Help with disability insurance claims
How to handle claims and ease employees’ return to work
To start a short-term or long-term disability claim for an employee, complete and submit the claim online.
Or, complete and submit the appropriate forms:
- Disability claim form instructions, employer and employee statements (PDF)
- Pregnancy disability claim form, employer and employee statements (PDF)
- Understanding your pregnancy leave (PDF)
- Attending physician's statement (PDF)
Submit forms by:
- Mail: Principal Life Insurance Company
Attn: Group Life & Disability Claims Department
711 High St.
Des Moines, IA 50392-0002
- Email: SBDClaims@principal.com
- Fax: 800-255-6609
- Phone submission available on employer request for cases with 300 lives or more.
If you purchased individual disability insurance through a financial professional, that process is handled differently. Get the individual disability insurance instructions (PDF).
Log in to your account and go to the “reports” section. If the claim isn’t listed, it means we haven’t received it yet. You can find out claim status, the analyst name and contact information. If a short-term disability (STD) claim is approved, the payment information is shown on the STD payment report.
As the employer, you should:
- Provide the employee (or family member) the paper claim form, online form link, or your telephonic claim submission number, if applicable. The employee needs to complete the employee statement on the claim form.
- Complete the employer statement on the paper claim form. If the employee completes the online claim form or the telephonic claim form, we’ll contact the employer for additional information.
- Emphasize the importance to your employee of providing the claim form to his/her physician as soon as possible. Medical information is needed to evaluate the claim.
- Keep communication lines open with employees while they’re out. This helps them feel that they will be welcomed back after recovery.
- Be open to temporary or flexible work arrangements while employees are recovering. A gradual (or part-time) return to work allows employees to return to their job more quickly while easing back into their normal duties. Our work incentive benefit helps this work for everyone.
- Show concern and compassion while respecting the employee’s privacy. Avoid asking about specific private health matters. Feel free to ask when they’re coming back to work and if there are any schedule accommodations or special equipment needed for their return.
- Discuss appropriate actions with our claim examiner.
The short answer—as soon as possible, however, no more than 30 days prior to the date of disability. When the employee is aware they’ll be off work longer than the time before benefits kick in, known as the elimination period, they should begin the filing process.
For employees who have LTD coverage only, we recommend the LTD claim be filed no later than halfway through the LTD elimination period.
Filing a claim early has its advantages. Early notification helps us:
- Be proactive in getting additional information that may be needed to make the initial claim decision.
- Make timely decisions.
There are 4 sections on the claim form. All 4 sections must be completed:
- HIPAA Authorization
- Employer section
- Employee section
- Physician section
No, a separate claim form isn’t required. Our integrated claim process includes: single notification of claim, 1 claim form, transition from STD to LTD upon receipt of forms returned from the claimant, early intervention, and case management.
If the group has life coverage with us, we will also automatically review for waiver of life insurance premium benefit.
Yes, occasionally we’ll request more information—usually additional medical documentation we’re missing. If the employee completes the online claim form or the telephonic claim form, we’ll contact you for additional information.
- If your company benefits are based on W-2 earnings for the prior 1 or 2 years, you’ll need to provide copies of W-2s from those years. For those employed less than 1 or 2 calendar years, we’ll need earnings from date of hire through the last day worked.
- If you are a business owner, please specify this on the form. We’ll be in contact to get more information in these cases.
- Contributory coverage and self-accounting groups, we request a copy of the enrollment form. This helps us verify that an employee enrolled for coverage on a timely basis. It also shows us what coverages are elected.
No. To be eligible for benefits, an employee must meet all qualifications as defined by the policy. Medical information submitted must support the definition of disability and isn’t based simply on a physician’s opinion. Each claim is reviewed to determine if it meets the contractual requirements for benefit payment.
- Short-term disability—Our goal is to make the STD claim decision 10 days after we receive the claim, but it’s usually sooner. If we need more information after the claim is submitted, that can affect the timing for the decision. Quick feedback helps keep the claim process moving.
