ETF 50.50(5)(a)1.
1. The employee is on a leave of absence and is not expected to resume active service and, as a consequence, the employee is not entitled to any further earnings from the employer.
ETF 50.50(5)(a)2.
2. The employee's participating employment has been terminated and, as a consequence, the employee is not entitled to any further earnings from the employer.
ETF 50.50(5)(b)
(b) The requirement of
par. (a) is not met if the employer certifies the employee was terminated or on leave of absence. The LTDI benefit will be denied if the employer contests the employee's application for disability benefits under
ch. ETF 50.
ETF 50.50(6)
(6) Physician certifications. Except as provided in
s. ETF 50.48 (6) (a) 2., the department has received certifications in writing from at least 2 licensed and practicing physicians approved or appointed by the department that the employee is disabled as described in
sub. (3) or, for a protective occupation participant who meets the requirements of
s. ETF 50.58 (1) (a), disabled as described in
s. ETF 50.58 (1) (a) 3.
ETF 50.50 History
History: Emerg. cr. eff. 10-15-92; cr.
Register, May, 1993, No. 449, eff. 6-1-93; am. (1) (c) 3.,
Register, September, 2000, No. 537, eff. 10-1-00; correction in (4) made under s. 13.93 (2m) (b) 7., Stats.,
Register November 2002 No. 563;
CR 02-057: am. (5) (a) (intro.) and 2., cons. and am. (5) (b) (intro.) and 1.,
Register November 2002 No. 563, eff. 12-1-02;
CR 07-062: am. (2) (b)
Register June 2008 No. 630, eff. 7-1-08.
ETF 50.52(1)(a)(a) Benefit amount. The basic LTDI benefit payable to recipients shall be a monthly payment of 40% of the recipient's final average salary or 50% of FAS for a recipient not personally covered under OASDHI. The basic benefit amount, once determined, shall subsequently be adjusted at the same time and by the same percentages as applicable to post-retirement annuity adjustments under s.
40.27, Stats.
ETF 50.52(1)(b)1.1. The department shall reduce the amount of a recipient's monthly LTDI benefits under
par. (a) by the amounts in
subds. 2. and
3. The amount by which any lump sum benefit or separation benefit under
subd. 2. exceeds the basic monthly LTDI benefit otherwise payable shall be carried over to reduce basic LTDI benefits payable in future months until the amount of the lump sum or separation benefit has been completely offset.
ETF 50.52(1)(b)2.
2. LTDI benefits shall be offset by an amount equal to the portion of any retirement annuity or lump sum benefit or separation benefit under s.
40.23,
40.24 or
40.25, Stats., on which the recipient is subject to federal income tax. This subdivision applies to any retirement annuity or lump sum benefit or separation benefit which is paid to the recipient as a result of the recipient's application for the annuity or benefit, excluding any benefit funded by employee additional contributions. This subdivision does not apply to an annuity or lump sum benefit for which the recipient is eligible solely as a beneficiary, alternate payee or joint survivor of another participant.
ETF 50.52(1)(b)3.
3. LTDI benefits shall be offset by the amount of any normal form retirement annuity or lump sum retirement benefit under s.
40.23 or
40.25, Stats., for which the recipient is eligible, excluding the portion of any annuity or lump sum benefit on which the recipient would not be subject to federal income tax, a separation benefit or a benefit funded by employee additional contributions. This offset shall be computed as of the recipient's normal retirement age. This subdivision applies only after a recipient's normal retirement date as defined by s.
40.02 (42), Stats. This subdivision does not apply to an annuity for which the recipient is eligible solely as a beneficiary, alternate payee or joint survivor of another participant.
ETF 50.52(1)(c)
(c) Proration. Initial monthly LTDI benefits beginning on other than the first day of a month and final LTDI benefits ending on other than the last day of a month are prorated based on effective date and termination date as provided in
s. ETF 50.62.
ETF 50.52(2)(a)(a) In addition to the basic LTDI benefit payable to a recipient, the LTDI program shall pay a retirement supplemental benefit in the form of an employer additional contribution to the Wisconsin retirement system for recipients qualifying under this subsection.
