Disability Terms and Definitions

Maximum Benefit Period (Benefit Duration) This is the maximum length of time for which benefits are payable under the plan as long as the employee remains continuously disabled. Deeming The process by which the income and resources of an ineligible individual are considered to be available to a recipient when determining eligibility or payment amount. DHO Disability Hearing Officer. Conducts in person hearings. Next appeal is to a federal Administrative Law Judge (ALJ). AEA acquired eleptiform aphasia (Landau-Kleffner syndrome) Partial Conservatorship This type of Conservatorship/Guardianship generally applies to the developmentally disabled and restricts the areas in which the Conservator/Guardian may act on behalf of the individual. Outcome Payment System The system providing a payments under the Ticket to Work program to an employment network for each month, up to a total of 60 months, during which Social Security disability benefits and Federal SSI cash benefits are not payable to a beneficiary because of the performance of substantial gainful activity (SGA) or by reason of earnings from work. Work Incentives/Employment Support SSA policies that help disability beneficiaries go to work and receive benefits in an attempt to become more independent. Section 1619(b) Status The special SSI recipient status for Medicaid purposes provided to working disabled or blind individuals when their earnings make them ineligible for regular or special cash payments. Impairment-Related Work Expenses (IRWE) The provision that permits the exclusion from earnings of the costs of items and services which are needed in order for a disabled individual to work, which are paid for by the individual, and which are necessarily incurred by that individual because of a physical or mental impairment. Conversion Privilege If included, this option allows employees who are terminating employment to continue some or all of their LTD coverage at their own expense without submitting evidence of insurability.

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	Did You Know?
	SHMO means Social Health Maintenance Organization A managed system of health and long-term care services geared toward an elderly client population. Under this model, a single provider entity assumes responsibility for a full range of acute inpatient, ambulatory, rehabilitative, extended home health and personal care services under a fixed budget which is determined prospectively. Elderly people who reside in the target service area are voluntarily enrolled. Once enrolled, individuals are obligated to receive all SHMO covered services through SHMO providers, similar to the operation of a medical model health maintenance organization (HMO).