BECOMING DISABLED

Becoming disabled can bring changes to your benefits. Click the tabs in the section below for more information on the changes you might need to make.

POTENTIAL PENSION CHANGES

  • Disability benefits from the Pension Plans are available regardless of your age.
    • Under the Basic Plan, you must be 10-year vested and have accrued at least 12 Credited Service Months in the 36 months immediately prior to the disability onset date to receive disability benefits. Currently, to qualify for disability pension benefits, you must also have earned a minimum of 12 CSMs in the 36 months immediately preceding the disability. If you are eligible for early retirement, a conversion option may be available. Please contact the Pension Plan at (877) 866-2200, Ext. 404 or pension@dgaplans.org for more information.
    • Under the Supplemental Plan, your Supplemental Plan Individual Account will be payable to you after providing the Plans office with a Notice of Award from the Social Security Administration.
  • If you decide to apply for disability benefits, the Pension Plans can commence your pension benefits on the first of any month.
  • If the application for a disability retirement pension and the Notice of Award from the Social Security Administration are filed with the Plans office within 90 days after the notice of Social Security benefits was issued, and if all other disability eligibility requirements are satisfied, disability benefits will become effective on the date that your Social Security disability benefits become effective (e., the date of entitlement to Social Security disability benefits as set forth in your Notice of Award).
  • If the application for a disability pension and the Notice of Award from the Social Security Administration are not filed with the Plans office within 90 days after the notice of Social Security benefits was issued, disability benefits will be effective on the first of the month following the month that you file the application and the Notice of Award with the Plans office, provided that all other disability eligibility requirements are satisfied and the application is received by the 15th of that prior month.
  • If your disability pension application is received more than 90 days after the date the Social Security Award was granted, the Plan may require proof of continuing disability.
  • If you are going to apply for disability benefits with the Social Security Administration, you should review pages 26-27 of the March 2025 Pension Plans Summary Plan Description to review the Plans’ provisions, regarding disability benefits.
 

DOCUMENTS TO COMPLETE

  • Notice of Award from the Social Security Administration – To apply for a disability benefit from the Basic and/or Supplemental Pension Plan, a copy of this notice must be provided to show that you are entitled to a disability benefit in connection with the Social Security Administration Retirement, Survivors and Disability Insurance. While you are not required to do so, you should notify the Plans within 90 days of your receipt of the Social Security award.
  • Benefit Application Request Form, written request for a benefit application or signed letter of instruction must be received at least 60 days prior to the date on which you wish to start disability benefits.

ADDITIONAL CONSIDERATIONS

The information on this page is only a summary of Pension Plans rules. For detailed information, please refer to:

POTENTIAL HEALTH PLAN CHANGES

  • The Health Plan does not offer disability insurance. In addition, the Health Plan does not endorse any outside insurance firms or coverage.
  • If you or a dependent are totally disabled on the date your coverage expires, your coverage for the disabling condition will be extended until the earliest of the following:
    • 12 months from the date premium payment ceased for you or your dependent;
    • the date that you or your dependent ceases to be disabled;
    • the date that coverage for you or your dependent becomes effective under any replacement policy which does not exclude the disabling condition.
  • In addition, if you or a qualified beneficiary become disabled during your initial 18-month COBRA self-pay period, you will be eligible for an 11-month extension of your COBRA self-pay coverage, provided that you or a qualified beneficiary are determined by the Social Security Administration (SSA) to be disabled at any time during the first 60 days of COBRA coverage.

DOCUMENTS TO UPDATE

  • A copy of your Social Security Administration (SSA) determination letter will be required to establish eligibility for the Health Plan’s 11-month extension of your COBRA self-pay coverage (see above). The Health Plan must receive this letter within 60 days of the later of:
    • the date of the determination letter
    • loss of earned coverage and within the initial 18-month COBRA period
  • Alternative documentation will be required to establish eligibility for disabled children age 18 and over who do not meet the resource limit or residency requirements to qualify for Social Security disability benefits. Refer to pages 32-33 of the March 2025 Health Plan Summary Plan Description for details.

ADDITIONAL CONSIDERATIONS

  • The Health Plan has special criteria for disabled dependent children who do not meet Social Security resource limit or residency requirements. Refer to page 33 of the March 2025 Health Plan Summary Plan Description for details.
  • Disabled dependent children under age 26 and who are under earned coverage, COBRA coverage or Extended Self-Pay coverage do not need to submit proof of disability to determine dependent eligibility.
  • Disabled dependent children under age 26 and who are under Retiree Self-Pay coverage will need to submit documentation on an annual basis demonstrating continued mental or physical disability to determine dependent eligibility. This documentation will be reviewed by the Health Plan’s medical review firm.
  • The information on this page is only a summary of Health Plan rules. For detailed information, please refer to:

HEALTH ACTION ITEMS

  •  Submit a copy of your Social Security Administration (SSA) determination letter to the Health Plan office if you would like establish eligibility for the Health Plan’s 11-month extension of your COBRA self-pay coverage. The Health Plan must receive this letter within 60 days of the later of:
    • the date of the determination letter
    • loss of earned coverage and within the initial 18-month COBRA period
  •  For disabled children age 18 and over who do not meet the resource limit or residency requirements to qualify for Social Security disability benefits, submit the alternative documentation referred to on  page 33 of the March 2025 Health Plan Summary Plan Description.

