Active, Full-time Employee: An individual must work for the employer on a regular basis in the usual schedule of the employer's business to be considered an active, full-time employee and eligible for coverage. Usually, a minimum number of hours of regular work is specified.

Benefit Percentage: The benefits payable are often determined as a percentage of the insured's pre-disability income up to an overall maximum benefit amount.

Conversion Privilege: If this is included, it allows employees who are terminating employment (usually not being discharged) to continue some or all of their LTD coverage at their own expense without submitting evidence of insurability.

Definition of Total Disability: This could be the most important provision in a disability contract. It is the definition of disability that will be used to determine an employee's eligibility for benefits.

Own Occupation (Own Occ): Under this definition, an insured will be considered disabled only if he / she is not able to fulfill the duties of his or her occupation.

Any Occupation (Any Occ): Under this definition, an insured will be considered disabled only if he/she is unable to work in any occupation for which he/she is qualified by education, training, or experience. This is closely related to the definition that the Social Security Administration uses in determining disability.

Definition of Partial/Residual Disability: This further definition of disability applies when an insured is able to return to work part-time or even full-time (with a loss of earnings). If the employee is working in this limited capacity and is earning less than a certain level of income, he or she will still be eligible for limited benefits under the plan. Not all disability insurance carriers use this terminology to describe a "part-time" work situation, but most provide some type of benefit to encourage return to work.

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.

Evidence of Insurability: Group disability coverage is generally sold as "guaranteed issue" which means that evidence of insurability is not required. However, under certain circumstances (e.g., late enrollment or a high benefit maximum), an employee must provide medical or financial information as proof to the insurance company that he or she is insurable.

Exclusions: There are specific provisions included in group disability plans which exclude coverage in certain situations. Typically, a plan will not pay benefits for disabilities arising from war, participation in a riot, commission of a felony, or self-inflicted injury.

Family Care Expenses. A disabled employee who has family care responsibilities may need extra help when trying to return to work. This type of benefit provides an incentive to the employee who is taking part in a rehabilitation program by allowing credit or partial reimbursement for certain expenses incurred for family care. This is normally an optional benefit under most long term disability policies.

Indexing: Indexing is designed to provide some protection against inflation. After the first year of disability, a disabled employee's pre-disability earnings are usually increased (or indexed) by a certain percentage on an annual basis.

Limitations:. There may be specific provisions included in group disability plans that limit coverage in certain situations. Often only limited benefits are payable for specific conditions or under specific circumstances (e.g., mental illness and pre-existing conditions).

" Mandatory" Rehabilitation: Based on the principle that most people want to work in order to lead active, productive lives, a "mandatory" rehabilitation provision encourages disabled employees to participate in rehabilitation efforts whenever appropriate. Such a stipulation allows for termination of benefits if the employee refuses to cooperate or participate with a rehabilitation plan.

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