Policyholder (Employer)

If you're an employer helping to file a claim on behalf of an employee in your organization, click the link below to get started

Employee


If you're filing a claim for disability coverage you receive through your employer, we're here to help you get started

Contact information

Toll-Free: 855-517-6365

Fax: (844) 287-9499


 

 

 
 

Please note: E-mail messages sent to one of these oneamerica.com e-mail addresses are not secure. Please send secure information to us at secure-oneamerica.com

The OneAmerica Financial℠ Disability Claimant Resource Guide

A guide to knowing the process and information “ins and outs ”of the disability claims process.

Frequently asked questions about disability claims

How do I file a claim?

Your disability claim can be submitted online, via phone, email, fax, or mail using the contact information provided.

Call Center representatives are available to assist with any claim questions during the hours of 8 a.m.-6 p.m. ET, Monday through Friday. Messages can be left after hours for a call back the next business day.

Your claim may be submitted by:

  • You
  • Your Employer
  • A third-party representative (e.g., spouse, another adult family member, attorney, or friend): To authorize a third-party, you must complete, sign, and return a Third Party Representative Authorization form. We will not be able to speak to your representative until we have receive your signed authorization.

You should file your disability claim approximately 30 days prior to your date of disability or as soon as possible. You may submit the claim during your policies’ defined elimination period.

If you submit your claim via DocuSign, paper, email or fax, the following disability claim forms must be completed and submitted:

  • Employee Statement
  • HIPAA Authorization
  • Attending Physician’s Statement (Not required for non-complicated maternity claims)
  • Policyholder Statement

If additional information is needed, a claim representative will notify you.

How long is the process?

No, however additional information will be required.

Your claim examiner will communicate with you via the telephone and in writing throughout the claim review process to keep you informed.

Short-term disability claim decisions are generally made within five (5) days from the receipt of all the necessary claim requirements and documentation. 

A long-term disability claim decision will generally be made within 45 days from the receipt of all necessary claim requirements and documents.

Your claim examiner will notify you via a telephone call and mail or email. 

If your claim is approved, your benefits will begin after the elimination period end date as defined by your policy. 

Additional questions answered

An elimination period is a period of time beginning on the first date of disability that must be satisfied before benefits are payable. The elimination period is stated in the “Schedule of Benefits” section of your policy. 

Your policy is designed to replace a portion of your regular pay. Please review your policy for details and terms of the specific coverage for which you may be eligible.

The definition of disability is defined in your policy. Information will be requested from you, your employer, and your physician(s) to determine your abilities, restrictions and limitations. This information will aide in determining if you are disabled, as defined by your policy.

Approved short-term disability benefits are paid on a weekly basis, for the prior week. As a service to you, benefits for routine maternities and some surgeries are paid via a lump sum benefit payment.

Approved long-term disability benefits are paid on a monthly basis, for the prior month, after the elimination period has been satisfied, subject to policy provisions and limitations.

The following two payment options are available:

  • Check; and 
  • Electronic Funds Transfer (EFT) to a bank account designated by you.

Disability benefits may have taxes withheld if your employer contributed premiums on a pre-tax basis. 

Other benefits and other income you're eligible to receive could reduce your benefit amount. Please review your policy for a list of other income and benefits that may reduce your disability payment.

Most short-term disability policies do not insure and cover work-related injuries. You should review your policy’s limitations and exclusions sections to determine if work-related injuries are covered.

 

Most long-term disability policies cover work-related injuries, but reduce the monthly benefits by Workers’ Compensation benefits received. A lump sum Workers’ Compensation benefit is prorated to determine long-term disability benefit reductions. Please review your policy’s limitations and exclusions sections to determine if work-related injuries are covered.

Up to six (6) weeks of post-partum disability is allowed for routine pregnancies and up to eight (8) weeks of post-partum disability may be allowed for C-section deliveries. Please note that the elimination period still applies and therefore, the six (6) and eight (8) week disability periods are reduced by the elimination period when determining the time period for which benefits are payable. Your disability period may be less or greater depending on your policy and your individual medical and vocational factors.

If employment ends during a period of disability for which benefits are approved, benefits may continue in accordance with your policy’s “Extended Benefits” provision.

Your employer is required to submit your earnings statements on a weekly basis for a short-term disability claim and a monthly basis for a long-term disability claim. Your employer will also be required to submit the number of hours you work each week and your rate of pay. The partial disability benefit will be calculated upon receipt of this information.

You should notify the claims department immediately regarding your return to work in order to prevent an overpayment of benefits.

You will not need to re-satisfy the elimination period if you return to work and the same disability recurs within the recurrent period outlined in your policy. In this situation, your claim is a continuation of your previous claim and benefits may be payable. 

 

A new disability claim elimination period would be required when:

  • You recover from your disability, return to work, and a new disability occurs; or
  • The same disability recurs outside the recurrent disability period outlined in your policy.

OneAmerica Financial is the marketing name for the companies of OneAmerica Financial. Products issued and underwritten by American United Life Insurance Company® (AUL), Indianapolis, IN, a OneAmerica Financial company.