"Money for Nothing"
(Exclusions & Limitations)
(Exclusions & Limitations)
Any treatment that is performed and prescribed by a doctor/ nurse practitioner or, when Sun Life believes it is necessary, by a medical specialist.
What is Appropriate Treatment?
A legally binding document outlining the terms of agreement between Sun Life and the Plan Sponsor.
What is the Contract?
F41.10 and S83.00 are examples of these.
What is the ICD-10?
Medical and functional information, restrictions and limitations, as well as occupational information regarding the essential duties of a Plan Member's own occupation are used to determine this.
What is Total Disability?
The statements, "Partner with the Plan Member" and "Empower the Plan Member" are examples of what?
What are the Case Management Principles?
The standard provision states that "Sun Life will not pay benefits for any period while the Plan Member is absent from Canada for longer than 4 weeks (STD)/4 months (LTD) due to any reason, unless Sun Life agrees in writing in advance to pay benefits during the period"
What is the Out of Country provision?
The system where you can find the full contract (active and terminated) and booklets.
What is DARC?
These barriers can either confine or prevent a Plan Member's ability from performing occupational tasks or duties while in the workplace.
What are Restrictions and Limitations?
The conversation with an employer that can help in confirming eligibility information, occupational duties, workplace issues directly involving the Plan Member.
What is a PSI - Plan Sponsor Interview?
The person or people who will review your work/claims and will assist you when you have any questions about your claims or processes/procedures.
Who is a Case Management Consultant?
Benefits are not payable if a Plan Member's condition results from a work injury/accident and makes them eligible to receive benefits under another governing body.
What is the Workers Compensation Board (WCB) provision?
An employee will be considered totally disabled while the employee is continuously unable due to an illness to do the essential duties of the employee's own occupation or any occupation.
What is a definition of disability?
The tool that is used regularly to better understand medical conditions, as well as their common symptoms, appropriate treatment, and length of disability by work classification.
What are MDGuidelines?
National system for describing an occupation's main duties, demands and educational requirements.
What is the NOC?
The page in Solar where you will find all of your assigned work including the Absence ID, start date of the task and the Urgency Score.
What is the Dashboard?
Something we must consider if a person received medical treatment, prior to being covered under a disability plan.
What is a pre-existing condition?
Someone who is licensed to practice medicine where that practice is located.
What is a Medical Doctor?
A condition that reduces normal functioning, interferes with activities, of daily living, can be noticeable to others and can impact social functioning and judgement.
What is Functional Impairment?
This is an alternative plan that we create in the planning stages of a claim in the event that the initial plan is not successful.
What is a Contingency Plan?
It is the mindset that we should build caring relationships, create an optimistic outlook, and show a relevant path forward.
What are the Client for Life principles?
Treatment that involves the process of cosmetically modifying a patient’s physical appearance.
What is Aesthetic Treatment?
This option is best suited to Plan Sponsors who have their own attendance management policies and procedures and who are confident managing straightforward absences but may require occasional case management support.
What is the Salary Continuance Agreement?
Financial, psychosocial, occupational and medical elements that can impact a person's recovery.
What are influencing factors?
Elements that influence an individual psychologically and/or socially.
What are psychosocial factors?
The document that has the date of birth, details about the illness, medical history, accident information (if applicable), return-to-work comments and the signed/dated consent form.
What is the Plan Member Statement?