Short-Term Disability

If a participant becomes disabled, as defined by the Disability Program, the participant must take the following steps to apply for benefits:

• Notify supervisor of the need for time off.
• If the participant is enrolled in the DSL, VSDI or Leidos CA VDP plan, he or she should call Sedgwick, Leidos' disability claims administrator, at 1-877-399-6443. Participants can contact Sedgwick to file a claim 7 days a week/24 hours a day. Participants may also file a claim via www.mysedgwick.com.  Sedgwick will need the following information:
  • The participant's personal information (including name, address, phone number, and employee number);
  • The participant's health care provider's name, mailing address, phone number and fax number; and
  • The participant's anticipated length of time away from work due to the qualified disability.
• Under DSL and VSDI:
  • Supporting medical documentation from the physician must be provided to Sedgwick within thirty (30) days of the date on the initial packet letter or thirty (30) days from the first date of absence, if a claim is future dated.  Medical documentation for disability extensions must be submitted within twenty (20) days of the date the employee requests the extension or the claim may be denied.
  • Sedgwick will make a decision on the disability claim within two (2) business days of receiving medical documentation. 
• Under the CA VDP:
  • Supporting medical documentation from the physician must be provided to Sedgwick within sixty (60) days of the first day of disability.
  • Sedgwick will make a decision on the disability claim within two (2) business days of receiving medical documentation. 
• If the participant lives in Colorado, Connecticut, District of Columbia, Hawaii, Massachusetts, New Jersey, New York, Oregon, Puerto Rico, Rhode Island, or Washington, or if the participant lives in California and is not eligible to enroll in the Leidos-CA VDP plan, he or she will also need to file for state disability or medical leave benefits. See the Other State-Mandated Short-Term Disability Plans section for more information.

The payment of a disability claim is not automatic - the participant must take the appropriate steps or disability benefits may be delayed or denied. Under most circumstances, if the participant is not able to contact the claims administrator(s), a family member or other designee can initiate the appropriate steps on the participant's behalf. The claims administrator will begin evaluating the participant's condition after receiving notification of the disability.

After certification of a qualified disability, the participant receives STD benefits based on the length of disability, elected coverage (VSDI), DSL balance and any state benefits.

Under DSL and VSDI, a participant will receive disability benefits based on the following schedule:*

• Week 1: 7 calendar day waiting period unless hospitalized as defined;
• Weeks 2 - 10: Up to 100% of weekly wages to a maximum plan benefit;
• Weeks 11 - 19: Up to 80% of weekly wages to a maximum plan benefit;
• Weeks 20 - 26*: Up to 66 2/3% of weekly wages to a maximum plan benefit.

*If hospitalized as defined, the participant will receive:

• Weeks 1 - 9: Up to 100% of weekly wages to a maximum plan benefit
• Weeks 10 - 18: Up to 80% of weekly wages to a maximum plan benefit
• Weeks 19 - 26: Up to 66 2/3 of weekly wages to a maximum plan benefit

If the participant is receiving benefits from the DSL, VSDI and/or Leidos CA VDP plan plans:

• Disability benefits will be paid through the Leidos payroll system;
• The benefit amount will be reduced proportionately if a benefit is payable for less than a full week;
• Benefits are paid through the participant's paychecks, through direct deposit, if applicable, as long as the check is processed as part of the regular payroll cycle;
• DSL and VSDI payments are taxable income. The Leidos CA VDP benefit payments are not taxable. 
• Payroll deductions will continue to be made for elected benefits such as medical, dental, vision, VSDI, GUL Insurance, and the Voluntary AD&D Plan.
• Participants on part-time disability will have a one pay period delay in receiving their benefit payment.

If the participant is receiving benefits from a state-mandated STD plan:

• Benefit payment schedules and taxability vary by state plan;
• The state plan determines eligibility for benefits;
• The employee will receive a separate check directly from the state plan;
• Contact the state agency for specific information.

Each STD claims administrator determines eligibility for the plan it administers and makes a determination of benefits eligibility.

