Employees who become mentally or physically incapable of performing the duties of their position due to an illness or injury which lasts more than fourteen (14) consecutive calendar days are eligible for disability benefits. Eligible employees include any part-time permanent (exempt and non-exempt), established-term regular, or established-term irregular employees who have worked 1500 hours or more within a twelve (12) month period or a full-time permanent employee who has completed one (1) year of continuous state service. Compensation for disability leave benefits shall be payable at 70% of the employees base rate of pay as of the date the employee becomes disabled for the first six (6) months and 50% for the remaining eighteen (18) months. Prior to the end of the first six (6) months of receiving disability, the employee shall submit application to Public Employees Retirement System (PERS) for disability retirement.

Disability leave benefits shall remain payable until it is determined that the employee is no longer disabled, until the effective date of retirement from a state employees retirement system, or as follows:

1. Employees with less than eight (8) years shall be eligible to receive disability leave benefits for a maximum of twenty-four (24) months.
2. Employees with eight (8) years of service but less than sixteen (16) years of service shall be eligible to receive disability leave benefits for up to twenty-four (24) months per disability not to exceed a total of thirty-six (36) months.
3. Employees with sixteen (16) or more years of service shall be eligible to receive disability leave benefits for up to twenty-four (24) months per disability not to exceed a total of forty-eight (48) months.

The lifetime maximum limitations regarding disability leave benefits were effective as of July 1, 1998. Disability leave benefits that were granted prior to the effective date shall be counted toward the lifetime maximum limitation.

The Application for Disability Leave Benefits, Employee Statement Form (ADM 4310, Pages 1 and 2) is to be submitted by the employee, representative or member of the employees family to the employees division/office personnel representative. The request must be submitted within twenty (20) days following the last day the employee worked. The Physicians Statement Form (ADM 4310, Pages 3 and 4) must accompany the application, indicating the nature and reason of your disability. This must be completed in its entirety. Based on the type of disability the Office of Human Resources will determine whether the application may be approved by the Agency or the Department of Administrative Services (DAS). If the claim can be approved by the Agency, the OHR Case Manager will issue the approval letter to the employee for the standard recovery period as outlined by DAS. If the claim must be sent to DAS for determination, the OHR Case Manager will complete the Application for Disability Leave Benefits, Employer Statement and forward all completed forms to the DAS, Disability Unit.

Disability leave benefits will commence on the first day following the fourteen day waiting period. Disability leave benefits will remain in effect until the employee is no longer disabled or a maximum of two (2) years or until the employee is otherwise disqualified. An employee returning to work following a disability leave may be required to obtain a physicians written determination stating that the employee is permitted to return to work.

In cases where an employee is going to remain off work for a period of time which exceeds the physicians original estimated return to work date, a Supplemental Report: Disability Leave Benefits (ADM 4311) must be submitted indicating when the employee may return to work and why the disability is longer than initially expected.

Following the payment of disability leave benefits to an employee, successive periods of disability separated by less than six months of full-time work will be considered one period of disability unless the subsequent disability is due to a disabling injury, illness or condition entirely unrelated to the cause or causes of the previous disability and is separated by a return to active work status for at least one (1) full day.

Disability leave benefits are payable bi-weekly, based on a pay period of fourteen (14) days. Disability leave benefits for any partial pay period remaining at the expiration of any period of disability accrue on an hourly basis, at a rate of eight (8) hours for each work day, and are payable at the expiration of the period of disability.

Employees receiving disability leave benefits shall continue to accrue service credit for purposes of determination of vacation leave accrual and longevity. However, vacation leave benefits shall not accrue while an employee is receiving disability leave benefits. Sick leave and personal leave benefits shall not accrue while an employee is receiving disability leave benefits. However, at the time an employee returns to a pay status, the sick leave the employee should have earned during the time they were on disability leave will be credited.

Employees desiring to supplement their disability leave benefits with sick leave credit, personal leave credit and vacation time, shall in writing, notify the Director at the time the claim is filed or after the employee begins to receive disability leave benefits. Any request for supplementation filed after the date an employee began to receive disability leave benefits shall be given an effective date as of the date the request was filed.

The total amount received by an employee while receiving disability leave benefits supplemented by sick leave credit, personal leave credit and vacation leave balances shall be an amount sufficient to give the employee up to 100% of pay. The total amount received shall not exceed the gross pay an employee would have received in an eighty (80) hour pay period. The computation of gross pay shall include the employees share of retirement benefits paid to PERS after receiving three (3) months of disability benefits.

Payments of the employees share of insurance premiums during the periods in which the employee is receiving disability leave benefits shall be paid by the employer.

Disability leave benefits are not payable for any disability caused by or resulting from:

1. Any injury, illness or condition incurred or existing before the date an employee commences service for which the employee has consulted a physician or received medical treatment.
2. Attempted suicide or self-inflicted injury.
3. Any act of war, declared or undeclared, whether or not the employee is in the armed services.
4. Participating in a riot or insurrection
   5. Drug addiction or alcoholism, except for the period of time the employee is in a certified residential treatment facility cooperating with treatment as determined by an Ohio Department of Alcohol and Drug Addiction Services (ODADAS) and/or Joint Commission for Accreditation of Healthcare Organization (JCAHO).
   6. Any injury incurred in the act of committing a felony.

Any employee receiving disability leave benefits will be subject to disqualification if the employee:

1. Is removed from state service or certified against.
2. Is not in active pay status and is receiving retirement or disability from a state employee retirement system.
3. Engages in any occupation for wage or profit except while in a rehabilitation program.
4. Engages in any act of fraud or misrepresentation involving his disability claim.
5. Does not consult a state licensed practitioner for necessary medical care.
6. Does not notify his appointing authority of a change of address.
7. Is convicted of the commission of a felony.

Per Article 34.05 of the OCSEA contract and 123:1-33-12(D) of the Ohio Administrative Code, Agencies and the Unions may mutually develop transitional work programs designed to encourage a return to work by an employee receiving disability leave benefits. During the time an employee is in a transitional work program (maximum 90 days), the employee will be assigned duties which the employee is capable of performing based upon the recommendation of the employees attending physician. Participation in the program shall be based upon the recommendation of the employees attending physician. Please refer to the Ohio Department of Natural Resources Transitional Work Policy.

If a request for disability leave benefits or the payment of a claim is denied, the employee shall be notified of the denial by the Director of Administrative Services. The employee may appeal, in writing, the denial of a claim to the Director within thirty (30) days of notice of denial/disqualification.

If the denial was based on the recommendation of a Department of Administrative Services (DAS) physician after a review of the medical documentation, then the Director or designee will obtain a medical opinion from an independent third party physician. The physician will be mutually agreed to, and selected within fifteen (15) days of the appeal, unless an extension is agreed to by both parties.

The third party physician must examine the employee and render a medical opinion within thirty (30) days of the selection. This decision will be binding.

Where a medical question is not at issue, the Director will render a final decision on the appeal within thirty (30) days.

Employees becoming disabled on or after July 1, 2000 will not be advanced disability benefits on work-related injuries unless the employee has received a denial order from the Bureau of Worker' Compensation (BWC). within 20 days of the BWC order denying benefits, the employee may submit a copy of the denial notification with an application for disability leave benefits.

The employee must also indicate whether he/she is appealing the BWC denial. If the employee is appealing the BWC decision, disability leave benefits may be paid as an advancement of the workers' compensation claim. If the employee is not appealing, the claim will be processed as a straight disability claim.

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