Exclusions & Limitations
Any health care 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. In Group Disability
What is the contract?
The code that identifies the specific injury or condition for the claim file.
What is an ICD 10 code?
The website that provides the physical and cognitive demands for an occupation
What is the NOC?
The types of claims where the Plan Sponsor continues to pay benefits while Sun Life manages the claim information.
What is SalCon?
When a Canadian resident leaves the country for an extended period of time.
What is out of country?
The system where you can find the full contract and all of it's details.
What is DARC?
The details of the medical condition and how they are affecting a person in regards to how they feel.
What are symptoms?
The classification of an employee: Full time or Part time are examples.
The people who will review your work and help you out if you have any questions in your new role.
What is a case management consultant?
A plan member is receiving benefits and wage replacement due to being injured in the course of employment.
What is Workers Compensation?
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.
What is a definition of disability?
A task or activity the plan member CANNOT do.
What is a restriction?
What is the career handbook?
Another online tool regularly used to gain understanding of an individual’s medical condition.
What are the medical disability guidelines?
A medical condition for which an individual received medical treatment, consultation, care or services including diagnostic measures, or had taken prescribed drugs or medicines during a period of time prior to being covered under a disability plan
What is a pre-existing condition?
A a physician or surgeon 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 will serve as alternative plan in the event the initial plan is not successful
What is a contingency plan?
The work items that you set to guide your next steps on the claim.
What are tasks?
Treatment that involves the process of cosmetically modifying a patient’s physical appearance.
What is Aesthetic treatment?
A 'royal' statement you should remember if you're unsure about eligibility.
What is, 'the contract is king'?
Characteristics or facets that influence someone psychologically and/or socially.
What are psychosocial factors?
Elements of the claim, both positive and/or negative, that may need to be addressed or leveraged in order to manage a claim to resolution
What are influencing factors?
A discussion with the plan sponsor to clarify any information or to ask about possible return to work opportunities.
What is a plan sponsor interview (PSI)?