Filing a Claim for a Non-Occupational Illness or Injury

It is your responsibility to call Sedgwick if you believe that you will be absent due to an illness or injury that will continue for eight or more consecutive calendar days (please see the "Questions" box under the "The Short-Term Disability Plan" for contact information). You may report your leave of absence in advance of your leave start date. Applications for short-term disability leave filed more than 30 calendar days after your first date of absence will be denied. When calling to report your leave of absence, you will be required to provide the following:
Last day worked;
Date of disability;
Your health care provider's name, address, and telephone number;
The reason for your leave; and
Time that you have taken in the calendar year for sick time, vacation, personal days, etc.
Please Note: If you are unable to call to report your leave due to incapacitation, a designee (such as a spouse or domestic partner), your manager, or a Human Resources Business Partner can report your leave on your behalf.
If you are out of work 8 or more days due to a work-related illness or injury, please refer to Filing a Claim for an Occupational Illness or Injury section.
Timely reporting of your short-term disability leave will facilitate a timely determination of the short-term disability pay for which you may be eligible.
You should also follow your Line of Business absence reporting requirements when reporting a leave of absence. Advance notification will enable your line of business to make the necessary arrangements to cover your work during your absence.
Following your call to report your leave of absence, Sedgwick, the claims administrator for the STD Plan, will send you a leave request acknowledgement letter that includes disability claims forms and instructions for filing your disability claims to determine if you are eligible for short-term disability leave and pay. California and Rhode Island employees will also receive forms and instructions to apply for the appropriate state disability insurance. Please refer to the "Important Note About California and Rhode Island Disability Benefits" for important benefit information and claim filing guidance for these states.
Your claim will either be approved or denied within 45 days of its submission to Sedgwick, unless you are notified in writing that special circumstances require a delay in the decision. If your claim is denied, you will be notified in writing and provided with instructions on how to appeal the decision.

You and your licensed physician or registered or licensed behavioral health provider will be required to provide documentation suitable to the claims administrator to support your request for short-term disability leave by sending the completed claims forms to Sedgwick no later than 30 calendar days after the date your claim was filed (effective August 1, 2021). Please Note: Any short-term disability pay for which you may be eligible will not commence until your claim is approved. If you do not submit the required documentation suitable to the claims administrator and/or your claim is not approved within the subsequent time frame communicated to you, your claim will be denied and your employment may be terminated.
The documentation requested of you must be supplied at your expense and within 30 calendar days from the date you filed your claim for your request for short-term disability leave to be evaluated - both initially and on an ongoing basis. You also will be required to provide signed authorization to Sedgwick to obtain and release all reasonably necessary information that supports your short-term disability pay claim.
Based on the documentation supplied, Sedgwick will determine your eligibility for short-term disability pay, including the duration of benefits. If you continue to require leave, periodic updates of documentation may be required at your expense. Short-term disability pay will be suspended and your employment may be terminated if you fail to provide the necessary supporting documentation when it is required.
JPMorgan Chase reserves the right to require you to be examined by a licensed physician chosen by the firm, at the firm's expense, as often as reasonably necessary while your claim continues. Failure to comply with this examination may result in the denial, suspension, or termination of any short-term disability pay provided under the STD Plan, unless JPMorgan Chase agrees you have a valid and acceptable reason for not complying.

You should only provide your personal health information to Sedgwick — it should not be provided to your manager, Human Resources Business Partner, or any other JPMorgan Chase employee. Any personal health information that you submit to Sedgwick is treated as confidential and used only for appropriate purposes.

Sedgwick will work with your manager and your licensed physician to determine when you may return to work. You are expected to return to work at the conclusion of your approved short-term disability leave (unless your short-term disability leave is extended or you are approved for additional time off under another JPMorgan Chase policy, such as the Accommodating Disabilities and Temporary Work Restrictions Policy).
If you return to work (or attempt to return to work) prior to the expiration of your approved short-term disability leave, Sedgwick may require a release from your health care provider before allowing you to return to work.
Except when prohibited by applicable law, JPMorgan Chase may at its expense request that an employee who is returning from a leave complete a fitness for duty evaluation, performed by a licensed physician selected by JPMorgan Chase, if there is a reasonable belief that:
The employee's ability to perform essential job functions will be impaired by a medical or behavioral health condition, or
The employee will pose a danger to him/herself or others due to a medical or behavioral health condition.
If your approved short-term disability leave could potentially continue beyond 25 weeks, your claim is automatically referred to the JPMorgan Chase Long-Term Disability plan administrator — as long as you had JPMorgan Chase-provided or elected coverage under that plan before becoming disabled. If your short-term disability leave is not approved and you choose to apply for long-term disability benefits, please contact The Prudential directly at (800) 842-1718.