Communication
A detailed discussion with the plan member to obtain updated information.
What is a functional telephone interview?
A condition where a plan member will often display symptoms of avoidance, panic, sadness and stress.
What is depression and/or anxiety?
What are the decision principles?
The stage where a member is receiving active treatment for an injury, episode or illness, an urgent medical condition, or immediate recovery from surgery.
What is the acute stage?
This staff member reviews Sun Life claim file information and provides answers to medical questions presented by DCMs/RCs/DCCs/SDCCs.
What is a medical consultant?
Every 6 weeks for STD and every 8 weeks for LTD.
When must an FTI be done?
What is a psychiatrist?
The written correlation between medical, functional and occupational information.
What is the analysis?
Psychosocial elements of the absence, both positive and negative that we need to address as they may impact the planning, recovery and return to work.
What are influencing factors?
This employee work in partnership with the Disability Case Managers (DCMs) in the management of claims towards resolution. and help prepare PMs for work readiness.
What is a rehabilitation consultant?
A collaborative conversation to help people find the motivation to make a positive behavior change.
What is motivational interviewing?
This employee provides consults to support optimal case management planning, treatment options and helping DCMs to prepare for Mental Health FTIs and difficult PM/PS conversations.
What is a senior mental health consultant?
You will be considered totally disabled while you are continuously unable due to an illness to do the essential duties of your own occupation.
What is the definition of disability?
A ‘back up’ plan, should something in your original plan not go as planned.
What is a contingency plan?
A functional-medical assessment done by a practitioner qualified in the appropriate specialty. This is a non-biased, non-invasive evaluation/examination of the plan member's (PM) condition.
What is an independent medical exam?
Queries that promote discussion and conversation rather than 'yes' or 'no' answers.
What are open-ended questions?
This Athena page is designed to be used in the ongoing management of an approved claim, and has a specific section dedicated to management of depression claims.
What is the case management program?
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?
A plan that will allow a PM to slowly return to the full hours and duties of their occupation.
What is a gradual return to work?
Testing uses an individual's saliva sample to identify genetic variants that determine how they will respond to medications.
What is Pharmacogenomics?
An effective strategy used to diffuse a situation, especially during a challenging call.
What is CARP? Control. Acknowledge. Refocus. Problem solve.
An illness that is characterized by an inability to control urges to use a substance, even though the use causes dysfunction and distress.
What is substance use disorder?
The information that must be collected if we are to make an informed change of definition decision for someone who is potentially capable of working in another occupation.
What is ET&E? (Education, training and experience)
The goal of this stage is to have the member obtain their maximum medical and functional recovery, improve their abilities and move towards resolution.
What is the functional stage?
A peer-to-peer conversation between a Sun Life Medical Consultant and a plan member's attending physician (psychologist).
What is a doc-to-doc call?