SHORT-TERM DISABILITY program extension

CLAIMS PROCESS

Information relating to Reliance Standard may change as we start working through short-term disability claims and streamline processes. Check back frequently.

There are three parts to filing a claim:

(1) employer portion

(2) employee portion

(3) physician portion

Step 1: Employer Portion

Start the process 30 days prior to exhausting the voluntary medical leave program. You may complete the employer portion online or prepare a printed/emailed packet.

Tips when completing the employer portion online:

• You cannot upload the job description. Send job description via email to ClaimsIntake@rsli.com.  Include employer name (Central Washington Public Utilities), policy number (ASW517214) and employee name in the subject line.

• If the employee chooses to file their claim via email, fax, or mail, they will need you to complete the employer portion of their short-term disability application.

• Once you complete your employer portion online, an email will be sent to your employee for information needed and next steps.

Step 2: Employee Portion

Employees are encouraged to complete the employee portion as soon as possible. Employees can submit their application and authorization online, via mail, email, or fax. They can also call claims intake at 855-RSL-CLAIM (855-775-2524). Note that the employee will be connected with Matrix for claims intake. Employees will be asked for their employer’s name, which is Central Washington Public Utilities (PUDs are not listed under the individual PUD name), policy number, and other personal and claims related questions, including preferred contact method. Please encourage your employees to use email for preferred communication for speeder and more effective communication. For future claims questions, the employee should call Customer Care at 800-351-7500. Take a look at  “How to file a Short Term Disability Claim”  for employee instructions on how to complete and submit their claim.

Tips when employees complete the form online:

• Employees can upload information when initially submitting the claim using the attach function. This includes medical information they may be able to access/download through their patient portal.

• Once the form is submitted, the employee cannot later access to review or update the form or attach files.

Step 3: Physician’s Statement

Employees are encouraged to provide their medical provider with the Attending Physician’s Statement as soon as possible. Either the provider or employee can send the Physician’s Statement directly to Reliance Standard via email ClaimsIntake@rsli.com or fax 267-256-4262.  In addition, employees may also download medical information through their patient portal and submit to Reliance directly.

Claim Review & Notification

Once Reliance Standard receives all three portions of the claim, a claims examiner will review the information within 2-3 business days and will reach out to the employee or employer if there is any outstanding information needed.

• If additional medical information is needed, the claims examiner will reach out to the claimant (employee) on day 15 using the individual’s preferred method of communication. If no response is received following the first outreach, Reliance will follow up on day 25 and then day 45.

• Once medical information is received, claims examiner approves or denies the claim within 3 business days.

• Communication is sent to employee and employer indicating claim determination of approval or denial. If claim is denied, employee has 40 days to appeal the decision and provide additional information. 

  NOTE: The approval/denial letter sent to the employer includes reasons for the approval/denial, including medical diagnosis. I have requested that medical diagnosis be omitted in the letter.

Transitioning to Long-Term Disability

30-45 days prior to reaching the maximum benefit duration, the claims examiner will review the claim and determine if recovery is progressing positively. If not, claim information will be forwarded to the LTD transition team, which will start the process of transitioning to long-term disability. The LTD transition team will work closely with the claims examiner to obtain medical information and will reach out to the employee/employer if additional information is required. If appropriate, the LTD transition team will create LTD claim file, starting the LTD claims process.