WMA Disability Quiz - Western Medical Assessments

WMA Disability Quiz

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What is a ‘Change of Definition’ as it applies to a disability claim?

When a disability claim goes from short-term disability to long-term disability within an employee’s own occupation.

When an employee is able to perform any tasks of their own occupation after an employee has been on extended long-term disability (usually one year).

When an employee can perform tasks of any occupation, after an employee has been on extended long-term disability (usually after two years).

What type of disability claim qualifies as a ‘Pre-Existing Condition’?

A medical condition that existed prior to the employee’s current employment.

A medical condition that existed within one year prior to the employee’s current disability insurance coverage.

A medical condition that existed within 10 years prior to the employee’s current disability insurance coverage.

How long does an employee have to experience illness prior to being able to claim short-term disability?

Benefits usually kick in between three to seven days, depending on the provision in the employer’s insurance plan.

Once an employee has claimed absenteeism for 10 – 14 business days.

If illness has occurred for more than 21 days.

Once a decision has been made on a disability claim, is the employee able to challenge the decision of his employer’s insurance company?

The employee cannot appeal the decision of their employer’s disability provider. All decisions are final.

An employee may appeal a decision only if they feel their disability provider is being unfair and the appeal is within 30 days of a decision.

An employee may always appeal the decision of their disability provider by obtaining any new medical or vocational information that may impact any decisions made.

Short-term disability benefits are most accurately defined as:

Coverage for three to seven days per year for occasional absences.

Coverage for a period of time until an individual returns to work, reaches 65, or no longer meets the definition of disability.

Coverage beginning after an initial waiting period, usually 17 to 52 weeks.