ETF 50.52(2)(b)
(b) The LTDI retirement supplemental benefit due shall be 7% of the recipient's FAS for each month a recipient qualifies under
par. (d). Except as provided in
sub. (1) (c), the LTDI retirement supplemental benefit is not prorated. If a recipient is not qualified for the LTDI supplemental benefit on any day during a month, no LTDI supplemental benefits are payable for that month. The supplemental LTDI benefit amount, once determined, shall subsequently be adjusted at the same time and by the same percentages as applicable to post-retirement annuity adjustments under s.
40.27, Stats.
ETF 50.52(2)(c)
(c) As of December 31 each year, the supplemental LTDI benefit due for each of the preceding 12 months during which the recipient qualified under
par. (d) to receive the retirement supplemental LTDI benefit shall be credited to the recipient's WRS employer additional contributions account.
ETF 50.52(2)(d)
(d) A recipient qualifies for retirement supplemental LTDI benefits if all of the following apply:
ETF 50.52(2)(d)3.
3. Payment of the LTDI retirement supplemental benefit would not exceed any limitation on additional contributions or cause the Wisconsin retirement system to fail to meet requirements for a qualified plan under the U.S. internal revenue code, applicable regulations adopted under the U.S. internal revenue code, including proposed regulations in force pending adoption, or rules of the department.
ETF 50.52(2)(d)4.
4. The recipient has not applied for any retirement annuity or lump sum retirement or separation benefit from the Wisconsin retirement system, other than a benefit funded by employee additional contributions or from a Wisconsin retirement system account held as an alternate payee. Qualification ceases on the effective date of a retirement annuity or other benefit or the approval date of a separation benefit. This subdivision shall not apply if the application is withdrawn, void, canceled or not granted.
ETF 50.52(2)(d)5.
5. The recipient is not qualified to receive duty disability benefits under s.
40.65, Stats., regardless of the amount of duty disability benefits actually received.
ETF 50.52(2)(e)
(e) Monthly LTDI retirement supplemental benefits due are prorated based on the effective beginning date and termination date as provided in
s. ETF 50.62.
ETF 50.52(3)
(3) Continuation of group health insurance coverage for state employees. Pursuant to s.
40.51 (3), Stats., a recipient of LTDI benefits under this subchapter who is an insured employee under any group health insurance plan for state employees insured directly by the public employee trust fund shall also be entitled to continuation of that group health insurance in the same manner and to the same extent as is a disability annuitant under s.
40.63, Stats. Effective no later than January 1, 1993, contracts between the group insurance board and other insurers of group health insurance plans covering state employees shall provide the same continuation rights for recipients insured under those plans.
ETF 50.52 History
History: Emerg. cr. eff. 10-15-92; cr.
Register, May, 1993, No. 449, eff. 6-1-93;
CR 11-040: am. (2) (a)
Register July 2012 No. 679, eff. 8-1-12.
ETF 50.54(1)(1)
Plan administrator. The department shall administer the plan established by this subchapter on behalf of the group insurance board unless otherwise expressly provided in an administrative services contract between the group insurance board and an outside administrator, in which the employee trust funds board concurs.
ETF 50.54(2)
(2) Effective date of benefits. The department shall begin payment of LTDI benefits on the later of the following dates:
ETF 50.54(2)(a)
(a) The first day of the first month beginning on or after 90 days preceding receipt of the application for LTDI benefits by the department.
ETF 50.54(2)(b)
(b) The first day after the date of termination of employment from the last participating employer by which the recipient was employed, as reported to the department by the employer. When the claimant is on a leave of absence, the date of termination of employment for effective date purposes shall be deemed to be the recipient's last day paid.
ETF 50.54(3)
(3) Periodic medical review. The department may require that any recipient shall be examined by at least one licensed and practicing physician, designated or approved by the department, during any calendar year the recipient receives benefits under this subchapter. The examining physician shall file with the department a written report of the examination which shall be in a form approved by the department and indicate whether the recipient is still totally and permanently disabled or, for a recipient qualifying under
s. ETF 50.58 (1) only, whether the recipient recovered to the extent that the recipient can efficiently and safely perform the duties required by the recipient's former position as a protective occupation participant and whether the recipient recovered to the extent that the impaired condition is not likely to be permanent.
ETF 50.54 Note
Note: Form ET-5909, "Recertification Medical Report," is sent to the claimant by the department as necessary.
