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Is my HR dept wrong?

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What is the name of your state (only U.S. law)? Wisconsin.

I was in an auto accident & have been taking meds for it, but not everyday. While on meds, I cannot perform my job and was told not to come into work on those days. HR said that unless I use vacation time, those days are unpaid.

My company has a short-term disability policy, which I believe I qualify for, however HR says I don't. Here are the eligibility requirements:

If you are disabled because of pregnancy, illness or accidental injury and your condition, as determined by the Plan Administrator, prevents you from working for pay or profit for any duration of time at any job or occupation within the Company for which you are reasonably suited, you may be eligible for short-term disability benefits. For purposes of the Plan, an accidental injury is defined as an unforeseeable, unintended, and unplanned event or circumstance causing physical or mental injury.

Short-term disability benefits, regardless of Organization Level, whether at full base salary or 60 percent of base salary, are not payable for weeks in which you receive vacation pay. Weeks in which you receive vacation pay count against the duration of your short-term disability payment period. You cannot receive vacation and disability benefits for a period that would exceed 52 weeks.

If you are eligible, short-term disability benefits will begin after the fifth consecutive work-day for employees whose regular schedule is five 8-hour days, and after the fourth consecutive work-day for employees whose regular schedule is four 10-hour days of a qualifying absence under terms of the Plan, except such benefits may be payable from the first day if you are hospitalized as an inpatient and under the regular care of a physician.


My disability is from an accidental injury & it has been determined I can't work because of it (on the days I'm on meds). Therefore I met the requirements. HR says I don't because I haven't missed 5 consecutive work days.

My interpretation of the policy is that missing 5 consecutive work days is not an eligibility requirement of the benefit, but rather a description of when that benefit actually kicks in because it says "if you are eligible..." instead of saying "You are eligible if you miss at least 5 consecutive work days." Furthermore, the policy doesn't specific what happens after those 5 consecutive work days. For instance, what happens if I'm out 5 consecutive days, but then out every third day afterwards?

Additionally, I was hospitalized and have been under the care of a doctor, so I think I meet the exception that would allow my benefits to start on the 1st day instead of after 5 consecutive days.

I don't want to argue with the company about it & piss them off because I don't them to come up with an "unrelated" (but related) reason to fire me. However, I don't want to miss out on a benefit I was told I would get when I accepted the job, assuming I meet the eligibility requirements, and I think I do.

So, how do I proceed? Do I "argue" with HR about it? Do I simply take the meds for 5 consecutive days?
 


UndercovrAngel

Junior Member
Is My HR Department Wrong

Unfortunately, your HR department is not wrong. You must be out a total of five consecutive days, and be expected to be out for a pre-determined amount of time (most short term disability covers you from 5 to 6 month) without any breaks in that outage time .. working 4 days and being out the .
5th, working three and being out the 4th and 5th day. It must be a continuos period. The only benefit that allows for this type of time off is FMLA (they have no monetary benefits, just keeps you from loosing your job while you use up your 12 weeks). You can be set up for it and miss days here and there..not continuos.. for a total period of 12 weeks or 60 days.

Is this considered a workers compensation claim ?? If so, have you been released back to full duty by your work comp treating Dr ?? If you haven't been released for full duty, are you on light duty with restrictions ?? If that is the case, then the work comp insurance company should be reimbursing you up to 66 2/3rds of pre-tax wages that you are loosing do to the meds that you are on.

Your only other option is to have your Dr put you on a medication that doesn't interfere with your work, so that you can work a full 5 days a week.

Angel ^j^
 

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