* 1. If you are currently employed, list all employer(s).

* 2. How long have you worked with your current employer?

* 3. Do you feel as though it is important for companies to offer supplemental disability pay to employees who are unable to work due to a medical condition

* 4. Does your current employer offer supplemental disability pay to employees who are disabled from work due to a medical condition? Ex: short term disability. If more than one employer, do one/both offer supplemental pay?

* 5. If answered yes to question 4, are all employees eligible to receive this benefit starting date of hire?

* 6. If there are requirement to qualify for disability pay select all that apply

* 7. If your employer offers short/long term disability does your employer administer those benefits or an outsourcing client/company?

* 8. Have you ever been on a medical leave of absence? (Do not feel obligated to reveal and personal information)

* 9. If you answered yes to question 8, was the handling of your claim a good and/or simple process? Or were you unhappy with your experience?

* 10. If you have been on any medical leaves of absences, what were the duration of the leave(s)?

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