Haw. Code R. § 12-11-35 - Claim for disability benefits

(a) The employee claiming for disability benefits or a person acting on the employee's behalf shall file a claim for disability benefits with the employer on a form prescribed by the director, or in the case where section 392-66, HRS, is applicable, with the director, within ninety days after commencement of the period of disability or as soon thereafter as is reasonably possible. Proof of disability shall be furnished to the employer, or, in the case where section 392-66, HRS, is applicable to the director, not later than ninety days after commencement of the period of disability and thereafter from time to time as the employer or director may require, but not more often than once each week. In the event the claimant has a controverted workers' compensation claim, the ninety-day filing period for temporary disability insurance is waived if the employee gave notice to the employer of a workers' compensation claim within ninety days after the date on which disability commenced. In such event, the date of notice of the workers' compensation claim shall be accepted as the filing date under this section.

(b) The claim for disability benefits shall include statements furnished by the claimant and the claimant's attending physician on a form prescribed for the purpose by the director. A carrier, employer, or the director may investigate a claim and for cause require additional information.

(c) Failure to file a claim for disability benefits within the time and in the manner above provided shall not invalidate the claim, but no benefits shall be required to be paid for any period more than fourteen days prior to the date on which the required claim for disability benefits is filed. However, if it is shown not to have been reasonably possible for the claimant to file the claim within the time above provided and that the claim was filed as soon thereafter as reasonably possible, benefits may be payable for the full period of disability, provided that no benefits shall be paid unless the required claim is filed within twenty-six weeks after commencement of the period of disability.

(d) In the case of an employer who has received approval from the department of its sick leave plan or a collective bargaining agreement where either or both require further disability benefit payments from an insurer upon the exhaustion of sick leave payments, the employer shall initiate the filing of the claim for disability benefits with the insurer within ninety days of the last date sick leave payments were made.

Notes

Haw. Code R. § 12-11-35

[Eff 5/11/81; am 11/3/89] (Auth: HRS § 392-91) (Imp: HRS § 392-25, 392-26, 392-27, 392-44)