Each STD plan may require, at the Plan's expense, an independent medical evaluation. The participant may be required to go to a doctor of the plan's choice to be examined or to have medical records sent to a third party for review.

In each plan, there is a formal appeal process if the participant disagrees with the determination of the claims administrator.

• For the DSL and VSDI plans, refer to "Claims Appeal and Review Procedures Under ERISA" in the Plan Information section for more information on relevant procedures.
• For all other plans, contact the claims administrator for information on the appeal process.

Pregnancy is treated as a disability. Participants who are considered to be disabled due to pregnancy must follow the same process that applies to all other disabilities. However, the 7-day waiting period for non-hospitalization will not apply to participants who give birth at home or at birthing centers. 

A participant on a rotational work schedule (e.g. 90 days on/90 days off) who has a qualifying disability, will be paid disability benefits even if the disability falls on a period the participant is scheduled to be off.

Illnesses or disabilities that involve home confinement and that have been certified by a physician or other health care provider qualify employees for disability benefits as of the 8th calendar day, based on approval from the claims administrator.

A disabled participant admitted to hospice care will not be required to complete the 7-day waiting period.  

The Plan reserves the right to waive the 7-day waiting period in the event of a pandemic or public health emergencies (declared or undeclared), as determined in the reasonable discretion of the Plan.

A participant will receive disability pay if on approved disability on a day bereavement, jury duty, voting time or holiday occurs.  The participant will not receive separate paid time off for bereavement, jury duty, voting time or holiday.

A participant may be approved for intermittent disability if the physician provides medical documentation supporting medically accepted and necessary intermittent treatments (e.g. cancer treatments).

All medical information that a participant and his or her physician or health care provider supply to the disability plans is kept confidential and will be protected from unauthorized use. Certain claims may require the use of a special, written authorization form. The participant will need to sign and return the form as soon as possible so there is no delay in processing the claims.

All STD plans require that the participant cooperate in collecting the medical information necessary to review the claims and make a benefit determination. The most common reason that claim payments are delayed is the failure of the participant's health care provider to return calls, return forms or otherwise provide requested medical documentation.

A participant can help the claims administrators make more timely decisions by:

• Explaining to the health care provider that the administrator will be contacting them;
• Following up with the health care provider's office after a request for information has been made to ensure that the information is being collected and sent to the administrator; and
• Notifying the claims administrator immediately if the participant's return-to-work plans change, or if the health condition significantly changes (for example, if a surgery is needed). This will allow the plan administrator to help the employee file for an extension of benefits, if appropriate.

Some state plans insist that the documentation be provided only on specific forms. The health care provider should be aware of these requirements. However, a participant who receives a letter from the state indicating that the documentation was not provided in the appropriate format should contact his or her health care provider immediately.

For the DSL, VSDI and Leidos CA VDP plans, Sedgwick will contact the participant's physician or health care provider to request the appropriate documentation. In addition, Sedgwick will make a determination as to the expected return-to-work date based on objective medical evidence provided by the participant's physician or health care provider. If a participant's qualified disability extends beyond the original estimated return-to-work date, the participant should have his or her physician or health care provider complete the extension form provided by Sedgwick. Failure to provide disability extension documentation could result in delayed or denied benefits.

The STD Program is designed to provide a certain degree of income protection if a participant is unable to work. The individual STD plans coordinate with each other so that participants do not receive duplicate benefits In addition, some offsets or deductions may be made for other plans for which the participant might be eligible. In general, STD benefits will be offset by:

