
Deductible - The portion of a loss for which the policy-holder is
responsible. In workers' compensation, the injured individual is generally not
liable for a deductible.
Deductible sources of income - Income from deductible sources listed in
the plan which you receive or are entitled to receive while you are disabled.
This income will be subtracted from your gross disability payment.
Dependent - A spouse or unmarried child under age 19 (if a child is a
full-time student in an accredited school, age 23 or 25 depending upon the
provisions of the contract). Children can include biological, adopted, foster
and step who are supported by the insured.
Diagnostic and Statistical Manual of Mental Disorders [Fourth Edition] (DSM-4)
- A tool used by the medical and psychological communities to identify and
classify behavioral, cognitive, and emotional problems according to a standard
numerical coding system of mental disorders.
Dictionary of Occupational Titles (DOT) - A book of job classifications
that specifies the duties of each job listed; maintained and updated by the
U.S. Department of Labor as new jobs are created and technologies change.
Disability - A physical or mental impairment that prevents or restricts
normal achievement. Something that hinders or incapacitates.
Americans with Disabilities Act (ADA) - A physical or mental impairment
that substantially limits one or more of an individual's major life activities;
also having a record of such an impairment or being regarded as having such an
impairment.
disability benefit - 1) Amount payable under a group disability (STD or
LTD) plan to a covered employee who meets eligibility criteria typically
between 50% and 70% of pre-disability income. Salary continuation plans often
provide 100% of pre-disability income prior to eligibility for STD/LTD. 2) A
provision added to a life insurance policy providing for a waiver of premium
and sometimes payment of monthly income if the insured becomes totally and
permanently disabled.
Disability, duration guidelines - Guidelines that describe the duration
of different types of disabilities according to diagnosis, symptoms, severity,
and occupational factors. Duration guidelines may be used to evaluate
disabilities and forecast an expected return-to-work time frame, such as in
duration control guidelines.
Disability, earnings - The earnings you receive while you are disabled
and working, plus the earnings you could receive if you were working to your
maximum capability.
Disability, employer-sponsored plans - A functional limitation that
impedes the performance of material duties of an employee's customary work.
Disabilities are usually classified as total (permanent total / temporary
total) or partial (permanent partial / temporary partial).
disability, full maternity - If an insured employee becomes disabled as a
result of a pregnancy or complications, the disability will be covered on the
same basis as any other illness.
Disability, individual with - Under the ADA, a person who has a physical
or mental impairment that substantially limits one or more of that person's
major life activities, has a record of such impairment, or who is regarded as
having such an impairment.
Disability, maximum benefit - For disability benefits, the maximum dollar
amount an insured will receive while disabled. For health benefits, the total
dollar amount the insurer will pay on any given individual.
Disability, maximum benefit duration - The longest period for which
employer-sponsored disability benefits will be paid, provided that the employee
remains continuously disabled. Typically, the lesser of the number of years
until Social Security normal retirement age or the age specified in the plan.
Disability, maximum monthly benefit - The highest dollar amount that an
employee who has been disabled will receive each month from the employer's LTD
plan.
Disability, pension - An annuity payable from a qualified pension plan to
an eligible employee who becomes disabled before normal retirement age. May be
paid as a supplement to another employer-sponsored disability benefit plan or
as a reduced pension.
Disability, permanent partial - A disability in which some portion of
earning power is lost, and the loss is expected to last for the individual's
lifetime.
Disability, permanent total - A disability in which all earning power is
lost, and the loss is expected to last for the individual's lifetime. In many
states, workers' compensation laws specify certain injuries as permanent total
disabilities even if the injured person is able to do some work. Compensation
may be limited by time or amount, or it may run for life.
Disability, social security - The inability to engage in any substantial
gainful activity because of a medically determinable physical or mental
impairment that can be expected to result in death or that lasts or can be
expected to last for 12 months or more.
Disability, temporary partial - A disability in which some portion of
earning power is lost for a period of time, but from which complete recovery is
expected. Benefits are generally based on a percentage of the difference
between the person's pre-disability wage and what he or she can earn during
disability.
Disability, temporary total - A disability in which all earning power is
lost for a period of time, but from which complete recovery is expected.
Benefits are payable until the individual returns to employment at some level
of pre-disability earnings.
Disability, workers' compensation - A physical or psychological condition
that occurs in or results from the workplace and that actually or presumptively
results in a loss of earning power. Disabilities may be total (permanent total
/ temporary total) or partial (permanent partial / temporary partial).
Disability Management - Programs that seek to prevent disability, reduce
the cost impact of disability, and provide mechanisms to promote maximum
functional recovery and return-to-work. Integrated disability management refers
to those programs that are implemented across all disability plans (e.g., STD,
LTD, WC, and salary continuation) in addition to, increasingly, group health
plans.
Disease Management - A coordinated care approach focused on prevention,
early identification, and intervention in the chronic disease process. Services
are typically provided by employer-sponsored health plans, contracted or "carve
out" provider groups, or through the employer's occupational health facility.
By controlling factors that determine the early course of a chronic condition,
disease management proponents attempt to show that such programs improve
individual health status, control medical costs, and reduce the incidence of
work limiting disability.