Disability Terms and Definitions

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. 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. Vocational Rehabilitation Services Those services identified in Rehabilitation Act of 1973, as amended, which are provided in an individualized plan for employment necessary to assist an individual with a disability in preparing for, securing, retaining, or regaining an employment outcome that is consistent with the strengths, resources, priorities, concerns, abilities, capabilities, interests, and informed choice of the individual. Family and Medical Leave Act The Family and Medical Leave Act of 1993 To grant family and temporary medical leave under certain circumstances Section 1619(a) Status The special SSI cash benefits provided to disabled individuals who lose eligibility for SSI benefits under the regular rules because they have earnings at the level that is ordinarily considered to represent substantial gainful activity. Licensed Clinical Social Worker (LCSW) Certification by a state as a licensed clinical social worker. Such licensure often requires at least two years experience with a direct client caseload under supervision. Continuation of Medicare Coverage (SSDI) You can receive at least 93 consecutive months of hospital and medical insurance after the trial work period. This provision allows health insurance to continue when you go to work and are engaging in SGA. Supplemental Security Income (SSI): A cash benefit authorized by Title 16 of the federal Social Security Act. Eligibility and benefits are administered by the federal Social Security Administration at field offices throughout each state. Blind Work Expenses (SSI) If you are blind, when we determine your SSI eligibility and payment amount we do not count any earned income that you use to meet expenses in earning the income. Outcome Payment System The system providing a payments under the Ticket to Work program to an employment network for each month, up to a total of 60 months, during which Social Security disability benefits and Federal SSI cash benefits are not payable to a beneficiary because of the performance of substantial gainful activity (SGA) or by reason of earnings from work.

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	Did You Know?
	SHMO means Social Health Maintenance Organization A managed system of health and long-term care services geared toward an elderly client population. Under this model, a single provider entity assumes responsibility for a full range of acute inpatient, ambulatory, rehabilitative, extended home health and personal care services under a fixed budget which is determined prospectively. Elderly people who reside in the target service area are voluntarily enrolled. Once enrolled, individuals are obligated to receive all SHMO covered services through SHMO providers, similar to the operation of a medical model health maintenance organization (HMO).