§ 5.27.400. Disability benefits.

A.

Payment of Benefits. An Eligible Participant shall begin accruing the benefit determined under Section 5.27.390 on the first day following the expiration of the waiting period. Except as otherwise herein provided, such benefit shall be paid as long as the Eligible Participant's Disability continues, but in no event longer than 26 weeks from the first day of Disability.

B.

Other Income Benefits.

1.

The STD Plan Benefit payable to the Eligible Participant shall be reduced by other income benefits. "Other income benefits" are those benefits identified below to which the Eligible Participant is entitled. Such benefits, which may be payable either periodically or in a lump sum, are:

a.

The amount of any benefit with respect to the same Disability and the same period for which the monthly benefit is payable under this STD Plan when such benefits are provided or payable:

(1)

By any federal, state, county, municipal or other government agency;

(2)

As temporary disability benefits under California workers' compensation laws;

(3)

Under any other workers' compensation law; or

(4)

Under any employer's liability law.

b.

The amount of any salary or other compensation, including sick leave, vacation, annual leave, or other pay the Eligible Participant receives from the County shall be coordinated with the STD benefit as specified in the Election Information.

2.

Where other income benefits are received in the form of a lump-sum payment or payments, such benefits shall be coordinated with the benefits otherwise payable under this STD Plan in the manner set forth in the Election Information.

C.

Termination of Benefits. No benefit shall be payable under this STD Plan if any of the following events occur:

1.

The 26-week period, calculated from the first day of Disability, concludes;

2.

The Eligible Participant ceases to be Disabled;

3.

The Eligible Participant dies, retires, or terminates employment with the County;

4.

The Eligible Participant engages in gainful self-employment or receives earned compensation from an employer other than the County, unless the earnings do not invalidate the legitimacy of the injury or illness as the basis of a claim under the Plan, as determined by the CEO or his designee;

5.

The Eligible Participant fails to provide satisfactory Evidence of Disability, ceases to be under the care of a Physician, and/or is not receiving appropriate treatment for the Disability as defined by a recognized professional association established for the license type of the Physician;

6.

The Eligible Participant refuses to accept an offer of County employment which is consistent with work restrictions imposed by the Claims Administrator or the CEO, and appropriate to his experience, training, and/or abilities;

D.

Recurrent Disability. If an Eligible Participant returns to active County employment and is disabled again for the same cause within 30 calendar days from the date of his return to active employment, or within such other time period as may be specified in the Election Information, STD benefit payments may be resumed without a new Waiting Period; provided, however, that nothing in this provision shall extend the payment of income replacement benefits for the original and any subsequent period(s) of Disability arising from the same cause beyond a total of 26 weeks from the first day of Disability. For purposes of this section, an Eligible Participant will be treated as having returned to active County employment, only if the Eligible Participant has resumed a normal working schedule at the County facility at which he is employed for the regularly scheduled working days during the 30 calendar days after his return to active employment.

(Ord. 2014-0033 § 3, 2014; Ord. 2005-0072 § 1 (part), 2005; Ord. 90-0164 § 1 (part), 1990.)