ETF 50.54(4)
(4) Requests for information. The department may request any information on earnings, salary, wages, earned income, compensation or OASDHI benefits or entitlements as it deems necessary to implement the provisions of
sub. (2) and
s. ETF 50.52 (1), including but not limited to copies of state and federal income tax returns.
ETF 50.54(5)
(5) Application of anti-fraud statute. This subchapter is an employee benefit program created under
ch. 40, Stats., through rule-making authority expressly granted in that chapter, for purposes of enforcement of the prohibitions of s.
943.395 (1) (c), Stats. Prohibited acts include presenting or causing to be presented false or fraudulent information, including a claim or benefit application, proof in support of a claim or benefit application, or information which would affect a future claim or application.
ETF 50.54(6)
(6) Overpayment. Section
40.08 (4), Stats., shall apply to obtain repayment of any overpayment of LTDI benefits.
ETF 50.54 History
History: Emerg. cr. eff. 10-15-92; cr.
Register, May, 1993, No. 449, eff. 6-1-93.
ETF 50.56(1)
(1)
Duration of benefits. Except as otherwise provided in this section:
ETF 50.56(1)(a)
(a) For a recipient whose LTDI benefit effective date is prior to the date the recipient attains age 61, all LTDI benefits terminate at the end of the month in which the recipient attains age 65.
ETF 50.56(1)(b)
(b) For a recipient whose LTDI benefit effective date is on or after the date the recipient attains age 61 and prior to the date the recipient attains age 63, all LTDI benefits terminate at the end of the month in which the recipient attains age 66.
ETF 50.56(1)(c)
(c) For a recipient whose LTDI benefit effective date is on or after the date the recipient attains age 63 and prior to the date the recipient attains age 65, all LTDI benefits terminate at the end of the month in which the recipient attains age 67.
ETF 50.56(1)(d)
(d) For a recipient whose LTDI benefit effective date is on or after the date the recipient attains age 65 and prior to the date the recipient attains age 67, all LTDI benefits terminate at the end of the month in which the recipient attains age 68.
ETF 50.56(1)(e)
(e) For a recipient whose LTDI benefit effective date is on or after the date the recipient attains age 67 and prior to the date the recipient attains age 68, all LTDI benefits terminate at the end of the month in which the recipient attains age 69.
ETF 50.56(1)(f)
(f) For a recipient whose LTDI benefit effective date is on or after the date the recipient attains age 68 and prior to the date the recipient attains age 69, all LTDI benefits terminate at the end of the month in which the recipient attains age 70.
ETF 50.56(1)(g)
(g) For a recipient whose LTDI benefit effective date is on or after the date the recipient attains age 69, all LTDI benefits terminate 12 months after the LTDI benefit effective date.
ETF 50.56(1)(h)
(h) Notwithstanding
pars. (a) to
(g), no LTDI benefits shall be payable for any date after the recipient's death.
ETF 50.56(1)(i)
(i) The effective date used to determine the duration of LTDI benefits is the effective date of the benefits being paid, not the effective date of terminated LTDI benefits paid under a previous application.
ETF 50.56(1)(j)
(j) The duration of LTDI benefits for recipients whose LTDI benefit effective date is on or after the date the recipient attains age 61 shall be periodically reviewed and may be revised based on the actuary's determinations, as approved by the employee trust funds board, so as to provide LTDI benefits meeting equal cost standards under federal age discrimination law. As part of the regular 3-year general investigation under s.
40.03 (5) (b), Stats., beginning with the investigation based on data through 1996, the actuary shall determine the appropriate duration for LTDI benefits beginning at and after age 61. The employee trust funds board shall be responsible for approving any change to the duration of LTDI benefits. If the duration of LTDI benefits is changed, the duration of LTDI benefits being paid as the result of an application received by the department prior to the effective date of the change shall not be affected. Any such revision shall be effective upon promulgation as an amendment to this rule by the group insurance board.
ETF 50.56(2)
(2) Termination for fraud, misrepresentation, error or mistake. ETF 50.56(2)(a)(a) Payment of LTDI benefits may be terminated immediately and overpayment recovered upon a department determination of either of the following:
ETF 50.56(2)(a)1.
1. LTDI benefits were granted as the result of fraud or misrepresentation in the application or in required evidence of eligibility.
ETF 50.56(2)(a)2.
