Introduction
If you
are disabled because of a
nonoccupational
illness or injury covered under this plan,
you may be eligible for time loss benefits:
- Your
disability must be continuous, and you must be incapable of performing any and
every duty pertinent to your occupation as a carpenter.
- You
cannot be engaged in any other occupation for wage or profit.
- Your
attending physician must certify your disability and you must remain under his
or her care for the duration of the disability. Periodic proof of the disability
may be required. For the purpose of this benefit, a physician means a physician
practicing within the scope of his or her license as a doctor of medicine (MD),
doctor of osteopathy (DO), doctor of podiatry (DPM), or oral surgeon (DDS or
DMD). No
other provider will be recognized.
- Your
disability must begin while you are eligible under this plan. Time loss benefits
are not available for any disability that begins while you are participating in
Self-Contribution
Coverage or COBRA Continuation
Coverage.
If
your time loss claim is approved, you receive a benefit equal to 33 percent of
journeyman pay based on 40 hours at the prevailing journeyman rate specified in
the Area Master Agreement. Benefits begin on the first day you begin care with
the attending physician who certifies your disability when your disability is
due to an injury, provided the disability commenced within 30 days of the date
of the injury. Or, benefits begin on the eighth day of disability when you do
not satisfy the 30-day requirement or your disability is due to an illness.
Weekly benefits continue for a maximum of 26 weeks for any one period of
disability.
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