Disability Claims Process

If you need to file a salary continuance, short term disability (STD), or long term disability (LTD) claim, contact the MetLife Leave of Absence Reporting Line at 1-866-WINN123 (1-866-946-6123), option 1. Or, visit MyBenefits at www.metlife.com/mybenefits.

Claim intake and data gathering

• Inform your supervisor/manager of your leave of absence request.
• Notify MetLife to initiate your salary continuation, STD, or LTD claim – you will be given a claim number at the end of the call. You may call or initiate your claim via MyBenefits at www.metlife.com/mybenefits.
• MetLife may contact you for additional details about you, your job, your condition, and your treatment plan and provider.
• MetLife will then mail an Acknowledgement Package to you with important information that requires action.

Initial review and decision

• You will be notified of the initial decision via phone and letter.
• You can check the status of your claim by visiting www.metlife.com/mybenefits.
• MetLife will keep you informed on the status of your claim and will notify you of additional information that is needed.
• If applicable, MetLife will discuss your Return to Work options with you and help determine an expected return to work date.

Ongoing evaluation

• MetLife will periodically contact you and your health care provider(s) to evaluate your status, treatment plan, and functional abilities.
• MetLife will contact you by phone and send a letter to inform you of changes in claim status, such as an extension or closure.
• If you are a salaried associate and continue to remain disabled after 90 days of salary continuance, you may be eligible for STD benefits. Should this occur, MetLife will automatically refer your salary continuance claim for an STD claim review.
• If you continue to remain disabled after 180 days of STD, you may be eligible for LTD benefits. Should this occur, MetLife will automatically refer your STD claim for an LTD claim review.
• You will be contacted to discuss your claim and if you are expected to remain disabled, the appropriate information and forms will be mailed to you to initiate your STD/LTD claim*.
• Southeastern Grocers’ Associate Assistance Program is available if needed during your time of disability. The number is 1-877-240-6863.

Return to work

• You may be required to participate in a rehabilitation/Return to Work Program. You may be contacted by your claims specialist, a nurse clinician, and/or a vocational rehabilitation consultant to discuss your return to work options, when appropriate.

Before you return to work, Southeastern Grocers requires that your health care provider complete a return to work note or Release to Work form; a copy of the form is included in your STD Acknowledgement Package.

• You must return a copy of the form to your supervisor and MetLife. The form can be sent to MetLife by fax at 1-800-230-9531, uploaded to www.metlife.com/mybenefits, or emailed to oriskanymetlife@metlife.com.

– If there are no restrictions on your return to work, contact your supervisor and confirm the date you will return, per the date indicated on your form.

– If there are restrictions provided on the Return to Work form, MetLife will confirm whether Southeastern Grocers can accommodate those restrictions. Your supervisor or HR business partner will contact you regarding your return to work status

If your claim is denied

• MetLife will contact you by phone and send a letter to explain why your claim was denied and provide information about how you may file an appeal. MetLife will also notify Southeastern Grocers of your claim denial.
• Your appeal must be received by MetLife within 180 days from the date of your decision letter and sent to:

• MetLife will send you a letter to let you know when your appeal request was received and when to expect an appeal decision.

For more information on this process, contact Southeastern Grocers Human Resources call center at 1-855-473-6763.