43.01 Disability Program

Eligibility and administration of disability benefits shall be pursuant to current Ohio Law and the Administrative Rules of the Department of Administrative Services except for the following modifications and clarifications:

A. Any full-time permanent employee with a disabling illness, injury, or condition that will last more than fourteen (14) calendar days and who has completed one (1) year of continuous state service immediately prior to the date of the disability may be eligible for disability leave benefits.

B. To be eligible for disability leave benefits, an employee must be disability separated pursuant to Administrative Rule 123:1-33-02 or 123:1-33-03; or in active pay status or approved sick leave; or on approved disability leave; or approved leave of absence pursuant to Administrative Rule 123:1-34-01 or the terms of this Agreement for the employee's personal medical reasons. Employees alleging conditions precluded by OAC 123:1-33-14 are not eligible for disability benefits, unless the exceptions of the section are met. An application for disability benefits based on a diagnosis of a mental disorder, including but not limited to, psychosis, mood disorders, and
anxiety, must be confirmed by a licensed mental health provider authorized by the Employer's mental health administrator. Where the initial application is accompanied by the opinion of such provider, it shall be processed accordingly. However, where the diagnosis is submitted by any other medical professional, the Employer shall make expeditious arrangements for the required examination by the licensed mental health provider. Approval of the application will be contingent upon receipt of substantiation from such provider. In the event the examination is outside the parameters of the employees mental healthcare plan, the cost of the examination shall be borne by the Employer.

C. Part-time or established term regular employees who have worked fifteen hundred (1500) or more hours within the twelve (12) calendar months preceding disability shall be entitled to disability benefits based upon the average regular weekly earnings for weeks worked over that twelve (12) month period.

D. Disability benefits will be paid at 70% of the employees base rate of pay for the first three (3) months, and 50 % for the next nine (9) months, and shall be entitled to receive disability leave benefits up to a lifetime maximum of twelve (12) months. Effective for all new claims filed on or after July 1, 2009, disability benefits will be paid at sixty-seven percent (67%) of the employee's base rate of pay up to a lifetime maximum of twelve (12) months. The lifetime maximum of twelve (12) months began with any new claim filed on or after March 1, 2006. All employees receiving payments under Article 43 prior to July 1, 2009 shall be paid according to the terms of Article 43 contained in the Collective Bargaining Agreement which expired on June 30, 2009.

E. Employees will participate in transitional work programs mutually agreed to by the parties and as provided for in the applicable Administrative Rules. The Employer agrees that transitional work programs will not violate the provisions of the Family and Medical Leave Act. An employee will continue to receive disability leave benefits for the hours the employee is unable to work while the employee participates in an authorized transitional work program.

F. Pursuant to OAC rule 123:1-33-14, employees who have been denied Workers' Compensation lost time benefits for an initial claim, may file an application for disability leave benefits twenty (20) days from the notification by the Bureau of Workers' Compensation of the denial of an initial claim.

G. Disability separations shall be made pursuant to OAC 123:1-33. The Employer's decision to disability separate an employee or to deny reinstatement from an involuntary disability separation shall not be grievable but shall be exclusively subject to appeal through the State Personnel Board of Review (SPBR).

H. In the event an employee submits an application for disability leave after either (1) the employee has received notice that he/she is under investigation for possible disciplinary action or (2) where an investigation regarding the employee is actively underway, disability
payments may be held in abeyance subject to the following procedure: The Agency shall promptly notify DAS that (1) an investigation is underway, (2) the date that the investigation was initiated, (3) the basis of the investigation and (4) why access to the employee is necessary for completion of the investigation. A copy of the disability leave application and all accompanying documentation shall be forwarded with the notification. In the event that DAS concurs that the disability payments should be held in abeyance, DAS shall notify the employee, by regular and certified mail, that the disability payments shall not be processed until the completion of the investigation. An investigatory interview pursuant to Article 18 of the collective bargaining agreement shall be scheduled no more than thirty (30) days after the Agency files the notice of investigation for possible discipline with DAS. The matter shall then be subject to the constraints of Article 18 and 19 of the collective bargaining agreement. Upon completion of the investigation, or the thirty (30) day period, payments may be made, providing the application qualifies for eligibility. However, if the investigation cannot be completed as a result of the employee's absence, the investigatory interview shall be cancelled and the application shall be denied. Said denial shall not prevent the
submission of a new application, subject to the above same requirements. This Section shall not be applicable where the absence, and subsequent disability, is the result of hospitalization for more than five (5) days for a serious medical condition. If an application for disability benefits is pending and/or has been approved prior to the initiation of the investigation, this Section shall not be applicable.
43.02 Insurance Providers and Third Party Administrators In the event that the administration of the disability program is conducted by a private insurance carrier or a third party administrator the administration shall be conducted in accordance with insurance industry
underwriting procedures and standards without reducing benefits or eligibility requirements as provided in this Agreement. The Employer reserves the right to contract with a licensed mental health adjudicator to evaluate and approve or disapprove applications for disability leave based on any form of mental disorder as provided in Article 43.01.

43.03 Information and Orientation
To facilitate the understanding of Disability Benefits and the application procedure requirements, the Employer and the Department of Administrative Services shall make explanatory materials available to Labor Council Members, Associates or individual members, upon request. The Employer will offer a Disability orientation program focusing on eligibility requirements for Labor Council representatives, so that they may train Associates in procedures.