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As a state of Ohio employee, you are eligible to apply for disability leave benefits. These medical benefits provide financial and emotional assistance to you and your family in the event that you are unable to perform the duties of your position due to a non-work-related disabling illness, injury or condition for a period of more than 14* consecutive calendar days.

*Contract exceptions for length of waiting period - Attorney General, FOP 46 and FOP 48 - please refer to your contract.

The disability leave program is governed by the Ohio Revised Code, Ohio Administrative Code and, for bargaining unit employees, their bargaining unit contract.

Click the links below to access the information you need quickly.

Eligibility
Application Process
Decision Process
Disability Retirement
Childbirth/Adoption Leave and Disability
Denials - Appeals Process
Return to Work
Payment Process
Behavioral Health Conditions

Eligibility
To be eligible for disability benefits, all of the following must apply:

  • You must be disabled and unable to perform the duties of your position for more than 14* consecutive calendar days.
    *Contract exceptions for length of waiting period - Attorney General, FOP 46 and FOP 48 - please refer to your contract.
  • You must be a full-time permanent employee or a part-time permanent employee who has worked 1500 hours or more in the 12 months immediately prior to the disability.
  • You must have completed one year of continuous state service immediately prior to the date of the disabling injury, illness or condition.
  • Click here for what may not be covered.                         

How Does the Disability Process Work?                                            

What's Covered?                                            

The following disabling illnesses, injuries or conditions may be considered for disability leave benefits:

  • Non-work-related injury or illness
  • Mental health conditions
  • Substance abuse conditions (Note: An employee must be receiving ongoing treatment, which prevents the employee from working.)

Application Process

Rules to Apply for Disability Leave Benefits
Ohio Administrative Code 123:1-33-02

  • Your claim must be filed within 20* calendar days of your date last worked to your agency’s personnel office or benefits coordinator.
  • If you are disability separated you have a filing deadline of 20* calendar days from the date of your separation.
  • You are responsible for providing medical documentation to substantiate your disabling condition.
  • You must file for disability retirement if your attending physician has deemed your disabling condition to be permanent.
  • You have 20* calendar days from your notification, or within 20* calendar days of your ending date of benefits, to submit additional information.
  • You have 30* calendar days from your notification to request an appeal if your claim is denied or if you disagree with the decision rendered.
  • You may submit a written statement explaining extenuating circumstances if you are unable to meet the filing deadlines.
  • You are responsible for informing your agency or the Department of Administrative Services of any change in your mailing address.
    * Contract exceptions for filing FOP 46 & FOP 48, please refer to your contract.

Steps for Applying for Disability Leave Benefits

Step1
Follow your agency’s standard reporting procedure.

Step 2
Obtain from your personnel office or agency benefits coordinator the Initial Application for Disability Leave (Form ADM4310).

Step 3
Employee completes Pages 2 and 3 of the Initial Application for Disability Leave (Form ADM4310 - the Employee Statement section).

Step 4
Provide the ADM4310 to your health care provider to complete Pages 4 and 5 of the ADM4310 Form (the Attending Physician Statement).

Step 5
The employee must submit Pages 2 through 5 to their personnel office or agency benefits coordinator within 20* calendar days from the employee's date last worked (the application is not considered complete or timely without Pages 2 through 5).

Step 6
Your personnel office or agency benefits coordinator must complete the Application for Disability Leave Benefits - Employer Statement (Form ADM 4312) within five days of receipt of an employee’s application and must submit all paperwork to the Department of Administrative Services.

Step 7
If you are asked to submit additional information, if you need to be off longer than anticipated or there is a change in your condition, you must obtain from your personnel office or agency benefits coordinator the Supplemental Report for Disability Leave - Employee Statement (Form ADM4311).

  • Employee completes Page 2.
  • Employee’s physician completes Pages 3 and 4 (Supplemental Report Attending Physician Statement).
  • The employer must complete the Application for Disability Leave Benefits -Employer Statement (Form ADM 4312) or the Disability Supplemental Information Form prior to submitting the application to the Department of Administrative Services.

    Note: Additional information must be submitted within 20* calendar days from the date of the letter or 20* calendar days from the ending date of benefits, whichever is the greater date.  
    * Contract exceptions for filing FOP 46 & FOP 48 - please refer to your contract. 

Decision Process

  • If your claim is approved you must serve a mandatory 14* consecutive calendar day waiting period before you can receive disability leave benefits. 
    *Contract exceptions for length of waiting period - Attorney General, FOP 46 and FOP 48 - please refer to your contract.  
  • You may use your leave time (sick, personal or vacation) to receive pay during the waiting period. This time will not be restored.
  • After the waiting period, benefits will be paid at 67 percent of your base rate of pay for the maximum 12 months of eligibility.
    *Contract exceptions for length of lifetime maximum effective percentage paid at what month - Attorney General Office FOP 45, FOP 46, FOP 48; State Treasurer 55 - please refer to your contract.
  • Disability benefits can last for a one* year life time maximum. 
    *Contract exceptions for length of lifetime maximum - Attorney General Office, FOP 45, FOP 46, FOP 48; State Treasurer 55 - please refer to your contract.
  • You will receive your disability benefits in standard bi-weekly paychecks.
  • Taxes and all regular deductions will be taken from your disability check.
  • If you are eligible for FMLA (Family and Medical Leave Act), the first twelve weeks of the approved disability benefits, including the waiting period, will count concurrently as FMLA.

