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Note: This benefit provided for Standard Plan (full) coverage only; no provision for “H” Plan (limited) coverage. Additionally, Retired Employees and Employees on COBRA are not eligible for Supplemental Occupational Accident Benefits.

If you are an eligible Active Employee and, as a result of a work-related accident or injury, become disabled or dismembered, lose speech, sight or hearing, or die as the result of a work-related accident, you or your beneficiary may be eligible for Supplemental Occupational Accident Benefits through this Plan. A loss must occur within one year from the date of an accident to be covered under Supplemental Occupational Accident Benefit.

The Supplemental Occupational Accident Benefits consist of two separate categories: 

The first category is Supplemental Worker’s Compensation Benefits, which covers occupational accidents involving Death, Dismemberment, Severe Burns or Loss of Hearing, Sight or Speech, as well as bereavement and trauma counseling relating to such occupational accidents. This benefit is guaranteed pursuant to an insurance contract with Nationwide.

The second category is Worker’s Compensation Supplemental Income involves general bodily injury that results in your receiving weekly wage loss workers compensation benefits. This benefit is self-insured by EWTF.

Worker’s Compensation Supplemental Income is intended to ensure that all eligible employees injured in occupational accidents receive the same benefits regardless of where the accident occurs. Depending on where you work, such benefits may be provided fully under local workers’ compensation laws. 

Your Occupational injury may make you eligible for either the Supplemental Worker’s Compensation Benefits, Worker’s Compensation Supplemental Income, or both.

What You Need To Do

You must provide satisfactory written proof of loss, usually in the form of a physician’s statement or death certificate, to the Fund Office within one year of the date of the loss. Contact the Fund Office at 301-731-1050 or at 1-800-929-3983 to begin receiving your benefit.

Supplemental Workers’ Compensation Benefits (Insured through Nationwide)

Amounts Payable for Occupational Accidental Death, Dismemberment, Loss of Sight, Speech or Hearing:

Amounts Payable for Occupational Accidental Severe Burns:

Amounts Payable for Bereavement and Trauma Counseling relating to an Occupational Accidental Injury or Death:For purposes of this benefit, a Severe Burn means a cosmetic disfigurement of the surface of the body due to an accidental injury that is a full-thickness or third-degree burn, as determined by a Physician.

If a participant suffers an injury or death for which occupational accident or death benefits are payable under this section, a counseling benefit of up to $100 per session for up to 5 sessions is available to the participant or the participant’s mother, father, spouse, children or siblings, for up to one year after the date of the occupational accident, provided the counseling:

• is ordered, and performed, by a Physician;
• meets generally accepted standards of medical practice; and
• is required to assist the counseled individual in coping with the loss resulting from the occupational accident or death.

How Supplemental Occupational Accident Benefits are Paid

The death, dismemberment, severe burn and loss of sight, speech or hearing benefits available under this provision are paid as lump sum amounts. If multiple losses occur because of a single accident, the maximum amount payable is the highest benefit amount payable for the single loss suffered. 

Workers’ Compensation Supplemental Income (Self-insured by EWTF)

Note: This benefit provided for Standard Plan (full) coverage only; no provision for “H” Plan (limited) coverage. Additionally, Retired Employees and Employees on COBRA are not eligible for Supplemental Occupational Accident Benefits.

The amount payable in the event of worker’s compensation supplemental income is an amount which, when combined with the weekly benefit payable under workers’ compensation, equals 66-2/3% of the member’s basic weekly wage rate, but not more than $150 per week. Payment of this benefit may be delayed until it is clear what you are receiving through your worker’s compensation claim. 

Permanently and totally disabled is the inability to perform the duties of your job for 12 months and, beyond the first 12 months, the complete inability to engage in any occupation or employment for which you are fitted by reason of education, training, or experience.

When Your Worker’s Compensation Supplemental Income Coverage Ends

The Workers’ Compensation Supplemental Income payments continue until the first of the following events occurs:

• You cease to receive Workers’ Compensation payments; or
• The total amount of Workers’ Compensation Supplemental Income paid equals $50,000; or
• The amount of Workers’ Compensation Supplemental Income paid, when added to the amount paid under Supplemental Workers’ Compensation Benefits, totals $100,000; or
• The 104-week benefit period is exhausted; or
• You die.

Upon your death, any portion of the up to $100,000 maximum benefit not already paid to you due to disability, dismemberment, or loss of sight, speech or hearing is paid as a Death Benefit to your designated beneficiary.

What’s Not Covered 

No Supplemental Occupational Accident Benefits are payable when a loss results from:

• Commuting to and from work; or
• Suicide, attempted suicide, or any intentionally self-inflicted injury committed while sane or insane; or
• Viral or bacterial infection (except from an accidental cut or wound); or
• Any injury for which workers compensation is not payable.

Please see Understanding the EWTF Plan and General Plan Exclusions for an in-depth listing of your Plan’s exclusions.