LDB FUNDAMENTALS
What does LDB stand for?
Limited Disability Benefits.
Which limited condition is defined by widespread soft‑tissue pain?
Fibromyalgia.
What happens to the LDB clock when a disabling non‑limited condition begins?
The LDB clock pauses.
Does surgery for a limited condition extend the LDB duration?
No — it counts within the same LDB period.
What is Sandy's favorite snack?
Beef Jerky
What is the standard lifetime limit for all LDB conditions combined?
24 months.
What condition must meet CDC criteria and involves persistent fatigue not relieved by rest?
Chronic Fatigue Syndrome.
Which state prohibits limits on NMS, Fibromyalgia, Self‑Reported, and Chronic Fatigue conditions?
New Hampshire.
If a complication arises from a non‑limited co‑morbid condition, what happens to the LDB clock?
It pauses until the non‑limited condition resolves.
What is Roux's favorite candy?
REESES
Name at least two types of conditions commonly limited under LDB.
Mental/Nervous disorders, Musculoskeletal/Neuromuscular disorders
Carpal Tunnel Syndrome falls under which LDB category?
Neuromuscular/Musculoskeletal/Soft Tissue Disorder (NMS).
Under “per occurrence” LDB plans, when does a new limit period begin?
When a claimant incurs a new LTD claim after the temporary recovery period.
If a claimant becomes disabled from both an NMS condition and a mental condition under combined limits, where do months deduct from?
The same combined limit bucket.
What are Mich's TWO favorite animals?
Pigs and Dogs
Does the LDB “months of benefits” period include the LTD elimination period?
No — it begins on or after the benefit start date.
Name one example of a “Self‑Reported Condition.”
Migraines, dizziness, fatigue, body aches, numbness, etc.
Under average plan language, name the two Mental/Nervous exceptions.
Neurocognitive Disorders and Schizophrenia.
What letter is used when more time is needed to determine LDB applicability near end date?
LTD Reservation of Rights letter.
What is Colin P's favorite smell?
Cinnamon Bun
What must the Claims Specialist review to confirm LDB provisions?
The plan document(s)
Under alcohol/substance abuse LDB, what is required to continue benefits?
Participation in a physician‑recommended recovery program.
In a lifetime combined plan, if 6 months were used previously, how many remain?
18 months.
When multiple conditions exist, which disability is used for DxCd tracking in Intellis?
The non‑limited disabling condition (if present).
What is Meg's favorite flower?
Tulip