This list identifies many common abbreviations and acronyms insurance companies use in disability insurance claims.
Acronyms and Abbreviations Used in Long-Term Disability Claims
| ACC: | Abilities Claims Consultant – claims handler or insurance adjuster typically responsible for reviewing an LTD claim and issuing a decision on the claim prior to the start of a lawsuit. |
| ACM: | Abilities Claims Manager – alternative name for an ACC. |
| ADLs: | Activities of daily living |
| APS: | Attending Physician’s Statement |
| Call Record: | An electronic document created by the claims handler to document telephone discussions during the determination/adjudication of a disability claim |
| C/B: | Call back |
| CHESS: | Stands for Chronic Pain, Hardship, Emotional Distress, Social Security, which are four factors that may be considered in a long-term disability claim |
| COD: | Change of definition, which is the date the definition of disability changes under the disability insurance plan/policy |
| DMAP: | Disability Management Action Plan, which is a plan developed by the insurance company or employer in a long-term disability claim to help an individual return to work after a period of disability. |
| DOB: | Date of birth |
| DOC: | Date of Coverage – the date an employee is eligible to receive disability insurance coverage under the group plan or policy |
| DOD: | Date of Disability |
| DOH: | Date of Hire – the date the eligible employee was hired |
| DX: | Diagnosis |
| EE: | Employee |
| EP ends: | The specific date the employment insurance benefits end |
| ER: | The employer |
| ETE: | Education, training, and experience |
| FAE: | Functional Abilities Evaluation |
| FD: | Forecast Date |
| FPD: | First Paid Date – the first date disability insurance benefits were paid |
| FTI: | Functional Telephone Interview – a telephone interview between a disability insurance company adjudicator and a claimant, which is used to assess claimant’s medical condition, functional limitations, and ability to perform job duties. |
| FU: | Follow up |
| GP: | General Practitioner or family doctor |
| GRTW: | Gradual return to work |
| HMC: | Health management consultant – a professional who is hired by the disability insurance company to help manage the medical aspects of the claimant’s case |
| HP: | Health partner, aka a medical consultant |
| IPC: | Independent Physician Consultant or someone hired by the insurance company to review the medical components of the claim |
| JD: | Job description |
| LDW: | Last day worked |
| LMVM: | Left message voice mail |
| LVMM: | Left voice mail message |
| Max Bnft Period: | Max benefit period – the maximum period for which benefits can be paid under the policy (ex. age 65) |
| Medical Consultant: | A medical professional that is consulted for the purpose of providing a medical opinion for an insurance company |
| MDA Guidelines: | Medical Disability Advisor guidelines used to reference typical disability recovery periods |
| MO: | Medical opinion |
| MX: | Medication |
| NCQR: | New Claim Quality Review – an internal review conducted by an insurance company during the adjudication of an LTD file for quality control purposes |
| Non-Refund: | The insurance company is responsible for the payment of benefits |
| Non-Stand LTD Change of Def: | A non-standard change of definition applies (i.e., something other than the typical 2-year own occupation test followed by the any occupation test) |
| O/P: | Overpayment – an overpayment of disability benefits has resulted |
| PM: | Plan Member – the individual/employee covered under the group plan (i.e., our client) |
| PM Code: | Indicates adjudication priority (ex. U = urgent/high priority – for example, recovery or return to work is anticipated in the near future. Opportunity = an opportunity has been identified, for example, to work with the individual toward rehab, recovery, and ultimately a return to work) |
| Pre x: | Pre-existing medical condition(s) |
| PS: | Plan Sponsor – the employer/holder of the group policy |
| PX: | Prognosis/expected period for recovery |
| QD: | Qualifying Date – the earliest date LTD benefits are eligible to be received if approved |
| R&L’s: | Restrictions and limitations |
| Recovery Score: | A numerical score assigned to indicate an anticipated/forecasted/predicted likelihood of the LTD claim being resolved either by way of a return to work or some other form of resolution/settlement |
| Refund: | The employer will ultimately be responsible for the payment of benefits |
| RTW: | Return to work |
| SDCC: | Senior Disability Claims Consultant – an LTD claims individual/adjuster typically assigned carriage of an LTD file once litigation has been commenced |
| SLC: | Salary continuance |
| SX: | Symptoms |
| Team Leader/Manager: | An individual at an insurance company that a claims consultant/ACM/adjuster reports to |
| TDAO: | Totally Disabled Any Occupation |
| TDOO: | Totally Disabled Own Occupation |
| TSA: | Transferrable Skills Analysis – an analysis/report prepared to identify an individual’s education, training, and experience that could potentially be applied toward securing an alternative occupation |
| TX: | Treatment |
| Ultera: | An electronic document storage system |
Work with an Experienced Disability Insurance Attorney
Ortiz Law Firm focuses primarily on disability claims, including group Long-Term Disability (LTD) claims, individual disability insurance policy claims, and ERISA disability claims. We assist claimants with administrative appeals and, if necessary, will represent you in court. If you need help with your disability insurance claim or have questions about an abbreviation or acronym not listed above, please do not hesitate to contact me—call (888) 321-8131 for a free case evaluation today.