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Word
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Definition
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Accessibility
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Accessibility: As required by the Americans with Disabilities Act, removal of barriers that
would hinder a person with a disability from entering, functioning, and working within a
facility. Required restructuring of the facility cannot cause undue hardship for the employer.
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Accident, Industrial (Occupational)
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Accident, Industrial (Cccupational): In workers' compensation, an unforeseen,
unintended event that occurs in the course of an individual's employment and results in an
injury or illness.
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Accidental Bodily Injury
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Accidental Bodily Injury: A bodily injury that is the direct result of an accident and not
related to any other cause.
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Active Employment
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Active Employment: Working for an employer on a permanent full-time basis and paid
regular earnings and performing the material duties of a regular occupation. An employee
must be working the minimum number of hours as specified in the contract and the
employee's work site must be at the employer's usual place of business, an alternative work
site at the direction of the employer, or a location to which the job requires the employee to
travel.
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Actively At Work
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Actively At Work: Performing all the material duties and required hours of a job in the
location where the duties are normally carried out.
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Activities of Daily Living (ADL)
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Activities of Daily Living (ADL): The activities an individual needs to perform to live
independently. These include bathing, dressing, toileting, transferring, continence and
feeding.
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Adjudication
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Adjudication: In workers' compensation, the process of handling a claim, from first report
through final resolution. In group disability benefit plans, the process of determining
eligibility for benefit payment.
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Age Discrimination in Employment Act (ADEA)
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Age Discrimination in Employment Act (ADEA): A 1967 Federal law that prohibits
employers with 20 or more employees from discriminating on the basis of age in hiring, job
retention, compensation, and benefits. ADEA also sets requirements for the duration of
employer-provided Disability benefits.
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Americans with Disabilities Act (ADA)
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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.
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Americans with Disabilities Act (ADA):
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Americans with Disabilities Act (ADA): A 1990 federal law that prohibits discrimination
against persons with disabilities in the terms and conditions of employment. Employers
must provide reasonable accommodation for the physical or mental limitations of a qualified
individual to enable him or her to perform the essential functions of a job.
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Any Occupation
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Any Occupation: In LTD plans, any gainful work or service for which an employee is
reasonably qualified, taking into consideration his or her training, education, and
experience. A minimum income standard is not typically specified, but administrative
practice commonly requires 60% or pre-disability earnings.
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Any Occupation Period
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Any Occupation Period: The period during which employees will continue to receive LTD
benefits as long as they cannot perform any job for which they are reasonably qualified by
training, education, and experience; usually six to 30 months. See also own occupation
period.
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Appeals Process
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Appeals Process: As mandated by ERISA, a procedure whereby individuals covered by an employer-sponsored benefit plan can appeal a benefit determination with which they
disagree. The appeal must be filed within 60 days of receiving the determination. The employer or its agent (usually an insurance carrier or third-party administrator) must
communicate its decision within 30 days of the filing of an appeal.
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Attending Physician
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Attending Physician: The physician responsible for the admitting and directing of care
and services provided to a patient while in an acute, skilled or rehabilitation facility. See
treating physician.
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Attending Physician Statement (APS)
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Attending Physician Statement (APS): A report, filled out the insured's physician documenting
current and prior health history. An APS helps the insurance company in the evaluation
process of approving an application or a claim.
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Average Weekly Wage (AWW)
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Average Weekly Wage (AWW): In workers' compensation, the wage used to determine
the amount of temporary Disability benefits for which an employee is eligible. Calculation
varies by state law.
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