HR = Human Resources

PIP = Personal Injury Protection

STD = Short-Term Disability

LTD = Long-Term Disability

RTW = Return to Work

WC = Workers' Compensation

For State Agencies, School Districts, Charter Schools, DTCC and DSU:
Disability Insurance Program Quick Reference Chart  - Refer to this chart for answers to commonly asked questions from HR, Benefit and Payroll Representatives.

For University of Delaware and Delaware Solid Waste Authority:
Disability Insurance Program Quick Reference Chart  - Refer to this chart for answers to commonly asked questions from HR, Benefit and Payroll Representatives.

Human Resources Disability Insurance Program Checklist  - Use this checklist if your employee is going to be out of work due to an accident, illness or pregnancy for more than 30 calendar days to ensure that the employee receives all the required documentation and information.

Short Term Disability Form Letter, Employee Acknowledgement and Claim Filing Checklist, Guidelines & Activity Log  - Required information to be provided to all employees by the 5th calendar day of their absence from work.

• Important - It is suggested that you download and resave the form with a new file name. The PDF Fillable Short Term Disability Form Letter is customizable. In addition to personalizing the participants information and HR/Benefits Representative contact information on the cover page, the checkboxes on page numbers 11 and 12 will indicate whether parental leave or workers' compensation is applicable to the participant; if not applicable, the content is removed. Please Note: Chrome is the suggested internet browser. Other browsers may not support the interactive PDF.

Workers’ Compensation Checklist 

Physical Demands Analysis (PDA) Form 

If an employee has not returned to work by the 20th week of his/her STD benefit period, the employing organization must send the following documents to the employee:

Information Sheet 

LTD Form Letter 

Correspondence from Office of Pensions 

Forms

• Non-Medicare Health Care Application or Refusal 

• Medicare Supplement Application 

• Dental Insurance Application or Refusal 

• Vision Insurance Application or Refusal 

• Request and Authorization for Deductions From LTD Benefit