|
|
|
Word
|
Definition
|
|
|
|
Material Duties
|
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
|
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
|
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 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.
|
|
|
|
|
|
|
|
Maximum Monthly Benefit
|
Maximum Monthly Benefit: The highest dollar amount that an employee who has been
disabled will receive each month from the employer's LTD plan.
|
|
|
|
|
|
|
|
Medical Necessity
|
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
|
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
|
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
|
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
|
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
|
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
|
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
|
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
|
Morbidity: The expected incidence and severity of illness and accidents in a specified
group.
|