D. PROOF OF TOTAL DISABILITY; DEFINITION

1. The First 12 Months of Benefits.

In order to qualify for benefits during the first 12 months of your disability, you must be considered “totally disabled” if you are unable, solely because of Illness, disease, or Injury, to work at your own job.

To be considered totally disabled, you must be under the care of an acceptable medical treatment source*. The proof required prior to receipt of Disability Benefits for the first 12 months of your disability is an Attending Physician’s Statement form, which is available at the Plan Office and which must be completed and submitted by your Physician to the Plan Office.

Proof from your attending Physician(s) that you continue to be totally disabled may be required at reasonable intervals by the Plan. The Board of Trustees may designate a Physician or other medical provider to make the disability determination. If you fail to furnish proof or if you refuse to be examined by a licensed Physician (designated and paid by the Plan), you will no longer be considered totally disabled and will lose your Disability Benefits.

*Acceptable medical treatment sources are:

1. Licensed Physician,
2. Licensed osteopaths,
3. Licensed or certified psychologists,
4. Licensed optometrists for the measurement of visual acuity and visual fields.

2. After 12 Months of Benefits.

In order to qualify for benefits beyond the first 12 months of your disability, you must have received a disability award from the Social Security Administration (“SSA”) and have filed a copy of this award with the Plan Office.

1. Exception. If you have satisfied all of the SSA’s requirements for receiving a disability award, but have been denied such award solely because you lacked a sufficient number of Social Security Quarters of Coverage, you will be deemed to have met the above qualification for purposes of receiving a benefit under the Plan.


2. 6-Month Benefit Extension. If you are still disabled after 12 months and have applied for but not yet received a Social Security disability award, you may apply for a six (6) month extension of benefits as described more fully in F.2.

Note: Since the process of applying for a Social Security disability award can often take up to a year or longer, if you feel you might need benefits beyond 12 months, you are strongly encouraged to begin the process of applying for a Social Security disability award as early in your disability as possible.