If a Member becomes Disabled, he/she must notify the Benefit Fund as soon as practicable.
- Upon receipt of such notice the Member will be furnished with a proof of claim form which is to be completed by the Member and his/her attending Physician, Dentist, Podiatrist, Chiropractor, practicing Psychologist, Optometrist, or Advanced Practice Nurse. The completed proof of claim form must be returned to the Benefit Fund within 30 days after the commencement of the period of Disability for which claim is made. Failure to furnish notice and proof within the time or in the manner prescribed shall not invalidate or reduce any claim if it shall be shown not to have been reasonably possible to furnish such notice and proof and that such notice and proof were furnished as soon as reasonably possible.
- If the Member mistakenly applies for benefits under the State Plan, such application shall later be deemed to have been received by the Benefit Fund on the date it was actually received by the New Jersey Division of Employment Security.
- The Benefit Fund shall have the right and opportunity to examine the Member when and so often as it may reasonably require while the claim is pending; however, no claimant shall be required to submit to an examination more often than once a week.
- Participation in this Private Plan will not deprive a covered individual of his/her rights to appeal to the Division of Unemployment and Disability Insurance in case of a disputed claim. In the event the Benefit Fund finds it necessary to deny a claim for Benefits in whole or in part, a copy of the letter of denial will be sent to the Division of Unemployment and Disability Insurance.
