LTD Seg 2 Final Review

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Final Review for LTD Segment Two

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Joan Murray

Estados Unidos

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LTD Seg 1 Final Review

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LTD Seg 2 Final Review


LTD Seg 2 Final ReviewVersión en línea Final Review for LTD Segment Two por Joan Murray 1 DOD = 7/3/2018 LTD EP = 90 days. What is the LTD BBD? Written answer 2 Assuming that the claimant enrolled in coverage on their DOH, is the EDOC the ER provided correct? a Yes b No c d 3 Using the Supply Technologies Contract, what is the numerical value for the pre-ex provision? Written answer 4 Using the Supply Technologies Contract: If the EDOC is 12/5/24 and the DOD is 12/4/25, is this employee subject to the pre-ex investigation? Choose one or more answers a Yes b No c d 5 You have 45 days from when to make an initial decision under ERISA? a LTD Benefit Begin Date b Day you send the acknowledgement letter c Claim Complete Date d Claim Received Date 6 Determine which action plan header would be the most appropriate based on the below scenario: The claimant is out of work due to arthritis. The claim is approved during the Own Occ period and the Change of Definition Date is 6/1/2026. A clinical review was received TODAY on 4/1/2024 and supports less than sedentary restrictions for 4 months while the claimant recovers from surgery. The claimant is currently in Physical therapy and sees their doctor monthly. a UPDATE AO JUN 2026 b NP MAY 2024 c UPDATE OO AUG 2024 d DENY OO APR 2024 7 Using the information provided and the Supply Technologies contract, what is the LTD benefit begin date? format as: mm/dd/yyyy, ex) 01/01/2001 Written answer 8 Using the information provided and the Supply Technologies contract, what is the maximum benefit date (the date that would be coded in the MBD field in S1)? format as: mm/dd/yyyy, ex) 01/01/2001 Written answer 9 You have an approved claim and the claimant is released to return to work on Monday. The claimant tells you that they are not returning to work until Friday because they need to take care of things before starting work again. What would you do? a Close the claim for RTW as of the day they were released, Monday b Close the claim for RTW as of the day they return, Friday c Ask the employer if they can accommodate the claimant while he runs errands d Close the claim for NTD as of the day they were released, Monday 10 Under which circumstances would VA Disability Benefits impact LTD benefit calculations? (Select all that apply) Choose one or more answers a If VA benefits are awarded after LTD approval and the contract specifies “other income benefits” include VA benefits b If VA benefits precede the date of disability and the contract excludes them from offsets c If VA benefits increase after LTD approval and the contract requires recalculation for any increase d VA benefits are never an offset 11 When requesting ongoing proof of disability for an LTD claim, which actions comply with internal guidelines after day 30 of no response? (Select all that apply) Choose one or more answers a Suspend benefits immediately without additional notice b Issue another request letter before claim closure c Document all outreach attempts in the claim file d Close the claim without further action if the claimant has not responded within 30 days 12 If the employer pays 75% of the premium and the employee pays 25% with after-tax dollars, how is the LTD benefit taxed? a Fully taxable b Partially taxable based on employer contribution c Non-taxable d Taxable only if the employee contribution was pre-tax 13 During an initial interview, the claimant reports injuries from a motor vehicle accident while driving for work purposes. Which exclusions or considerations should you investigate? (Select all that apply) Choose one or more answers a Hospital records and accident report b Self-Inflicted Injury c Felony or misdemeanor exclusion d Riot exclusion 14 What is the numerical value for the pre-ex provision for ABC Company? Written answer 15 Using the ABC Contract, what would be the pre-ex lookback period for someone with a DOH 4/15/2023? (mm/dd/yyyy - mm/dd/yyyy) Written answer 16 Using the ABC Company Contract, would this claimant qualify for the second chance provision? DOH: 2/15/2025, DOD: 9/25/2025 a Yes b No Feedback 8 DOD 12/10/25 + EP 180 days + 1 = BBD 6/8/2026. Age 60 at DOD, therefore allowed 60 months of LTD. The last payable date is 6/7/2031 (BBD 6/8/2031 + 60 months)

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LTD Seg 2 Final ReviewVersión en línea

por Joan Murray

DOD = 7/3/2018 LTD EP = 90 days. What is the LTD BBD?

Assuming that the claimant enrolled in coverage on their DOH, is the EDOC the ER provided correct?

Using the Supply Technologies Contract, what is the numerical value for the pre-ex provision?

Using the Supply Technologies Contract: If the EDOC is 12/5/24 and the DOD is 12/4/25, is this employee subject to the pre-ex investigation?

You have 45 days from when to make an initial decision under ERISA?

Using the information provided and the Supply Technologies contract, what is the LTD benefit begin date? format as: mm/dd/yyyy, ex) 01/01/2001

Using the information provided and the Supply Technologies contract, what is the maximum benefit date (the date that would be coded in the MBD field in S1)? format as: mm/dd/yyyy, ex) 01/01/2001

You have an approved claim and the claimant is released to return to work on Monday. The claimant tells you that they are not returning to work until Friday because they need to take care of things before starting work again. What would you do?

Under which circumstances would VA Disability Benefits impact LTD benefit calculations? (Select all that apply)

When requesting ongoing proof of disability for an LTD claim, which actions comply with internal guidelines after day 30 of no response? (Select all that apply)

If the employer pays 75% of the premium and the employee pays 25% with after-tax dollars, how is the LTD benefit taxed?

During an initial interview, the claimant reports injuries from a motor vehicle accident while driving for work purposes. Which exclusions or considerations should you investigate? (Select all that apply)

What is the numerical value for the pre-ex provision for ABC Company?

Using the ABC Contract, what would be the pre-ex lookback period for someone with a DOH 4/15/2023? (mm/dd/yyyy - mm/dd/yyyy)

Using the ABC Company Contract, would this claimant qualify for the second chance provision? DOH: 2/15/2025, DOD: 9/25/2025