days? Actually, the law states that an employee taking FMLA can be required to substitute any accrued paid personal leave [vacation, sick days, paid personal time, etc.] for FMLA. It doesn't matter how you choose to categorize it.

Do I really need to pay them back Yes. because they think I should have only received the difference of 3 weeks in STD even though I'm eligible for 7? You would only be eligible for seven weeks of STD benefits if you had not received any other compensation for the time off.

Shouldn't I be entitled to the full 7 weeks, vacation time aside? No. As long as you are receving compensation from your employer for leave time, your STD benefit wouldn't kick in. Why should your employer be required to pay you twice for the same time?

 

[Village Idiot]

Shouldn't I be entitled to the full 7 weeks, vacation time aside? No. As long as you are receving compensation from your employer for leave time, your STD benefit wouldn't kick in. Why should your employer be required to pay you twice for the same time?

That's exactly what I mean though, STD benefit wouldn't kick in until after my compensation for vacation time, thus shouldn't I be eligible for 7 weeks of STD after I have used my earned vacation? If the policy says that no benefits are payable until all sick day have been used, then doesn't that mean that the benefits begin after my vacation time has been used up? Nowhere in the policy does it say that vacation pay will be used in lieu of STD. I'm going to end up needing the full 12 weeks, thus shouldn't I be entitled to my 4 weeks of vacation time, and then the 7 weeks of STD would kick in?

 

[Beth3]

This is getting confusing as heck. Let's start over.

What date did your leave begin?

For what period of time did you receive compensation from your employer, whether in the form of paid vacation, paid sick days, paid personal days?

For what period of time did you receive STD benefits?

 

[Village Idiot]

What date did your leave begin? December 16th

For what period of time did you receive compensation from your employer, whether in the form of paid vacation, paid sick days, paid personal days?

Vacation, sick, personal days were advanced to me through January 11th.
On January 28th I received my first STD payment (we are paid on a weekly basis so it would have been for week of Jan17th through 21st. I received 4 STD payments ending Feb 18th (for week of Feb 7th through 11th).

For what period of time did you receive STD benefits? I was eligible for 7 weeks, but only received 4 weeks, now they want a week back.

 

[cbg]

And you returned to work on what date?

 

[Beth3]

She's still off work, cbg.

 

[cbg]

In that case I'm totally confused and want to have a calendar in front of me before I go any further. Back in a bit.

 

[Beth3]

Yeah, that's why I asked you to take over. My brain was starting to hurt.

 

[Village Idiot]

I'm sorry it's so confusing, and thank you for taking the time to look into it I really appreciate it. I really did understand it as though STD wouldn't begin until after my vacation time was used up and then I would get the 7 weeks of STD.

 

[cbg]

Okay, after giving this matter considerable thought, I have come to the conclusion that without reading your STD policy, there is no way for us to say whether this is right or wrong. I had to go out for a while just now, and while driving I was able to think of three valid and legal reasons why they might have done this (of course, right now, an hour later, I can only remember one of the three but I know I had three earlier).There is no way of knowing which of the three, if any, is the correct one.

What I can tell you is that they have not violated any laws. They may or may not have violated the disability plan, but there's no way for either Beth or me to say since we haven't read the plan.

 

[Beth3]

I had to go out for a while just now, and while driving I was able to think of three valid and legal reasons why they might have done this (of course, right now, an hour later, I can only remember one of the three but I know I had three earlier). You need to quit hitting the taverns in the afternoon, cbg.

 

[cbg]

It's not the taverns, it's the meds.

 

[Village Idiot]

Summary Plan Description of Short Term Disability

This is exactly what the summary plan says that they provided me when I notified them that I would be taking maternity leave:

Schedule of Short Term Disability Coverage

Weekly Benefits
75% of an employee's weekly earnings.

Waiting Period During Disability
No benefits payable until eligible sick days have been used.
Due to an Accident/ Sickness 5 working days; payable for Day 1.

