Glossary of Long Term Disability Acronyms

Access request: when an individual or an individual’s lawyer requests an insurance company to provide them with a copy of the disability claims file
ACM: Abilities Claims Consultant – the individual/claims person/adjuster typically responsible for the adjudication of the LTD file prior to the commencement of litigation
ADLs: activities of daily living
APS: Attending Physician’s Statement
Call Record: an electronic document created to record telephone discussions during the adjudication of a disability claim
C/B: call back
CHESS: an electronic program/database/system where various claims information is located and stored (i.e. policy particulars, benefit amount calculations, payment details)
COD: change of definition - the date the definition of disability changes under the policy
Commensurate Amount: the amount an individual would have to earn in order to satisfy the any occupation test
DMAP: electronic notes entered and recorded by the claims person/adjuster/individual(s) involved in the adjudication of a claim
DOB: Date of birth
DOC: Date of Coverage – the date an employee is eligible to receive coverage under the group policy
DOD: Date of Disability – the date the medical symptoms/condition first prevent the individual from being able to work
DOH: Date of Hire – the date the employee was hired
DX: diagnosis
EE: employee
EP ends: the date employment insurance benefits end
ER: the employer
ECI: salary continuance/STD benefit equivalent
Elimination Period: the period an individual is required to wait before they are eligible to receive benefits under the policy
ETE: education, training and experience
FAE: Functional Abilities Evaluation
Forecast Date (FD): indicates an anticipated/predicted/forecasted claim resolution date (ex. symptoms to resolve, return to work etc.)
FPD: the first date benefits were paid
FTI: functional telephone interview – a telephone interview conducted on behalf of an insurance company, in effort to assess what the individual is able to do/level of function
FU: follow up
Fund Arrang: indicates who is responsible for the payment of benefits (ex. the insurance company or the employer – see also refund and non-refund)
Government DI: group disability policy issued to the Government of Canada
GP: family doctor
GRTW: gradual return to work
HMC: health management consultant – an individual or group that is used by an insurance company for the purpose of rehabilitation
HP: health partner – similar/interchangeable with the term medical consultant
JD: job description
LDW: last day worked – the last day the individual worked
LMVM: left message voice mail
Max Bnft Period: max benefit period – the maximum period for which benefits can be paid under the policy (ex. age 65)
Medical Consultant: a medical professional that is consulted, for the purpose of providing a medical opinion for an insurance company
MDA Guidelines: Medical Disability Advisor guidelines used to reference typical disability recovery periods
MO: medical opinion
MX: medication
NCQR: New Claim Quality Review – an internal review, conducted by an insurance company during the adjudication of an LTD file, for quality control purposes
Non-Refund: the insurance company is responsible for the payment of benefits
Non-Stand LTD Change of Def: a non-standard change of definition applies (i.e. something other than the typical 2 years own occupation test followed by the any occupation test)
O/P: overpayment – an overpayment of disability benefits has resulted
PM: Plan Member – the individual/employee covered under the group plan (i.e. our client)
PM Code: indicates adjudication priority (ex. U = urgent / high priority - for example, recovery or return to work is anticipated in the near future, Opportunity = an opportunity has been identified, for example, to work with the individual toward rehab, recovery and ultimately a return to work)
Pre x: Pre-existing medical condition(s)
PS: Plan Sponsor – the employer / holder of the group policy
PX: prognosis / expected period for recovery
QD: Qualifying Date - the earliest date LTD benefits are eligible to be received if approved
R&L's: restrictions and limitations
Recovery Score: a numerical score assigned to indicate an anticipated/forecasted/predicted likelihood of the LTD claim being resolved either by way of a return to work or some other form of resolution/settlement
Refund: the employer will ultimately be responsible for the payment of benefits
RTW: return to work
SDCC: Senior Disability Claims Consultant – an LTD claims individual/adjuster typically assigned carriage of an LTD file once litigation has been commenced
SLC: salary continuance
SX: symptoms
Team Leader/Manager: an individual at an insurance company that a claims consultant/ACM/adjuster reports to
TDAO: Totally Disabled Any Occupation
TDOO: Totally Disabled Own Occupation
TSA: Transferrable Skills Analysis – an analysis/report prepared to identify an individual’s education, training and experience that could potentially be applied toward securing an alternative occupation
TX: treatment
Ultera: an electronic document storage system