[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-303124-105":3,"detail-sidebar-cat-1-en-105":80,"doc-detail-303124-en":126},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":73,"head_meta":75,"extra_data":77,"updated_unix":79},105,"en","short-term-disability-benefits-application","Short-Term Disability Benefits Application","","Short-Term Disability Benefits application materials for Transit Employees' Health & Welfare Fund. The booklet explains eligibility for payment when an employee is off work or expected to be off for more than 30 days after exhausting sick leave, including retroactive and weekly check timing. It outlines the application process (up to 45 business days), monthly updated physician certificate requirement, email claim status updates, and mailing or direct deposit start timing. It also lists required forms and the certification authorizing deductions and repayment of overpayments.",{"@graph":14,"@context":72},[15,34,55],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/template/","Template",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/template/forms/","Forms",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/template/short-term-disability-benefits-application/303124/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/short-term-disability-benefits-application/303124.png","ImageObject",442,249,{"name":42,"@type":43},"Sage","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-09-30","2026-09-19",true,{"@type":52,"interactionType":53,"userInteractionCount":30},"InteractionCounter",{"@type":54},"ViewAction",{"@type":56,"mainEntity":57},"FAQPage",[58,64,68],{"name":59,"@type":60,"acceptedAnswer":61},"Who may be eligible for Short-Term Disability benefits?","Question",{"text":62,"@type":63},"You may be eligible if you are off (or expected to be off) for more than 30 days, exhausted your sick leave, and were enrolled in the Health & Welfare Plan on your last day worked and are still enrolled.","Answer",{"name":65,"@type":60,"acceptedAnswer":66},"How long does the Short-Term Disability application process take?",{"text":67,"@type":63},"The process can take up to 45 business days.",{"name":69,"@type":60,"acceptedAnswer":70},"What happens if you do not submit an updated Physician Certificate?",{"text":71,"@type":63},"You are required to send an updated Physician Certificate once a month (or when requested). Failure to do so within 5 days will result in suspension of STD payments until the certificate is received by Health and Welfare.","https://schema.org",{"og:url":32,"og:type":74,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":76,"canonical":32},"index,follow",{"doc_id":78,"site_id":7},303124,1790081733,{"code":4,"msg":81,"data":82},"success",[83,88,93,98,103,108,112,117,122],{"id":84,"doc_module":22,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},11,"Presentations",90,"presentations",{"id":89,"doc_module":22,"doc_module_name":25,"category_name":90,"show_sort_weight":91,"slug":92},12,"Resumes",80,"resumes",{"id":94,"doc_module":22,"doc_module_name":25,"category_name":95,"show_sort_weight":96,"slug":97},14,"Invoices",70,"invoices",{"id":99,"doc_module":22,"doc_module_name":25,"category_name":100,"show_sort_weight":101,"slug":102},15,"Posters",60,"posters",{"id":104,"doc_module":22,"doc_module_name":25,"category_name":105,"show_sort_weight":106,"slug":107},16,"Social Media",50,"social-media",{"id":109,"doc_module":22,"doc_module_name":25,"category_name":29,"show_sort_weight":110,"slug":111},17,40,"forms",{"id":113,"doc_module":22,"doc_module_name":25,"category_name":114,"show_sort_weight":115,"slug":116},18,"Letters",30,"letters",{"id":118,"doc_module":22,"doc_module_name":25,"category_name":119,"show_sort_weight":120,"slug":121},21,"Paper Templates",5,"papers-templates",{"id":123,"doc_module":22,"doc_module_name":25,"category_name":124,"show_sort_weight":4,"slug":125},158,"General","general-158",{"code":4,"msg":81,"data":127},{"doc_id":78,"user_id":128,"nickname":42,"user_avatar":129,"doc_module":22,"category_id":109,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":130,"file_id":131,"file_url":132,"file_type":133,"file_size":134,"view_count":33,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":89,"language":135,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":136,"faqs":137,"seo_title":138,"seo_description":12,"update_tm":139,"read_time":33},687197207057,"https://ap-avatar.wpscdn.com/davatar_29158cc5080c5b710cf443261637dec0","(MD)  \nTRANSIT EMPLOYEES' HEALTH ANO WELFARE PLA  \n2701 WHlT EY PLACE • SUITE 100 • FORESTVILLE, MARYLA O 20747  \nPHO 1 E: (301) 568-2294 • FAX: (301) 568-7302  \nWEBSITE: WWW.TEHW.ORG • EMAIL: I FO@TEHW.ORG  \nShort-Term Disability Benefits  \nDear Valued Member:  \nYou requested a Short-Term Disability (STD) application booklet because you