Disability Terms and Definitions

ADA Title I: Employment Title I requires employers with 15 or more employees to provide qualified individuals with disabilities an equal opportunity to benefit from the full range of employment-related opportunities available to others. Medicaid provider A professional or medical facility who is enrolled as a provider for the Medicaid Program by entering into a contract with the Medicaid Program to provide medical services to Medicaid eligible recipients. By entering into this contract the professional has agreed to abide by all rules and regulations governing the Medicaid Program. Benefit Percentage The benefit payable is usually determined as a percentage of the insured's pre-disability income up to an overall maximum benefit amount. Maximum Benefit Period (Benefit Duration) This is the maximum length of time for which benefits are payable under the plan as long as the employee remains continuously disabled. Conversion Privilege If included, this option allows employees who are terminating employment to continue some or all of their LTD coverage at their own expense without submitting evidence of insurability. PD Presumptive Disability. Only for SSI claims. Enables an early (presumptive) allowance of benefits for 6 months based on a substantial probability of a final allowance when all required documentation is obtained. A PD can be reversed to a denial, but the claimant does not return the PD benefits. Survivor Benefit The survivor benefit is a lump sum payment that will provide benefits to the insured's eligible waiting period can also be the time period between when a disability occurs and when payments from the disability insurance policy begin. Social Security and Social Security Disability Insurance (SSDI) Monthly cash benefit administered by the federal Social Security Administration (SSA) to retired or disabled workers and their qualified dependents. Beneficiaries must be 62 years of age or older, or disabled, and have enough work "credits" to be qualified. Elimination Period This is the period of time between the date the disability commences and the beginning of the benefit payment period. It is the period during which an employee must be disabled before payment of benefits begins. It is sometimes referred to as the Qualifying Period. Continuing Disability Review (CDR) An evaluation of an individual's impairment(s) to determine whether the person is still disabled within the meaning of the law for purposes of eligibility for SSI and OASDI benefits.

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	Did You Know?
	EPSDT stands for Early and Periodic Screening, Diagnosis, and Treatment Program A program mandated by law as part of the Medicaid program. The law requires that all states have in effect a program for eligible children under age 21 to ascretain their physical or mental defects and to provide such health care treatments and other measures to correct or ameliorate defects and chronic conditions discovered. The state programs also have active outreach components to inform eligible persons of the benefits available to them, to provide screening, and if necessary, to assist in obtaining appropriate treatment.