The disability leave benefit program is a temporary program designed to help you until you are able to get back to work. Your disability benefits will continue until one of the following happens:

  • Your health care provider determines that you are able to return to work;
  • The medical documentation of your injury or condition does not support your claim for disability benefits; or
  • You reach the one* year life time maximum of benefits.
    *Contract exceptions for length of lifetime maximum - Attorney General Office, FOP 45, FOP 46, FOP 48; State Treasurer 55 - please refer to your contract.

Disability Retirement
Ohio Administrative Code 123:1-33-02(D)

  • If your disability is deemed permanent*, you will be required to file for disability retirement from a state employee retirement system.
    *Contract exceptions for retirement application requirement - State Treasurer 55 - please refer to your contract.
  • Disability retirement programs are totally independent and separate from the disability leave program provided by the state of Ohio. 
  • If you have less than five years of state service or are age 60 or older, you may not be eligible for disability retirement. 
  • If you are not eligible for disability retirement, you may still be eligible to receive disability benefits for up to the one** year life time maximum. 
  • Once you submit proof that you have filed for disability retirement, disability leave benefits may be approved on a month-to-month basis until a decision is reached by the disability retirement system.
  • If your disability retirement is approved, you may receive disability leave benefits to supplement your disability retirement benefits.
  • The supplement brings your benefits up to what you have received from the disability leave program and is only available until you reach the lifetime maximum**.
    **Contract exceptions for length of lifetime maximum - Attorney General Office, FOP 45, FOP 46, FOP 48; State Treasurer 55 - please refer to your contract.

Childbirth / Adoption Leave and Disability

  • If you are disabled prior to your delivery due to complications, you may receive disability benefits for two weeks beyond your actual delivery date.
  • Your childbirth/adoption leave will begin the 15th day following delivery, as your waiting period is covered by disability leave.
  • If you remain disabled after your childbirth/adoption leave, you may be eligible for a reinstatement of your disability leave benefits.

Denials - Appeals Process
Ohio Administrative Code 123:1-33-04

If you receive a denial notice from the Department of Administrative Services, you will have 30 calendar days to appeal that denial. It is very important that you submit your request for appeal by the deadline date indicated in the letter or your claim may be closed.

  • If your claim is denied because of a medical issue, your claim will be reviewed by an independent third-party physician.
  • The third-party physician will not examine you. The doctor’s decision will be based on a review of all medical information contained in your disability file.
  • If the third-party physician denies your claim, you will automatically be scheduled for a Chapter 119 disability hearing. 
  • If your claim is denied because of a technical issue, you will be scheduled for a Chapter 119 disability hearing.
  • You will be notified by certified mail of the date, time and location of your hearing.
  • Failure to appear at the hearing may uphold the denial of your benefits.

Appeal Process - Hearings
At a Chapter 119 hearing:  

  • You may be represented by an attorney or by yourself.
  • You may present evidence and examine witnesses. 
  • The employee and the state will have the opportunity to testify before the hearing officer.

After the hearing:

  • The hearing officer will issue a report and recommendation based on the results of the hearing. 
  • All parties will have 10 calendar days to file objections. 
  • The director of the Department of Administrative Services will review the recommendation and objections, if any, and issue an Adjudication Order to all parties.
  • If you disagree with the director’s order, you will have 15 calendar days to appeal to the Court of Common Pleas.
  • If the denial of benefits is upheld, the employing agency will be notified to initiate all necessary steps to recover disability leave benefits or insurance premiums paid on the employee’s behalf.

Return to Work

Transitional Return to Work Program
Ohio Administrative Code 123:1-33-07

If you are capable of returning to work with temporary work restrictions as requested by your attending physician, the state, in partnership with your employing agency, may be able to place you in a transitional work program (TWP).

What Is a Transitional Work Program?               

  • A TWP provides the opportunity for a disabled employee to make a gradual return to work as they continue their recovery.
  • The program promotes the physical conditioning and recovery of an employee with restrictions, with the ultimate goal of returning the employee to their original position.
  • The TWP is mutually agreed upon by the employing agency and employee’s health care provider based upon work restrictions and available work accommodations.

What Are the Requirements for Participating in a Transitional Work Program?

  • Prior to returning to work, you must provide your agency with a written release from your doctor to include:
    • The number of hours you are able to work;
    • Any restrictions to your work activities; and
    • The expected duration of the work restrictions.
  • Your agency must approve the requested work hours and/or restrictions prior to your actual return to work.
  • A participation agreement should be signed by the employee, agency and committee members.
  • The agreement should list the physical restrictions imposed by your doctor and the temporary work assignments.

