Group Long Term Disability Insurance

Qualified Medical Condition Definition of Disability

Sold only in conjunction with Own Specialty,1 the Qualified Medical Condition (QMC) definition of disability is available to eligible physicians (M.D.) and dentists (D.M.D., D.D.S.). Under this definition of disability, medical professionals may be considered disabled and eligible for Long Term Disability (LTD) benefits if their licenses have been restricted or they have suffered a loss of earnings because of a QMC.

Qualified Medical Condition means the employee has tested positive for a disease categorized as communicable by the U.S. Centers for Disease Control and Prevention which is potentially life threatening to patients. The disease must not present any physical or mental symptoms that cause the employee to otherwise be disabled. Infection must be proven by a test licensed by the FDA and administered according to the standards established by the CDC. Diagnostic tests for a QMC must not be self-administered.

Definition of Disability

Under the QMC definition of disability, an employee is considered disabled if the employee is a medical professional and as a result of a qualified medical condition:

• The employee’s right to perform the material duties of the employee’s own occupation is restricted by the state licensing board, a governing body other than the employee’s state licensing board or the employee’s employer because

• The material duties of the employee’s own occupation routinely include procedures which reasonably could pose a risk of transmission of the Qualified Medical Condition to patients or

• The employee is unable to earn 80 percent of indexed predisability earnings because of disclosure of a qualified medical condition and

• The employee is not disabled as a result of any other physical disease, injury, pregnancy or mental disorder.

Maximum Benefit Period

Under the QMC definition of disability, the maximum benefit period may be either five years or to the end of the maximum benefit period. The QMC benefit period must not be longer than the Own Specialty benefit period.

For more information, contact us here.

Note: Not available in all states. This policy has exclusions, limitations, reductions of benefits and terms under which the policy may be continued in force or discontinued. For costs and complete details of the coverage please contact your insurance advisor or the Employee Benefits Sales and Service Office.