
Material
duties - In LTD plans, the basic and essential requirements
of a job. To be considered disabled, employees must be unable to perform material
duties, not incidental or insignificant tasks.
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.
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.
Maximum
monthly benefit - The highest dollar amount that an employee
who has been disabled will receive each month from the employer's LTD plan.
Maximum
medical improvement (MMI) - Maximum medical improvement
(MMI) - The point at which an employee who has been disabled reaches a plateau
in recovery, so that any remaining impairment is considered to be permanent.
In workers' compensation, MMI triggers the transition from temporary to permanent
Disability benefits.
Medical
necessity - Services/procedures which are approved in accordance
with recognized medical standards as effective and appropriate and are essential
to retard, reduce or eliminate an impairment.
Medical
only - A type of workers' compensation claim that involves
no wage replacement (because no work time was lost) but only reimbursement of
medical expenses.
Medical
record - A written or electronic account of a patient's
medical history, current illness, diagnosis, details of treatments, chronological
progress notes, and discharge recommendations. This is a legal document the
patient is entitled to read and is authenticated by the physician's signature.
There are strict rules regarding the confidentiality of the medical record.
Medicare
- Federally administered health insurance plan intended primarily for person
age 65 and older; also available to individuals with disabilities after they
have received Social Security Disability Insurance benefits for 24 months. Medicare
has two parts, part A covers hospital costs; part B covers medical expenses.
Mental
illness - A psychiatric or psychological condition regardless
of cause such as schizophrenia, depression, manic depressive or bipolar illness,
anxiety, personality disorders and/or adjustment disorders or other conditions.
These conditions are usually treated by a mental health provider or other qualified
provider using psychotherapy, psychotropic drugs, or other similar methods of
treatment.
Mental
illness limitation - Limit
on the period of time (often 24 months) over which LTD benefits will be paid
when an employee is disabled as a result of mental, emotional, or nervous condition
that is being treated on an outpatient basis. The limitation does not apply
while the individual is confined to a hospital or institution.
Minimum
monthly benefit - The lowest
dollar amount an employee who has been disabled will receive each month from
the employer's LTD plan. Some plans guarantee a minimum benefit, regardless
of income received from other sources.
Monopolistic
state fund - In certain states,
a fund set up as an agency of a state government, from which all employers who
are not self-insured or covered by group self-insurance are required to purchase
workers' compensation insurance.
Morbidity
- The expected incidence and severity of illness and accidents
in a specified group.