How Long Can I Participate in a Transitional Work Program?

  • TWPs are approved for up to 30 calendar days but may be extended to a maximum of 90 calendar days based on your doctor’s recommendation
  • The employee will continue to receive disability leave benefits for the hours he or she is unable to work while participating in an authorized TWP
  • The agency will reinstate the employee on a full-time basis to the original position once the employee’s doctor has determined that he or she is no longer disabled and has released the employee to perform the duties of their position.
  • Hours worked during authorized TWP for up to 90 days shall not count toward the employee's lifetime maximum eligibility*.
    *Contract exceptions for length of lifetime maximum - Attorney General Office, FOP 45, FOP 46, FOP 48; State Treasurer 55 - please refer to your contract.

Full-time Return to Work
If you are capable of returning to work without restrictions, your agency will reinstate you to your position on a full-time basis. At this time, you are no longer eligible to receive disability leave benefits.

Subsequent Disability
Ohio Administrative Code 123:10-33-08

A subsequent disability is:

  • A disability that is unrelated to a previous illness, injury or condition and occurs while an employee is on an approved disability leave is considered the same claim.
  • An unrelated disability that occurs after a previously approved disability is considered a new claim with a new waiting period.
  • A related disability that occurs within six months of an employee's return to active work status. This is considered the same claim if the employee remains disabled and off work for at least 14* consecutive calendar days.
    *Contract exceptions for length of waiting period - Attorney General, FOP 46 and FOP 48 - please refer to your contract.  
  • A related disability that occurs beyond six months of the employee's return to active work status is considered a new claim with a new waiting period.
  • A related disability that occurs while an employee is participating in an authorized transitional work program is considered the same claim.

Time accumulated under both the original and subsequent disability periods will be added together and applied towards the maximum lifetime eligibility for disability leave benefits. 

For more information, refer to Ohio Administrative Code 123:10-33-01.

Payment Process

As a state of Ohio employee, there is no cost to you for disability leave benefits. Each state agency pays a percentage of its payroll into the disability fund. For more information regarding the payment process, please refer to Ohio Administrative Code 123:1-33-05.

Waiting Period
The waiting period shall begin the day the disabling illness, injury or condition prevents you from performing the duties of your position.

  • If your claim is approved you must serve a mandatory 14* consecutive calendar day waiting period before you can receive disability leave benefits. 
    *Contract exceptions for length of waiting period - Attorney General, FOP 46 and FOP 48 - please refer to your contract.  
  • You may use your leave time (sick, personal or vacation) to receive pay during the waiting period. This time will not be restored.

Payment of Disability Leave Benefits
Disability leave benefits shall be paid at 67 percent of the employee’s base rate of pay for the maximum 12 months of eligibility whether the employee files a new, subsequent-related or subsequent-unrelated claim.

*Contract exceptions for length of lifetime maximum effective percentage paid at what month - Attorney General Office, FOP 45, FOP 46, FOP 48; State Treasurer 55 - please refer to your contract.

Payment of Disability Retirement Benefits
If an employee is approved for disability retirement benefits, the employee shall receive:

  1. The retirement benefit; and
  2. A supplement that brings your benefits up to what you have received from the disability leave program and is only available until you reach the lifetime maximum**.
    **Contract exceptions for length of lifetime maximum - Attorney General Office, FOP 45, FOP 46, FOP 48; State Treasurer 55 - please refer to your contract.

Payment of Retirement System Contributions
The employee shall be responsible for paying the employee's share of retirement contributions.

Payment of Insurance Premiums
The employer’s and employee’s share of the health, life and other insurance benefits will be paid by the employer during the period the employee is pending and receiving disability leave benefits.

Supplementation of Benefits
An employee receiving disability leave benefits may supplement the disability leave benefits with accumulated sick, personal, vacation leave balances and comp time to receive up to 100 percent of pay.

Recovery of Improperly Paid Benefits
The director shall initiate all necessary steps to recover disability leave benefits or insurance premiums paid in error or paid as a result of fraud, or to make any needed adjustments. The director shall request the attorney general to take appropriate action to recover improperly paid benefits or insurance premiums.

Behavioral Health Conditions

Ohio Administrative Code 123:1-33-01 (D)

United Behavioral Healthcare, the state's behavioral health care provider, manages disability claims for state of Ohio employees who are enrolled in a state health plan. To be eligible for disability leave benefits for a behavioral health condition, the following must apply:

  • The employee must have a behavioral health/substance abuse condition that prevents the employee from working;
  • The employee must be in treatment with a behavioral health/substance abuse specialist; and
  • The employee must follow the treatment plan prescribed by their provider.

To request a disability assessment, an employee may contact their agency, the Employee Assistance Program (EAP), Department of Administrative Services - Disability Services unit or UBH directly at 1-800-852-1091. Agencies are required to complete the State of Ohio Agency Disability Questionnaire.

For more information regarding state of Ohio Behavioral Health services, or United Behavioral Healthcare, click here.

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