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Disability Income Insurance and Disability Benefits Programs

4 States that allow maternity benefits in normal pregnancy are

California, Hawaii, New Jersey, Rhode Island

49 days

Time limit to claim temporary disability benefits in California

52 weeks

Time limit that a person can keep getting state disability insurance

After a month he retired, Roger Reagan had a gallbladder operation. Can he receive tsdb?

No, because he is retired and has no state disability insurance

After the 7th day

Waiting time period to start getting state disability benefits (first day confinement only in Hawaii and Puerto Rico)

Betsy C Palm works in Hawaii and had an emergency appendectomy. She was hospitalized 3 days. Will she receive state disability benefits?

No, she will receive benefits only if she was ill for more than a week

Betty T Kraft had to stay home to take care of her sick daughter, she applied for state benefits, will she be paid?

No, Betty herself must be ill to receive benefits

DISABILITY DETERMINATION SERVICES

A SSA DIVISION THAT DETERMINES A PERSON ELIGIBILITY FOR A FEDERAL DISABILITY PROGRAM

Disability Income Insurance

Health insurance that provides income when a person is unable to work because of a nonindustrial illness or injury

Double indemnity

Provision that some insurance contracts that pay twice the face amount of the policy if accidental death occurs have

Dr. Kay examines Ben Yates and completes a sability income claim form. Name documents that may be requested to justify payments of benefits

Employer's records, Employee's wage statements and/or tax forms, Medical records of attending physician

EXCLUSIONS

PROVISIONS THAT LIMIT THE SCOPE OF INSURANCE COVERAGE

Ezra Jackson makes no contribution toward the policy premiums. Are his monthly benefits taxable?

yes, because he has not made any payments toward the premium

Frank E Thompson is a part-time worker that had an accident skiing, can he still collect benefits?

Yes, as long as he has meet his quarterly amount that the state requires, he is eligible

Gene went back to work for 3 weeks and then become sick again. Would he be able to collect benefits again?

Yes, because more than 15 days have elapsed between his return to work and the recurrence of his illness

HOSPITAL BENEFITS MAY BE PAID FOR INJURY UNDER HAWAII AND PUERTO RICO TDB

TRUE

IF A WOMAN HAS AN ABNORMAL CONDITION DURING PREGNANCY SHE MAY NOT RECEIVE BENEFITS

FALSE

INDEMNITY

ANOTHER DISABILITY INCOME INSURANCE TERM FOR BENEFITS

Jane M Lambert fell in her backyard and fractured her ankle, she was unable to work for 28 weeks. For how long she will be able to collect?

The 28 weeks

Jerry L Slate is out of a job, but he is offered a job interview that he can't attend, because he is sick. Can he still collect?

Yes, because at the time of the interview he is still sick

John S Thatcher applied for temp state disabilitty after 1 week of his injury will he be paid?

Yes, benefits become payable after 7th day of disability

THE MOST IMPORTANT ITEM REQUIERED IN A CLAIM FOR STATE BENEFITS IS THE SSN

TRUE

Name the 2 methods or options to bill in a Veterans Affairs pt case seen on the ER by Dr. Onion

Physicians may bill VA outpatient clinic, or pt may pay physician and get reimbursed by the VA by following the back of his VA instructions

Name the states and territory that have nonindustrial state disability programs

California, Hawaii, New Jersey, New York, Puerto Rico, Rhode Island

Nick Tyson has recovered since a previous illness ended and becomes ill again with the same ailment. Is he entitled to state disability benefits?

Yes, if 15 days have elapsed

NONCANCELABLE CLAUSE

WORDS TO LOOK FOR THAT MEAN THAT THE PREMIUM CANNOT BE INCREASED AT RENEWAL TIME

Peggy Jonson has an ectopic pregnancy and is unable to work because of complications of this condition. Can she receive temp disability benefits?

Yes

Residual or Partial Disability

When an individual is insured under an income disability insurance policy cannot perform one or more of his or her regular duties

The SSAdministration may hire a physician to do one of this 3 roles

Physician treating the pt, Consultative examiner, or full or part time medical or psychologic consultant

SSDI and SSI

2 federal programs for people younger than 65 with a severe disability

Time frame for a Veteran to claim an injury

Within one year of injury

TO BE ELIGIBLE TO APPLY FOR DISABILITY BENEFITS UNDER SS, YOU MUST DISABLE FOR NO LESS THAN 12 MONTHS

TRUE

Trent Walters a permanently disabled individual, applies for federal disability benefits. To be eligible he must be no more than

1year old

Vincent P Michael was ill with a bad cold for 1 week. Will he receive state benefits?

No, he must be ill more than a week to qualify

WAITING PERIOD

THE TIME PERIOD FROM THE BEGINNING OF DISABILITY TO RECEIVING THE FIRST PAYMENT OF BENEFITS

Waive of premium

When a person becomes permanently disabled and cannot pay the insurance premium

WHEN A PERSON CANNOT WORK REGULARLY FOR A LIMITED PERIOD OF TIME, THIS IS CALLED PERMANENT DISABILITY

FALSE

While on strike, Gene J Berry become ill with pneumonia for 2 weeks. Can he collect tsdb?

Yes, because he might become ill, whther the strike was on or not

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