2. LTDI benefits were granted due to an error or mistake by the department or due to an error or mistake in the information supplied by the employer used for determining eligibility, effective date or amount of LTDI benefits.
ETF 50.56(2)(b)
(b) A department determination under
par. (a) shall be treated as a department denial of the application for LTDI benefits as provided in
s. ETF 50.48 (4).
ETF 50.56(2)(c)
(c) The amount of monthly LTDI benefits may be altered upon a determination that the amount of LTDI benefits was computed in error.
ETF 50.56(2)(d)
(d) LTDI benefits may be terminated effective upon a determination by the department that the recipient has made misrepresentations or submitted false or fraudulent information regarding continued disability, earnings, wages, salary or other earned income.
ETF 50.56(2)(e)
(e) If the department alters the amount of monthly LTDI benefits under
par. (c) or terminates payment of LTDI benefits under
par. (d), the department shall send notice of the action to the recipient. The notice shall be in the form of a written determination stating the reasons for the termination. The recipient may file a timely appeal of the alteration or termination with the group insurance board as provided in
ch. ETF 11. If no timely appeal is filed, the alteration or termination of LTDI benefits is final.
ETF 50.56(3)
(3) Termination upon recovery or for failure to furnish information. ETF 50.56(3)(a)(a) The payment of LTDI benefits shall be terminated based on a determination by the department of any of the following:
ETF 50.56(3)(a)1.
1. The written physician's report required in
s. ETF 50.54 (3) indicates that the recipient has recovered from the medically determinable impairment so that the recipient is no longer totally and permanently disabled, or, for a recipient qualifying under
s. ETF 50.58 (1), recovered to the extent that the recipient can efficiently and safely perform the duties required by the recipient's former position as a protective occupation participant or that the recipient's impaired condition is not likely to be permanent. LTDI benefits are payable up to the date of recovery.
ETF 50.56(3)(a)2.
2. The recipient refuses to submit to an examination under
s. ETF 50.54 (3) or refuses to submit information regarding earnings, wages, salary or other earned income as requested by the department. LTDI benefits shall not be payable for any month following the deadline for the recipient's compliance set by the department.
ETF 50.56(3)(b)
(b) If the department terminates payment of LTDI benefits under this subsection, the department shall send notice of the termination to the recipient. The notice shall be in the form of a written determination stating the reasons for the termination. The recipient may file a timely appeal of the termination with the group insurance board, as provided in
ch. ETF 11. If no timely appeal is filed, the termination of LTDI benefits is final.
ETF 50.56(4)
(4) Termination or suspension based on earnings. ETF 50.56(4)(a)(a) Except as provided in
par. (b) and
s. ETF 50.58 (1) (c), the payment of LTDI benefits shall be terminated and no LTDI benefits shall be payable after the first of the month in which a determination is made by the department that the recipient has received during the calendar year earnings or other earned income exceeding the earnings limit.
ETF 50.56(4)(b)
(b) On the first occasion that the department determines that the recipient has exceeded the earnings limitation as described in
par. (a), the payment of LTDI benefits shall be suspended rather than terminated. Payment of LTDI benefits suspended under this paragraph shall resume on the earlier of the first day of the next calendar year or the first day of the second month following the termination of personal services due to recurrence of the medically determinable impairment which was the basis for payment of LTDI benefits. A recipient's LTDI benefits may only be suspended once and must be terminated if
par. (a) subsequently applies.
ETF 50.56 History
History: Emerg. cr. eff. 10-15-92; cr.
Register, May, 1993, No. 449, eff. 6-1-93.
ETF 50.58
ETF 50.58
Special provisions applicable to certain categories of employment. ETF 50.58(1)(a)(a) Not totally and permanently disabled. Notwithstanding
s. ETF 50.50 (3), an otherwise qualifying claimant who is a protective occupation participant is not disqualified from receiving LTDI benefits although not totally and permanently disabled, provided all of the following apply:
ETF 50.58 Note
Note: The accumulated creditable service need not be in the protective employment category and may include military service.
ETF 50.58(1)(a)2.
2. The claimant would attain age 55 in 60 months or less after the occurrence of disability.
ETF 50.58(1)(a)3.