PENSION ACTION ITEMS

  •  To apply for a disability benefit from the Basic and/or Supplemental Pension Plan, a copy of your Notice of Award from the Social Security Administration must be provided to show that you are entitled to a disability benefit in connection with the Social Security Administration Retirement, Survivors and Disability Insurance. While you are not required to do so, you should notify the Plans within 90 days of your receipt of the Social Security award.
  •  Submit a Benefit Application Request Form, (the written request for a benefit application) or signed letter of instruction so that it is received at the Plans office at least 60 days prior to the date on which you wish to start disability benefits.

POTENTIAL PENSION CHANGES

  • Disability benefits from the Pension Plans are available regardless of your age.
    • Under the Basic Plan, you must be 10-year vested and have accrued at least 12 Credited Service Months in the 36 months immediately prior to the disability onset date to receive disability benefits. If you are eligible for early retirement, a conversion option may be available. Please contact the Pension Plan at (877) 866-2200, Ext. 404 or pension@dgaplans.org for more information.
    • Under the Supplemental Plan, your Individual Account will be payable to you prior to age 60 after providing the Pension Plans Office with proof that you are totally disabled.
  • If you decide to apply for disability benefits, the Pension Plans can commence your pension benefits on the first of any month.
  • If you are going to apply for disability benefits with the Social Security Administration, you should review pages 26-27 of the March 2025 Pension Plans Summary Plan Description to review the Plans’ provisions, regarding disability benefits.
 

DOCUMENTS TO COMPLETE

  • Notice of Award from the Social Security Administration – To apply for a disability benefit from the Basic and/or Supplemental Pension Plan, a copy of this notice must be provided to show that you are entitled to a disability benefit in connection with the Social Security Administration Retirement, Survivors and Disability Insurance. While you are not required to do so, you should notify the Plans within 90 days of your receipt of the Social Security award.
  • Benefit Application Request Form, written request for a benefit application or signed letter of instruction must be received at least 60 days prior to the date on which you wish to start disability benefits.

ADDITIONAL CONSIDERATIONS

The information on this page is only a summary of Pension Plans rules. For detailed information, please refer to:

POTENTIAL HEALTH PLAN CHANGES

  • The Health Plan does not offer disability insurance. In addition, the Health Plan does not endorse any outside insurance firms or coverage.
  • If you or a dependent are totally disabled on the date your coverage expires, your coverage for the disabling condition will be extended until the earliest of the following:
    • 12 months from the date premium payment ceased for you or your dependent;
    • the date that you or your dependent ceases to be disabled;
    • the date that coverage for you or your dependent becomes effective under any replacement policy which does not exclude the disabling condition.
  • In addition, if you or a qualified beneficiary become disabled during your initial 18-month COBRA self-pay period, you will be eligible for an 11-month extension of your COBRA self-pay coverage, provided that you or a qualified beneficiary are determined by the Social Security Administration (SSA) to be disabled at any time during the first 60 days of COBRA coverage.

DOCUMENTS TO UPDATE

  • A copy of your Social Security Administration (SSA) determination letter will be required to establish eligibility for the Health Plan’s 11-month extension of your COBRA self-pay coverage (see above). The Health Plan must receive this letter within 60 days of the later of:
    • the date of the determination letter
    • loss of earned coverage and within the initial 18-month COBRA period
  • Alternative documentation will be required to establish eligibility for disabled children age 18 and over who do not meet the resource limit or residency requirements to qualify for Social Security disability benefits. Refer to pages 32-33 of the March 2025 Health Plan Summary Plan Description for details.

ADDITIONAL CONSIDERATIONS

  • The Health Plan has special criteria for disabled dependent children who do not meet Social Security resource limit or residency requirements. Refer to page 33 of the March 2025 Health Plan Summary Plan Description for details.
  • Disabled dependent children under age 26 and who are under earned coverage, COBRA coverage or Extended Self-Pay coverage do not need to submit proof of disability to determine dependent eligibility.
  • Disabled dependent children under age 26 and who are under Retiree Self-Pay coverage will need to submit documentation on an annual basis demonstrating continued mental or physical disability to determine dependent eligibility. This documentation will be reviewed by the Health Plan’s medical review firm.
  • The information on this page is only a summary of Health Plan rules. For detailed information, please refer to:

HEALTH ACTION ITEMS

  •  Submit a copy of your Social Security Administration (SSA) determination letter to the Health Plan office if you would like establish eligibility for the Health Plan’s 11-month extension of your COBRA self-pay coverage. The Health Plan must receive this letter within 60 days of the later of:
    • the date of the determination letter
    • loss of earned coverage and within the initial 18-month COBRA period
  •  For disabled children age 18 and over who do not meet the resource limit or residency requirements to qualify for Social Security disability benefits, submit the alternative documentation referred to on  page 33 of the March 2025 Health Plan Summary Plan Description.

PENSION ACTION ITEMS

  •  To apply for a disability benefit from the Basic and/or Supplemental Pension Plan, a copy of your Notice of Award from the Social Security Administration must be provided to show that you are entitled to a disability benefit in connection with the Social Security Administration Retirement, Survivors and Disability Insurance. While you are not required to do so, you should notify the Plans within 90 days of your receipt of the Social Security award.
  •  Submit a Benefit Application Request Form, (the written request for a benefit application) or signed letter of instruction so that it is received at the Plans office at least 60 days prior to the date on which you wish to start disability benefits.