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STD - Exclusion - HELP

EthelEthel 194 Posts
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Am updating very out-of-date handbook and we have something presently in there that I'm not sure of. Can we deny STD company paid benefits to anyone " if, in the opinion of management, their disabillity was caused as a result of a. use of drugs, intoxicants or narcotics"? Would like to word this in manner that would be acceptable in today's world.
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  • 6 Comments sorted by Votes Date Added
  • jujujuju 120 Posts
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    [font size="1" color="#FF0000"]LAST EDITED ON 10-29-03 AT 04:54PM (CST)[/font][p]I don't think it's up to management to decide the nature of the disability. That would be up to the employee's doctor. And what about ADA (sorry to open that can of worms)? What if a recovering drug addict(clean for quite some time) cannot work due to complications stemming back to that use? Technically that would be drug-related, but should they be denied STD coverage?
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  • EthelEthel 194 Posts
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    Exactly! That's why I need help on revising.
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  • jujujuju 120 Posts
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    I'm not nearly as experienced as most of the folks on this forum, but I personally would drop that phrase altogether. Any restrictions on STD coverage can surely be found in your plan documents. I would leave it at that.
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  • irenesmsaclaimsirenesmsaclaims 241 Posts
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    Is it your intent to exclude all use, as it is currently written? Standalone STD is not subject to HIPAA, but some medical plans have altered this kind of provision with "except for a medical condition, ie., depression". You may want to add the word "illegal" to the substances; again, it depends on your intent. Is this a self-funded STD plan? If not, obviously the insuror would have to approve the change.
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  • EthelEthel 194 Posts
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    Yes it is a company funded STD plan. Our LTD has a policy, so they have the final determination there. Besides being company funded, there really is not a formal plan document. It is administered off of the info in the handbook.
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  • mushroomHRmushroomHR 583 Posts
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    We have a self-funded STD plan that states: "Weekly income benefits are not paid for any period of disability caused by: ... for any disability caused or related to drug/substance/alcohol abuse." This language is in our SPD, directly from the insurance company that administers our plan.
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