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:

Submit forms by:

  • Mail: Principal Life Insurance Company
    Attn: Group Life & Disability Claims Department
    711 High Street
    Des Moines, IA 50392-0002
  • Email: DLSBDCLAIMS@exchange.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 an advisor, that process is handled differently. Get the individual disability insurance instructions (PDF).

Hopefully, you and your employees don’t deal with disability claims very often. But when you do, you need the claim-filing process to be clear and easy.

These six videos walk you and your employees through what you need to know for each claim situation.

For you

For your employees

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.

Short-term disability

Encourage the employee to file the claim as soon as you’re aware that he/she will be off work beyond the elimination period.

Long-term disability

Encourage the employee to file the claim 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 to the claim form. All 4 sections must be completed:

  1. HIPAA Authorization
  2. Employer section
  3. Employee section
  4. 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.

If the claim form is completed in its entirety, we can better evaluate the claim and may be less likely to need additional information.

If the employee completes the online claim form or the telephonic claim form, we’ll contact the employer for additional information. 

  • Employee’s benefits based on W-2 earnings–If an employee has been employed for more than one calendar year, we ask the employer to provide a copy of the prior year’s W-2. For those employed less than one calendar year, we’ll need earnings for all completed months.
     
  • Business owner–Please specify this on the form. We’ll contact you about additional information needed.
     
  • Contributory coverage and self-accounting groups–We’ll request a copy of the employee’s enrollment form. It assists us in verifying that an employee enrolled in coverage on a timely basis. It also shows us what coverage the employee elected.

No, filing a claim is no guarantee of benefits. To receive benefits, the employee must meet the definition of disability, as defined by the policy. Medical information submitted must support the definition of disability and cannot be based simply on a physician’s opinion. Each claim is reviewed to determine if it meets the contractual requirements for benefit payment.

  • STD claims timing goal–10 business days from the receipt of the claim. If additional information is needed to make a decision, we’ll pend the claim until we receive all documentation.
     
  • LTD claims timing goal–45 business days from the receipt of the claim or by the completion of the elimination period, whichever is later. The claimant receives an acknowledgement letter within 5 business days of receipt of the LTD claim. Then, the claimant receives a follow-up phone interview to gather additional information.

Short-term disability

Claimants receive weekly benefit checks, issued at the end of the period. For routine maternity leave and some routine surgeries, we offer a lump-sum payout for the approved duration period.

Long-term disability

Claimants receive monthly payments. They may choose to receive payment by check or by electronic funds transfer (EFT). 

It depends on whether the “salary continuance offset” is included in the “other income source” section 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.

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.

Want more information about ADA and accommodations? Check out the Job Accommodation Network.

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:

  • Emails
  • Purchase orders
  • Driving logs
  • Signed and dated work documents
  • Other documents may vary dependent on an employee’s job/occupation
Are you an employee?
Don't see the topic you need help with? 

Give us a call.

  • Businesses with retirement plans call 877-475-3436
  • Businesses with group insurance products call 800-843-1371

Or send us an email