- Long-term disability—LTD decisions are made 45 days from the receipt of the claim or by the completion of the elimination period, whichever is later.
We issue benefits on a weekly basis. For routine maternities and some routine surgeries, we offer a lump-sum payout for the approved duration period.
We offer 2 monthly payment options:
- Check—We’ll mail a check to the employee’s address. LTD payments are made on the 10th of the month.
- Electronic Funds Transfer (EFT)—Employees can elect to transfer their LTD benefit funds to a bank account they designate.
It depends on whether the “salary continuance offset” is included in the “other income source” definition of the policy or not.
- Policy includes salary continuance offset—The disability benefit is directly reduced by any salary continuance paid. This doesn’t allow the employer to supplement income with salary continuance.
- Policy doesn’t include salary continuance offset—The employer can supplement the claimant’s income. However, the weekly payment limit will prevent the claimant from receiving more than 100% of pre-disability earnings.
- Insured businesses–We don’t withhold state or federal taxes. However, these can be withheld at the claimant’s request. FICA tax is withheld for 6 months from the date last worked.
- ASO business-applicable states–Federal, state and FICA tax are automatically withheld.
Premiums are not waived, so premium should be continued while a person is receiving STD unless employment is terminated or LTD is approved.
Premiums are waived when the LTD claim is approved, based on the date LTD benefits begin.
Log in to your account and go to the “tax services” section. This will show you which tax services were elected and what your responsibilities are. If you need additional assistance, contact our accounting department at 866-309-1625, ext. 84742.
When you hear "accommodations," you may think of permanent job changes, but that’s not necessarily the case. An accommodation can mean several things and isn’t always permanent. Restrictions that need accommodations can include limited sitting/standing, limited walking or no repetitive hand use.
- Reduced work schedule–Allows the employee to return to work part-time, gradually increasing to full-time over a specific time period.
- Flexible work schedules–Allows the employee to come in earlier or later, or to take longer breaks. This can give an employee time for medical or therapy appointments, or simply a resting period.
- Equipment/worksite modifications–May include items such as scooters, walkers or wheelchairs to assist with walking. Or, desks, chairs, keyboards or foot stools to help with sitting restrictions. In addition, adaptive computer software phone headsets, or an increase in email or texting processes, may help with a variety of restrictions.
- Remote work site–Allows an employee to work from home or an office closer to home, reducing lengthy commutes that may cause stress on an employee’s recovery.
- Job duty changes–Adapts specific tasks, such as separating heavier items to be lifted into smaller, more manageable weights. Or, perhaps job duties that the returning employee can’t handle could be temporarily assigned to another employee.
This full-service program encourages employees to get back on their feet and back to work by focusing on appropriate treatment and rehabilitation.
We review each case early to identify options and assist in developing return-to-work programs. Some resources used to promote high-quality, cost-effective results:
- Job analysis and modification–We get a clear understanding of the job and evaluate possible modifications so the employee can return to work.
- Skills assessment–Our vocational resources evaluate the activities employees are able to proficiently perform. This helps us determine if it’s possible to transfer the employee to another job or occupation. We also identify barriers the employee may need to overcome and help them find resources in their area.
- Job placement/outplacement services–If the employee isn't able to return to work in the same capacity, we provide a career transition coach to assist them in returning to work. Services provided to help them return to the workforce include: resume writing, interview skills, application assistance and more.
A claim is potentially payable if it incurs after the effective date of coverage. However, if the employee has had coverage for 6 months or less at the time of disability or death, we may need to request additional documentation showing the employee was actively working at the time they were eligible for coverage.
Additional documentation could include, but is not limited to:
- Purchase orders
- Driving logs
- Signed and dated work documents
- Other documents may vary dependent on an employee’s job/occupation
No, if someone is donating an organ to a transplant patient, this condition is not considered an elective procedure.
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This information is provided with the understanding that Principal® is not rendering legal, accounting or tax advice. Consult with appropriate counsel or other advisors on all matters pertaining to legal, tax, or accounting obligations and requirements.
Insurance issued by Principal Life Insurance Company, Des Moines, IA 50392.