Compliance Notes for How to Manage Overlapping Benefits

By Marjory Robertson, JD

AVP, Senior Counsel
Sun Life Financial

By Abigail O’Connell, JD

Senior Counsel
Sun Life Financial

Understanding which of the many private and statutory insurance and paid/unpaid leave and benefit plans may apply to an employee absence is confusing. To add to the confusion, these various programs may run concurrently, successively, or altogether separately. A general understanding of each law, insurance policy, and program is required to support compliance, productivity, and retention in your workplace.

The following statutory and non-statutory programs and benefits require integration and coordination:  (1) workers’ compensation (WC); (2) employer-sponsored short-term disability (STD) and long-term disability (LTD); (3) statutory disability insurance programs in California, Hawaii, New Jersey, New York, and Rhode Island; (4) the federal Family and Medical Leave Act (FMLA) and comparable state and local leave laws; (5) paid family leave (PFL) benefits that may be employer-sponsored or required by state or local laws; and (6) the federal Americans with Disabilities Act (ADA).

These programs overlap, which can confuse employees and employers alike. For example, many employers and employees do not realize that FMLA can run concurrently with WC, that a WC claim filing can trigger the duty to provide notification of FMLA rights, and a request for FMLA leave may trigger a duty to report a work-related injury. Many employers do not understand that the ADA applies to WC claims, and may even require a workplace accommodation to allow an injured employee to return to work.

Connect employee events to the applicable laws, insurance, or program. Notice of the need for absence — whether it be an accident, illness, or missing work to care for a family member — should prompt a set of questions to administer the appropriate benefits:

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