are off or expected to be off from work for more than 30 days and you have exhausted your sick leave. You May be eligible for payment of STD benefits if you were enrolled in the Health & Welfare Plan on your last day worked and are still enrolled. Once your application is reviewed, approved, and processed you may be eligible for benefits. Your first check will be retroactive to your initial date of eligibility. Subsequently, checks will be issued weekly for $170 dollars per week for a normal disability or $270 dollars per week for maternity leave. We will take deductions for Federal and State taxes and partial Health and Welfare premiums for coverage. STD checks are mailed weekly to the address provided on your application unless you choose the direct deposit option, which will begin on the second payment.  \nThe Short-Term Disability application process can take up to 45 business days. You will receive email notifications from ([disability@tehw.org](disability@tehw.org)) bi weekly to give you an update on  \nyour claim status.  \nYou are required to send an updated Physician Certificate once a month or when requested. Failure to do so within 5 days, will result in suspension of STD payments until the Certificate is received by Health and Welfare.  \nBy signing and checking the boxes of the application, you agree that the Transit Employees' Health and Welfare Fund has the right to collect any over-payments made for  \nany reason.  \nIf you have any questions regarding your application for short-term disability benefits, please contact the Health & Welfare office, Monday [through Friday from 9:00 A.M. to 1:30 P.M](through Friday from 9:00 A.M. to 1:30 P.M).  \nYour Application Includes:  \n1. Application for STD Benefits: to be completed and signed by the applicant.  \n2. Physician Disability Certificate: to be completed and signed by your attending physician.  \n3. Federal and State Tax withholding forms: to be completed and signed by the applicant.  \n4. Direct Deposit form (attach VOIDcheck): to be completed and signed by the applicant.  \n5. Short-Term Disability Checklist: to be checked off and signed and dated by an H&W staff.  \nAPPLICATION OF CONTENTS  \n02  \n03  \n04  \n05  \n06  \n07  \n08  \n09  \nApplication of Contents  \nApplication for ShortTerm Disability Part l  \nApplication for ShortTerm Disability Part 2  \nPhysician Disability Certificate  \nFederal Withholding  \nForm  \nState Withholding form  \nDirect Deposit Form  \nCompleted  \nApplication Checklist  \nAPPLICATION PROCESS  \n| How do I qualify for Short-Term Disability? | 2) You are out of work due to an illness or injury that isn't related to Workers Compensation. |\n| --- | --- |\n\n____S t_l: __Yo_____havea-l_____readyt-e__________d all paid sickl_e__ve_ -􀁋  \nStep 2:  \nWhere can I receive a Short-Term Disability application?  \n1) You can receive at Short-Term Disability application by calling Health and Welfare at (301) 563-2294 and asking for an application or [byemailing disability@tehw.org ](byemailing disability@tehw.org )to receive an application.  \now do I apply for Short-Term disability?  \nit to [disability@tehw.org](disability@tehw.org), fax to (301)560-7302 or bring the application to theH& W office.  \n􀀆\\􀀼 1) Once you complete the application, you can-----,email  \nStep 4: l)Once your application is submitted Health and Welfare What's Next? will work with WMATA to get perinate information.  \n2) It can take up to 45 business days to get approved for Short-Term Disability.  \n(»\\  \n􀀁  \nStep 5:  \nWhen will I start receiving payments?  \n1) Once your Short-Term Application is approved, members will start to receive payments.  \nApplication for Short","cbCaivESnIpSRqlf","https://ap.wps.com/l/cbCaivESnIpSRqlf","pdf",1248775,"English","# Short-Term Disability Benefits\n## Eligibility and payment timing\n## Application process and required documentation\n## Application contents\n## Application form fields and certifications","[{\"question\":\"Who may be eligible for Short-Term Disability benefits?\",\"answer\":\"You may be eligible if you are off (or expected to be off) for more than 30 days, exhausted your sick leave, and were enrolled in the Health \\u0026 Welfare Plan on your last day worked and are still enrolled.\"},{\"question\":\"How long does the Short-Term Disability application process take?\",\"answer\":\"The process can take up to 45 business days.\"},{\"question\":\"What happens if you do not submit an updated Physician Certificate?\",\"answer\":\"You are required to send an updated Physician Certificate once a month (or when requested). Failure to do so within 5 days will result in suspension of STD payments until the certificate is received by Health and Welfare.\"}]","Short-Term Disability Benefits Application | PDF",1789800016]