II. Background

  1. Covers inability to work longer than 90 days
  2. Insures continued income not covered by other insurance

III. Definitions

  1. Insurance based on occupation
    1. Own Occupation Insurance (Professionals)
      1. Covers inability to work in own occupation
    2. Regular Occupation (non-professional occupations)
      1. Covers inability to work in regular occupation
      2. Not specific to patient returning to his usual job
      3. Reverts to Any Occupation after 2 to 5 years
    3. Any Occupation
      1. Covers inability to work in any capacity
  2. Insurance based on duration
    1. Short-term Disability (accident or sick insurance)
      1. Partial salary replacement for 13, 26 or 52 weeks
      2. Patient unable to return fully to work
    2. Long-term Disability
      1. Follows 26 to 52 week waiting period
      2. Covers extended Disability
      3. First 1-2 years Total Disability Criteria
        1. Unable to perform regular occupation
      4. After first 1-2 years Total Disability Criteria
        1. Unable to perform any gainful employment
        2. Employment must be reasonably appropriate
          1. Education, training, and experience
          2. Physical and mental capacity

IV. Protocol: Certification with Form DB-450

  1. Complete accurately and completely to prevent delays
  2. Define patient's diagnosis
    1. Maintain confidentiality per local law
  3. Express Symptoms and objective findings
  4. Track important dates
    1. Date of first treatment
    2. Date of most recent treatment
    3. Date of Disability onset
    4. Date of anticipated work return (avoid "uncertain")

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