Employee Weekly Supplemental Disability Benefits
(Self-Insured Benefit)

Benefit Amount and Qualifications: A Weekly Disability Benefit of $150.00 ($30 per work day) will be payable to you if, while eligible, you become disabled so as to be unable to work. This benefit will be paid for a period of continuous disability not to exceed 26 weeks from the onset of the specific illness or injury that resulted in the claim.

In order to be eligible to receive this benefit, you must submit proof that you are eligible and receiving either New York State Weekly Disability or Workers' Compensation Benefits or similar benefits under the laws of any State of the United States.

Limitations and Exclusions:

1. No Supplemental disability benefits will be payable for any period for which you are entitled or receiving Unemployment Insurance Benefits, Vacation Pay or Retirement Income Benefits under an industry Pension and Retirement Benefit Plan.
2. No benefits will be payable for any period of disability resulting from any injuries sustained:

1. while engaged in any employment other than that of a Metal Tradesmen,
2. while participating in the commission of a felony,
3. while serving in the armed services of any country or International Authority.

How to File for Benefits: To file for benefits, you must notify the Fund Office to obtain the appropriate claim form. Complete this form and submit it together with a copy of your New York State Disability or Workers' Compensation check. Thereafter, during the period of disability, you will be required to furnish a copy of your weekly disability check as proof of your continued disability.

All claim forms, together with required proofs, must be filed with the Fund Office within 90 days from the date of disability. Failure to file a claim within the required time period shall result in a forfeiture of benefits for any period of disability exceeding the 90 days from the date of disability, unless the claimart can furnish satisfactory evidence showing that it was not reasonably possible to file wihtin the requried time period. Notwithstanding anything herein to the contrary, no benefits will be paid for a period of disability for which a claim form has not been filed within the 12-month period following the date of disability.

Continuation of Eligibility: During the period in which you qualify for the Supplemental Disability Benefits program, you and your eligible dependents will remain covered in the Welfare Fund.

Assignment: No assignment can be made of this benefit.