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Disability Plan
Membership Application

(pdf format)
Disability Claim Statement
(pdf format)
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The Plan - The PSEA Member Disability Plan (DP) was established by your PSEA Board of Trustees in 1923. As a member-funded plan, DP provides additional financial assistance to members who become disabled and are unable to work.

Benefits Of Membership - The disability plan pays benefits in addition to sick-leave pay and Worker's Compensation. The additional money adds financial security to members who are off work due to a disability.

Cost Of Membership - For only $5.00 per month, you can become a member of this Plan. For added convenience, an automatic monthly payroll deduction is established.

Who May Join - If you are an employee of Pacific Gas & Electric Company or its subsidiaries, you can join the Plan once you become a member of PSEA.

How To Join - Complete a PSEA Member Disability Plan application.

How Much The Plan Pays - If you become disabled and file a claim, your benefits will be calculated according to your length of membership in the plan.

Years of MembershipWeekly Benefit
Less than 5 years $60
5 years, but less than 10 years $70
10 years or more $90

Benefits are paid every two weeks or, for shorter periods of disability, as soon as the amount due can be determined.

Waiting Period - DP benefits begin after the seventh day of your qualifying disability, even if you are hospitalized on the first day of disability. No benefits will be paid the first 30 days of membership in the Plan.

Maximum Benefits Period - The maximum time you can receive benefits from this Plan is 25 weeks per disability. If your disability extends 25 weeks, benefits will cease until after you return to work for at least 15 consecutive weeks, with no absences for illness.

However, in accordance with the State of California Employment Development Department guidelines, claims for pregnancy are paid up to four weeks prior to the estimated date of delivery and up to six weeks after delivery, if there are no complications.

Benefits For Recurring Disabilities - If after receiving benefits, you return to work and are again disabled within four weeks, the second period of disability will be considered as a continuation of your first disability, unless it is the result of an entirely new and unrelated cause. If it is considered a continuation of your first disability, the seven-day waiting period is waived. Benefits paid for the combined periods of disability will not exceed the maximum 25 weeks.

Benefits Exclusions - The Plan does not cover:

Disabilities resulting from unlawful acts or any act of war.

Disabilities or illness incurred during any period when failure to pay contributions or assessments to the plan, or while dues were in arrears.

Disability which occurs while on a personal leave of absence over 90 days.

The above does not constitute a complete list of exclusions. For a complete list of exclusions, please contact the PSEA Benefits Department.

How To File A Claim - Obtain a PSEA Member Disability Plan Claim Statement from the PSEA Benefits Department.

Complete the front portion of the form. Have your doctor complete the back portion and return the completed form to the PSEA Benefits Department. It is your responsibility to submit a completed claim form to the PSEA Benefits Department within six (6) months of the first date of disability.

For More Information - For more information about the PSEA Member Disability Plan and its regulations, please contact the PSEA Benefits Department at (925) 246-6212.

PSEA information is also available on the PG&E Intranet under Employee Services & Activities, or you can locate us on the internet at http://psea.info.

Pacific Service Employees Association
1390 Willow Pass Road
Suite 240
Concord, CA 94520