3. The medical evidence, as provided in
s. ETF 50.50 (6), establishes a disability to the extent that the participant can no longer efficiently and safely perform the duties required by the participant's position, and that the condition is likely to be permanent.
ETF 50.58 Note
Note: Form ET-5353, "LTDI Special Disability Medical Report" is available upon request from the department, P.O. Box 7931, Madison, Wisconsin 53707-7931.
ETF 50.58(1)(b)
(b) Integration with benefits under s. 66.191, 1981 Stats. Any person entitled to payments of LTDI benefits who may otherwise be entitled to payments under s.
66.191, 1981 Stats., may file with this department and the department of workforce development a written election to waive payments due under this subchapter and accept in lieu of the payments under this subchapter payments as may be payable under s.
66.191, 1981 Stats., but no person may receive payments under both s.
66.191, 1981 Stats., and this subchapter. However, any person otherwise entitled to payments under this subchapter may receive the payments, without waiver of any rights under s.
66.191, 1981 Stats., during any period as may be required for a determination of the person's rights under s.
66.191, 1981 Stats. Upon the final adjudication of the person's rights under s.
66.191, 1981 Stats., if waiver is filed under this paragraph, the person shall immediately cease to be entitled to payments under this subchapter and the LTDI account shall be reimbursed from the award made under s.
66.191, 1981 Stats., for all payments made under this subchapter.
ETF 50.58(1)(c)
(c) Exceeding earnings limit. Notwithstanding
s. ETF 50.56 (4) (a), LTDI benefits for a recipient under
sub. (1) may not be terminated for exceeding the earnings limit. The payment of LTDI benefits shall be suspended and no LTDI benefits shall be payable after the first of the month in which a determination is made by the department that the recipient has received during the calendar year earnings or other earned income exceeding the earnings limit. Payment of LTDI benefits suspended under this paragraph shall resume on the first day of the next calendar year.
ETF 50.58(1)(d)
(d) Reemployment in law enforcement or fire fighting. Payment of LTDI benefits shall be immediately terminated upon employment of a recipient under
sub. (1) in a law enforcement or fire fighting capacity.
ETF 50.58(2)
(2) Elected officials. For purposes of the department's determination of eligibility under
s. ETF 50.50 (1), an elected official shall be considered to have terminated active service due to disability if the medically determinable impairment is determined to exist at the end of the elected official's term of office.
ETF 50.58 History
History: Emerg. cr. eff. 10-15-92; cr.
Register, May, 1993, No. 449, eff. 6-1-93;
CR 11-040: am. (1) (b)
Register July 2012 No. 679, eff. 8-1-12.
ETF 50.60(1)(1)
LTDI account. A separate account for the LTDI program shall be maintained within the public employee trust fund.
ETF 50.60(2)(a)(a) The employee trust funds board shall pay a monthly premium to the LTDI program account for the LTDI coverage provided to participating employees under this subchapter.
ETF 50.60(2)(b)
(b) The initial amount of the required monthly premium shall be as determined and certified by the actuary. The actuary shall determine and certify future required premiums annually at the same time contribution rates are determined under s.
40.05, Stats., for the Wisconsin retirement system, based on the information available at the time the determination is made and on the assumptions the actuary recommends and the group insurance board approves.
ETF 50.60 History
History: Emerg. cr. eff. 10-15-92; cr.
Register, May, 1993, No. 449, eff. 6-1-93.
ETF 50.62
ETF 50.62
Proration of adjustment percentages and monthly benefits. ETF 50.62(1)(1)
Annual adjustments to benefits. The percentage of the annual adjustment to a recipient's LTDI basic benefits or retirement supplemental benefits under
s. ETF 50.52 (1) (a) or
(2) (b) shall be prorated in the first calendar year after the effective date of the benefits. The applicable adjustment percentage shall be determined by multiplying the percentages as applicable to post-retirement annuity adjustments under s.
40.27, Stats., by the proration factor from Table 1 according to the effective date the benefits began. If the resulting prorated adjustment percentage is less than 1%, no increase shall result.
-
See PDF for table 
EXAMPLE 1: A recipient begins to receive LTDI benefits effective August 10. The annual adjustment for the following year is an increase of 5%. The recipient would instead receive an increase of 1.67% (5% x 0.333 = 1.67%). The following year the annual adjustment is an increase of 6%. The recipient receives the entire 6% increase.
