Summary Plan Description
Time Loss Benefits Are Not Provided Under Retiree Coverage
If you are disabled because of a nonoccupational illness or injury covered under this plan, you may be eligible for time loss benefits:
- Your disability must be continuous, and you must be incapable of performing any and every duty pertinent to your occupation as a carpenter.
- You cannot be engaged in any other occupation for wage or profit.
- Your attending physician must certify your disability and you must remain under his or her care for the duration of the disability. Periodic proof of the disability may be required. For the purpose of this benefit, a physician means a physician practicing within the scope of his or her license as a Doctor of Medicine (MD), Doctor of Osteopathy (DO), Doctor of Podiatry (DPM), or Doctor of Dentistry (DDS or DMD). No other provider will be recognized.
- Your disability must begin while you are eligible under this plan. Time loss benefits are not available for any disability that begins while you are participating in Self-Contribution Coverage or COBRA Coverage.
If your time loss claim is approved, the weekly time loss benefit is based on the benefit package you work under:
- For the Western and Central Washington benefit package time loss equals 33 percent of journeyman pay based on a 40-hour work week at the prevailing journeyman's rate specified in the Area Master Agreement signed by your most recent contributing employer.
- For the Eastern Washington, Idaho, Montana, and Wyoming benefit package time loss is $100.
Time loss benefits begin on the first day you begin care with the attending physician who certifies your disability when your disability is due to an injury, provided the disability commenced within 30 days of the date of the injury. Or, benefits begin on the eighth day of disability when you do not satisfy the 30-day requirement or your disability is due to an illness. Weekly benefits continue for a maximum of 26 weeks for any one period of disability.
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