• Social Security benefits (except family Social Security benefits) for any period of time during which disability benefits are paid. Once disability benefits begin, however, they will not be further reduced by any statutory increase in Social Security benefits. If the receipt of Social Security retirement benefits commenced prior to the Participant's Disability such benefits will not be offset
• Any benefits based on wages payable to the participant under any worker's compensation law;
• Disability benefits payable to the participant under any employer-sponsored group policy other than the Leidos disability plans;
• Disability/medical leave benefits for employee's own serious health condition payable under any federal or state law;
• Any salary (excluding vacation pay), income or sick pay from any employer or from self-employment.
• Any government retirement or disability plan that is initiated or increased as a result of a participant's disability.
• Any plan, fund or other arrangement, by whatever name called, providing disability benefits pursuant to any Compulsory Benefit Act or law of any government;
• Any income or wages earned during rehabilitation employment; 
• Any financial settlement, award, benefit or other monetary recovery the participant receives — through litigation or otherwise — attributable in whole or in part to the negligence, the wrongful act or any other civil or criminal incident that resulted, in whole or in part, in the disease, illness, incapacity or injury that substantiates the disability claim. (This offset can be made for the entire amount of the third party recovery, regardless of whether it is attributable to lost wages, incurred medical expenses or punitive damages.)
• Benefits payable under any Unemployment Compensation Act of the United States or of any state during any period of disability leave

Although the coordination of benefits may reduce the amount received from the STD plans, all benefits together will still equal the total amount under the STD plan(s) that the participant is eligible for and enrolled in.

The participant is responsible for any fees associated with obtaining medical records and medical certification forms related to the disability claim. However, the Plan will pay for document translation services if necessary. 

Leidos requires that all participants returning from a disability leave provide a "fitness for duty" or "doctor's release" clearly stating the date he or she is no longer considered to be disabled, as well as the date he or she is able to return to work. This document is usually a note from the health care provider stating that the participant may return to full duty. If the health care provider is requesting modified duty or limited hours, this should be discussed with the claims administrator and the workplace in advance of the participant's return to work. A participant who does not present a release may not be allowed to work until the release is presented.

In the event that a participant is injured through the acts of a third party (e.g. auto accidents), the Plan will provide benefits only under the condition that the participant agrees in writing that the Plan will be subrogated to all rights of recovery that the participant may have as a result of the injury.  The participant must sign the Reimbursement Agreement prior to receiving claim payments from the Plan.  If the participant is incapacitated and unable to sign the agreement, the Plan will pay the claim and pursue reimbursement at a later time. The Plan will pursue reimbursement regardless of whether a signed reimbursement agreement is in place.

The Plan reserves the right to reduce the amount of its recoverable subrogation interest if, in the discretion of the Plan, a reduction is in the best interest of the Plan and its participants and warranted by the circumstances. The Plan is not responsible for the expenses or attorney fees incurred by the participant in connection with any recovery.

STD benefits generally end when the participant:

• Returns to work as cleared by the participant's physician
• Is no longer disabled as defined by the particular disability plan;
• Reaches the maximum duration payable under that plan;
• Refuses to submit to an independent medical examination (arranged and paid for by the claims administrator) or fails to comply with any request, by the claims administrator, to help substantiate that the participant is disabled;
• Is no longer under the regular and continuous care and treatment of a qualified Physician; or
• Dies

If a participant's disability started prior to termination of employment, disability benefits will continue to be paid up to the maximum duration approved under the plan.

For collectively bargained participants, disability benefits will continue to be paid if a strike occurs and the disability started prior to the strike. Benefits will be paid up to the maximum duration approved under the plan.

For more information about when benefits end for all disability plans, refer to the plan's SPD or Certificate of Insurance for each plan.

If a participant recovers from an illness or injury and returns to full active employment with Leidos (other than in rehabilitation employment), the participant may again be eligible for disability benefits if, within 31 days, the participant suffers another period of disability caused by, related to, and based on the same diagnosis as the prior period of disability. If these conditions are met, the participant will not be required to satisfy another waiting period. The period of time worked will not count against the maximum benefit leave duration.

Successive disability benefits will begin on the most recent date the participant was unable to work. The participant must notify Sedgwick within five days of the successive disability. Participants in a state-mandated plan must also notify the appropriate state claims administrator.

For more information about what happens when a participant becomes disabled again, refer to the plan's SPD or Certificate of Insurance for each plan. State-mandated plans, have different maximum benefit durations.

