OCT Loss of Time Benefits

Employee Only

If while eligible for benefits you become disabled due to a non-occupational accident or injury, you can receive weekly payments (less any applicable taxes) while you recover.

To be eligible for and receive these benefits, you must be under the continuous care of a physician, and complete and submit a Loss of Time Claim Form. Please note that:

  • Your employer must confirm your last day worked on the employer portion of the form. i. If you take vacation or personal time, you will not be paid Loss of Time benefits for those days.
  • Your physician, such as a doctor of medicine (M.D.), doctor of osteopathy (D.O.) or doctor of podiatric medicine (D.P.M.), must indicate the diagnosis, dates of disability, and the date they were first consulted for the disability. Please note that a disability certified by a D.P.M. for more than six (6) weeks is subject to review.

Loss of time benefits will be payable to you:

  • On the first day of a disability which is due to an accident; or
  • On the eighth day of a disability which is due to sickness.
IMPORTANT! No disabilities, including those resulting from accidents, will be considered as beginning more than three days prior to the date you first received treatment by a physician.

Maximum Benefit

The maximum number of weeks as well as the amount of your weekly benefit is listed in the Summary Plan Description (SPD) booklet for your specific Plan. The SPD booklet is included in your enrollment packet if you are a newly eligible participant. You can also view it on our Documents page.

If you are on a loss of time leave, return to work, and go on another leave for the same accident or sickness within two weeks, your leave will be considered as one continuous period for purposes of determining the maximum number of weeks. You cannot use paid time off, such as vacation time, to meet the two weeks requirement.

However, if you have a second period of disability unrelated to the prior accident or sickness, and if you have completed at least one day of active work between the two periods, then the second period will be a new period for purposes of determining the maximum number of weeks.

Benefit Payments

You don’t have to wait until you return to work to file for benefits. Once a fully completed Loss of Time Claim Form has been received, you will receive a check for a period of time to be determined by the Fund office, based on your disability and the information on the claim form.

The Fund will also send you a Continuation of Disability form closer to the date you are due to return to work. If you are still disabled, you should submit this form, completed by you, by your employer confirming that you have not returned to work, and by your physician confirming that you are still disabled. Additional benefits will then be determined, and you will receive another check and another Continuation of Disability form to file if you are still disabled. This process is repeated until you are able to return to work or have received the maximum benefits payable for the period of disability.

Benefit Exclusions and Limitations

Benefits are not payable for any disability covered by a Workers' Compensation Act or similar legislation, or for a disability due to injury arising from other employment for wages or profit.