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Word
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Definition
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Deductible
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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.
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Deductible Sources of Income
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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.
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Dependent
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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.
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Diagnostic and Statistical Manual of Mental Disorders [Fourth Edition] (DSM-4)
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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.
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Dictionary of Occupational Titles (DOT)
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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.
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Disability
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Disability: A physical or mental impairment that prevents or restricts normal achievement.
Something that hinders or incapacitates.
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Disability Benefit
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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.
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Disability Management
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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.
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Disability, Duration Guidelines
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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.
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Disability, Earnings
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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.
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Disability, Employer-Sponsored Plans
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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).
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Disability, Full Maternity
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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.
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Disability, Individual with
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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.
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Disability, Maximum Benefit
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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.
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Disability, Maximum Benefit Duration
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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.
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Disability, Maximum Monthly Benefit
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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.
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Disability, Pension
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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.
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Disability, Permanent Partial
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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.
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Disability, Permanent Total
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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.
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Disability, Social Security
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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.
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Disability, Temporary Partial
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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.
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Disability, Temporary Total
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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.
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Disability, Workers' Compensation
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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).
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Disease Management
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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.
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