FAQ

A pre-existing condition is any mental or physical condition, diagnosed or misdiagnosed, discovered or suspected at any time during the three-month period just before your employment with the district, enrollment for coverage or increase in coverage. This includes any condition for which you:

• Consulted a physician or other licensed medical professional
• Received medical treatment, services or advice
• Participated in diagnostic procedures, including self-administered procedures, or
• Took prescribed drugs or medications

If you are enrolled for a 14-day waiting period, you are not covered for a disability that exceeds 90 days that is caused or contributed to by a pre-existing condition unless, on the date you become disabled, you have been continuously insured by the disability plan for 12 months. This applies to increases in coverage, as well.

If you are enrolled for a 90-day waiting period, you are not covered for any disability that is caused or contributed to by a pre-existing condition unless, on the date you become disabled, you have been continuously insured by the disability plan for 12 months. This applies to increases in coverage, as well.

Pre-existing Condition means a Sickness or accidental injury for which You:

•  received medical treatment, consultation, care, or services;
•  took prescribed medication or had medications prescribed; or
•  had symptoms or conditions that would cause a reasonably prudent person to seek diagnosis, care or treatment;
• in the 3 months before your insurance under this certificate takes effect.  

The Hartford will not pay benefits for a Disability that results from a Pre-existing Condition if you have been Actively at Work for less than 12 consecutive months after the date Your Disability insurance takes effect under this certificate.

To file a disability claim, fill out The Hartford disability claim form online. For assistance during this process, call 281-396-2241.

You can monitor the status of your claim on the The Hartford website. 

Disability benefits begin when your disability exceeds the waiting period you elected, either 14 days or 90 days. Benefits are coordinated with other earned-income benefits such as workers compensation. Benefits are not paid for the first 90 days for a work-related injury.

The Hartford uses the following process to figure your payment:

1. Multiply your monthly earnings by 66-2/3%. Your monthly earnings are determined by your base salary in October of the year before or the date you become benefits eligible, if later. Base salary does not include overtime, car allowance or other supplemental pay.
2. Compare the answer from step 1 with the maximum monthly benefit ($5,000 for STD,  $9,000 for LTD). The lesser of these two amounts is your gross disability payment.
3. Subtract any deductible sources of income from your gross disability payment, such as such as workers’ compensation, Teacher Retirement System, Social Security (if applicable) and any other wage continuation benefits.

Payments for short-term disabilities (the first 90 days) are weekly, and payments for long-term disabilities (after the first 90 days) are monthly.

Your benefits last until your doctor releases you to return to work, not to exceed age 65. If you file a claim for long term disability after age 60, your maximum period of payment is as follows:

Age 60 – 60 months
Age 61 – 48 months
Age 62 – 42 months
Age 63 – 36 months
Age 64 – 30 months
Age 65 – 24 months
Age 66 – 21 months
Age 67 – 18 months
Age 68 – 15 months
Age 69 and over – 12 months

Your Disability benefit payments will end on the earliest of:

• The end of the Maximum Benefit Period;
• The date benefits end as specified in the section entitled LIMITED DISABILITY BENEFITS;
• The date You are no longer Disabled;
• The date You die;
• The date You cease or refuse to participate in a Rehabilitation Program that We require and that is approved by Your Physician;
• The date You fail to have a medical exam requested by Us as described in the Physical Exams subsection of the GENERAL PROVISIONS section;
• The date You fail to provide required Proof of continuing Disability.

The Hartford will not pay for any Disability caused or contributed to by:

• War, whether declared or undeclared, or act of war, or participation in an insurrection, rebellion, riot or terrorist act;
• Intentionally self-inflicted injury;
• Attempted suicide; or
• Commission of or attempt to commit or taking part in a felony.

If your occupation requires a license, the fact that you lose your license for any reason will not, in itself, constitute Disability.

For additional information, refer to the Katy ISD Disability Plan Benefits.