How much is the social security disability benefit payable to a covered worker?

Your benefit amount is based on the quarter with your highest wages earned within the base period.

A base period covers 12 months and is divided into four consecutive quarters. The base period includes wages subject to SDI tax that were paid about 5 to 18 months before your disability claim began. The base period does not include wages paid at the time your disability begins. For a DI claim to be valid, you must have at least $300 in wages in the base period. The following information may be used to determine the base period for your claim.

If a claim begins on or after January 1, 2022:

January, February, or March:
The base period is the 12 months ending last September 30.
Example: A claim beginning February 14, 2022, uses a base period of October 1, 2020, through September 30, 2021.

April, May, or June:
The base period is the 12 months ending last December 31.
Example: A claim beginning June 20, 2022, uses a base period of January 1, 2021, through December 31, 2021.

July, August, or September:
The base period is the 12 months ending last March 31.
Example: A claim beginning September 27, 2022, uses a base period of April 1, 2021, through March 31, 2022.

October, November, or December:
The base period is the 12 months ending last June 30.
Example: A claim beginning November 2, 2022, uses a base period of July 1, 2021, through June 30, 2022.

This optional benefit provides you with a portion of your monthly insurance salary if illness or injury keeps you from working. For complete information on coverage for Texas Income Protection Plan (TIPP) long-term disability insurance, please visit the TIPP website. 

Monthly Benefit 

• Maximum: lesser of 60% of your monthly salary (capped at $6,000 per month for individuals making more than $10,000 monthly).
• Minimum: not less than 10% of your income (occurs if you are receiving Worker’s Compensation, a disability retirement benefit, Social Security benefits, or other disability benefits).

Coverage Period 

The maximum benefit period depends on your age at the time of disability. Once you are approved for benefits and complete the required waiting period, benefits are paid until you return to work, reach full Social Security Retirement Benefits age, or are no longer considered totally disabled under the plan. If you become disabled at age 69 or older, benefits are payable for up to 12 months.

Enrollment

• You can enroll in this plan during your Hire or Rehire event without evidence of insurability (EOI) and coverage would begin right away.
• You can enroll in this plan during your first 31 days of employment without EOI and coverage would begin the first of the following month.
• If outside your first 31 days of employment, you can apply through EOI if you have a qualifying life event (QLE) like birth or marriage and coverage will begin the first of the month following the approval or during Summer Enrollment and coverage will be begin September 1 or first of the month following the approval.

Eligibility

• Certified as totally disabled by an approved practitioner.
• Completed the waiting period.
• Approved for disability payments by third-party administrator.

Waiting period

Before the plan begins to pay you benefits, you must use your sick leave balance (including extended sick leave, sick leave pool, and/or donated sick leave) or finish a 180-day waiting period, whichever option is a longest. Sick leave use and waiting period run concurrently. However, you are not required to use your vacation or other annual leave.

If you receive disability payments from other sources, such as Social Security disability or Workers’ Compensation, TIPP benefit payments are reduced. This will also apply to members that are paid short‐term and long‐term disability benefits simultaneously.

You must file your disability claim within one year after the first day of your disability in one of two ways: online using the self‐service option on the TIPP website or call TIPP Customer Care.

Pre-existing condition clause

In the three months prior to the date coverage begins, if you have a medical condition for which you received:

• medical treatment,
• medical advice,
• medical services, or
• prescription drugs or medicine.

Disability benefits for that specific condition would not be covered for the first six months of enrollment. After the six-month period ends, you must fulfill the waiting period before the plan begins to pay benefits. 

For your convenience, ERS has made the coverage historical plan documents available.

If you receive disability payments from other sources, such as Social Security disability or Workers’ Compensation, TIPP benefit payments are reduced. This will also apply to members that are paid short‐term and long‐term disability benefits simultaneously. For example, if a member is paid short-term disability and long-term disability benefits concurrently, the long-term disability benefit would be reduced.

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