2023 Utah Code › Title 49 - Utah State Retirement and Insurance Benefit Act › Chapter 21 - Public Employees' Long-Term Disability Act › Part 4 - Disability Benefits › Section 402 - Reduction or reimbursement of benefit -- Circumstances -- Application for other benefits required.

Effective 7/1/2023
49-21-402.
Reduction or reimbursement of benefit -- Circumstances -- Application for other benefits required.
(1) A monthly disability benefit may be reduced, suspended, or terminated unless:
(a) the eligible employee participates in ongoing care and treatment in accordance with Subsection 49-21-406(3) or (4); and
(b) the eligible employee provides the information and documentation requested by the office.
(2)
(a) The monthly disability benefit shall be reduced or reimbursed by any amount received by, or payable to, the eligible employee for the same injury or illness that is the basis for the monthly disability benefit from the following sources:
(i) workers' compensation indemnity benefits, regardless of whether the amount is received as an ongoing monthly benefit, as a lump sum, or in a settlement with a workers' compensation indemnity carrier;
(ii) any money received by judgment, legal action, or settlement from a third party liable to the employee for the monthly disability benefit;
(iii) automobile no-fault, medical payments, or similar insurance payments;
(iv) any money received by a judgment, settlement, or other payment as a result of a claim against an employer; or
(v) annual leave or similar lump-sum payments.
(b) The monthly disability benefit shall be reduced or reimbursed by any amount received by, or payable to, the eligible employee for the same period of time during which the eligible employee is entitled to receive a monthly disability benefit from the following sources:
(i) social security disability benefits, including all benefits received by the eligible employee, the eligible employee's spouse, and the eligible employee's children as determined by the Social Security Administration;
(ii) unemployment compensation benefits;
(iii) sick leave benefits; or
(iv) compensation received for employment, including self-employment, except for eligible amounts from approved rehabilitative employment in accordance with Section 49-21-406.
(3) The monthly disability benefit shall be reduced by any amount in excess of one-third of the eligible employee's regular monthly salary received by, or payable to, the eligible employee from the following sources for the same period of time during which the eligible employee is entitled to receive a monthly disability benefit:
(a) any retirement payment earned through or provided by public or private employment; and
(b) any disability benefit, other than social security or workers' compensation indemnity benefits, resulting from the disability for which benefits are being received under this chapter.
(4) After the date of disability, cost-of-living increases to any of the benefits listed in Subsection (2) or (3) may not be considered in calculating a reduction to the monthly disability benefit.
(5) Any amounts payable to the eligible employee from one or more of the sources under Subsection (2) are considered as amounts received whether or not the amounts were actually received by the eligible employee.
(6)
(a) An eligible employee shall first apply for all disability benefits from governmental entities under Subsection (2) to which the eligible employee is or may be entitled, and provide to the office evidence of the applications.
(b) If the eligible employee fails to make application under this Subsection (6), the monthly disability benefit shall be suspended.
(7) During a period of total disability, an eligible employee has an affirmative duty to keep the program informed regarding:
(a) the award or receipt of an amount from a source that could result in the monthly disability benefit being reduced or reimbursed under this section within 10 days after the day of the award or receipt of the amount; and
(b) any employment, including self-employment, of the eligible employee and the compensation for that employment within 10 days after beginning the employment or a material change in the compensation from that employment.
(8) The program shall use commercially reasonable means to collect any amounts of overpayments and reimbursements.
(9)
(a) If the program is unable to reduce or obtain reimbursement for the required amount from the monthly disability benefit for any reason, the employee will have received an overpayment of monthly disability benefits.
(b) If an eligible employee receives an overpayment of monthly disability benefits, the eligible employee shall repay to the office the amount of the overpayment, plus interest as determined by the program, within 30 days from the date the overpayment is received by:
(i) the eligible employee; or
(ii) a third party related to the eligible employee.
(c) The executive director may waive the interest on an overpayment of monthly disability benefits under Subsection (9)(b) if good cause is shown for the delay in repayment of the overpayment of monthly disability benefits.
Amended by Chapter 37, 2023 General Session
Amended by Chapter 274, 2023 General Session