In general, benefits may be limited if:

• The participant is referred or recommended by competent medical authority to participate as a resident in either an approved alcoholism recovery program or an approved drug-free residential program.  Benefits for alcoholism recovery treatment will be paid for a period not to exceed thirty (30) days for a period of disability.  Benefits for drug-free residential facility participation will be paid for a period not to exceed forty-five (45) days for a period of disability.  If the referring physician certifies the need for continuing resident services, benefits will be payable for up to sixty (60) additional days for alcoholism recovery treatment and up to forty-five (45) additional days for drug-free residential facility participation;
• The participant receives wages from Leidos (excluding Paid Time Off pay) for any day. Benefits will be paid for any seven-day week or partial week, in an amount that does not exceed the participant's maximum weekly benefit amount and which, when added to the wages received, does not exceed the participant's weekly wages, exclusive of the wages paid for overtime immediately prior to the commencement of the participant’s qualified disability;
• The participant, for any day of unemployment or disability, receives or is entitled to receive benefits or cash payments for temporary or permanent disability under a workers' compensation or employer liability law of the federal government or any state (in which case, if the cash payments for temporary or permanent disability are less than the amount of disability benefit the participant would have received, the participant, if otherwise eligible, will be entitled to receive disability benefits, reduced by the amount of such cash payments); 
• The employer can provide alternative employment that is within the capabilities of the employee, and that has status and compensation comparable to the employee’s regular occupation as determined solely by the employer

In general, benefits may not be available, if:

• The participant is not in an employment status that is eligible for disability benefits
• The disability leave is not supported by objective medical evidence from a treating physician or other health care provider and approved by the claims administrator
• The participant has reached the maximum benefits or duration allowed under the plan
• The participant’s illness or injury is caused by participation in a violent disorder, assault or illegal occupation
• The participant:
  • Is incarcerated in any federal, state, or municipal penal institution, jail, medical facility, public or private hospital, or in any other place because of a criminal conviction of a federal, state or municipal law or ordinance; or
  • Commits a crime and is disabled due to an illness or injury, caused by, or arising out of the commission of, arrest, investigation, or prosecution of any crime that results in a felony conviction.
• The participant has willfully, for the purpose of obtaining benefits, either made a false statement or representation, with actual knowledge of the falsity thereof, or withheld a material fact, in order to obtain any benefits from the Plan.
• The disability is:
  • Not disabling (i.e., do not prevent the employee from doing his or her job)
  • Incurred during, or as a result of, engaging in a criminal act
  • Incurred while on layoff or leave of absence, severance, military leave of absence, or any other status where the participant was not engaged in active employment with Leidos
  • Incurred while on full-time or part-time long-term disability
  • Incurred while the employee was on unauthorized absence, or was not an employee
  • Incurred as a result of service in any armed forces, except as required by law
  • Intentionally self-inflicted
  • Incurred because the participant was not receiving care or following the prescribed treatment plan that is:
    • From a health care provider whose training and clinical experience are suitable for treating the disease, illness, incapacity or injury
    • Consistent in type, frequency and duration of treatment with relevant guidelines of national medical, research, and health coverage organizations and governmental agencies
    • Consistent with the diagnosis of the condition
    • For the purpose of maximizing medical improvement
• The participant is not under the continuous care and treatment of a duly qualified physician
• The illness or injury is caused by any act of war, declared or undeclared, or insurrection, except while traveling overseas on company business
• The disability is filed more than 60 days after the qualified disability began. The Plan Administrator may extend this period for good cause (for example, physician’s delay in providing the requested medical information)

State-mandated plans may have different limitations and exclusions.  Refer to each respective state’s disability program for more information. See the Leidos California Voluntary Disability Plan (CA VDP) section for limitations and exclusions related to the CA VDP.

Participation in the STD Plans generally ends on the earliest of the following:

• On the end date of the pay period which marks the termination of employment
• On the end date of the pay period in which an approved leave of absence without pay commences, except as required by law
• At 12:00 midnight when a protected leave ends, if the participant fails to return to work
• On the end date of the pay period in which an employee ceases to be eligible
• On the end date of the pay period in which a strike occurs (if the participant is a member of the bargaining unit engaged in the strike)
• On the date of a qualified life event
• On the date of termination of the Plan