Maximum Benefit Period for each Disability

Due to an Accident/Sickness 12 weeks

In no event will this benefit, together with similar benefits provided in another group policy or benefit plan, including statutory and/or self-insured plans, exceed 75% of the employee's weekly earnings.

Earnings, with respect to weekly Short Term Disability Salary Continuation, means an employee's earnings exclusive of bonus, overtime pay, or other forms of renumeration.

In the event that a regular, active full-time or salaried employee is totally disabled due to accident or illness to the employee for a period in excess of five working days, the company will pay a portion of the employee's weekly earnings for the number of weeks specified in the schedule below. Salary continuance will only be paid as schedule below with the employee is totally disabled and under the continuous care of a licensed physician. Such total disability must be verified to the company's satisfaction by the employee's physician on an Certification of Disability statement provided to the company.

EMPLOYEE'S CONTINUOUS SERVICE 75% PAY FOR:
Less than 1 year 5 weeks
One year, but less than three years 7 weeks
Three years, but less than five years 9 weeks
five years or more 12 weeks

SUCCESSIVE DISABILITY:

If the same or related disability re-ccurs within ninety (90) days after the employee has returned to work, payments will be made as if the disability had been continuous. If the same or related disability re-occurs after ninety (90) dayrs from returning to work, the employee's benefits will begin over again according to the schedule.

Disabilities due to totally different or unrelated injuries or sickness are covered for the full payments schedule as long as the employee returns to work for at least one (1) full day between period of disability.

All coverage terminates at retirement.

Summary of Short Term Disability Coverage

This coverage provides for payment of 75% of an employees normal weekly earnings during disability if you become wholly and continuously disabled from an accident, injury or sickness which prevents you from performing any and every duty pertaining to your occupation, provided you do not engage in any work for renumeration or profit.

No benefits are payable for:
(a) Any disability due to accidental bodily injury arising out of, or in the course of, your employment, or due to disease covered by a Workers' Compensation Act or similar legistlation, or
(b) Any disability for which you are not treated by a physician licensed to practice medicine.
(c) Disabilities resulting from intentionally, self-inflicting injuries, riot or insurrection.
(d) Disabilities resulting from the commission or intest to commit felony, misdemeanor or other crime.

Eligibility and Termination Provisions

Eligible Employees
All salaried, active full-time employees. "Full-time" means an employee regularly works more than 30 hours per week.

When coverage starts
Coverage starts normally 60 days after date of employment. Employees must be actively at work on a full-time basis on the schedule effective date. If the scheduled effective date is not a regularly scheduled work day, coverage will start on the effective date provided the associate was actively at work on a full-time basis on his last regularly scheduled work day.

When coverage ends
Coverage ends on the date an employee's active full-time service ends for any reason. Such reasons include disability, death, retirement, layoff, leave of absence and the end of employment.

Coverage also ends on the date the employee stors being a member of the salaried class of employee covered under this benefit

Termination of this Plan
The company may terminate this plan or alter any provisions of the plan at any time at it's sole discretion, without prior warning or motive. Administation of the Plan, including but not limited to denial of claims is at the sole discretion of the Plan Administrator.
I'm guessing this is the clause that makes it legal for them to deny me the 7 weeks, but does it mean I have to pay them back?

Also according to the company handbook:

"Disabilities arising from pregnancy or pregnancy-related illness are treated the same as any illness that prevents an Employee from working. Details of the STD benefits plan including benefit amounts, when they are payable, and limitations, restrictions, and other exclusions are described in the Summary Plan Description provided to eligible Employees."

 

[cbg]

What I'd like to see, if you're posting, is anything the disability plan has to say about waiting periods over and above what you've already posted, anything about pregnancy or maternity leave, and anything about coordination of benefits. At the moment I'm not concerned about what the company handbook says; just the disability policy.

Also, is this a self-funded plan (your checks are issued by your employer) or a fully insured plan (your checks are issued by Unum, Provident, Prudential or some other carrier)?