MENTAL ILLNESS means a psychiatric or psychological condition classified in the Diagnostic and Statistical Manual of Mental Health Disorders (DSM), published by the American Psychiatric Association, most current as of the start of a disability. Such disorders include, but are not limited to, psychotic, emotional or behavioral disorders, or disorders relatable to stress. If the DSM is discontinued or replaced, these disorders will be those classified in the diagnostic manual then used by the American Psychiatric Association as of the start of a disability. MONTHLY BENEFIT means the total benefit amount for which an employee is insured under this plan subject to the maximum benefit. MONTHLY EARNINGS means your gross monthly income from your Employer as defined in the plan. MONTHLY PAYMENT means your payment after any deductible sources of income have been subtracted from your gross disability payment. PART-TIME BASIS means the ability to work and earn between 20% and 80% of your indexed monthly earnings. PAYABLE CLAIM means a claim for which Unum is liable under the terms of the policy. PHYSICIAN means: - a person performing tasks that are within the limits of his or her medical license; and - a person who is licensed to practice medicine and prescribe and administer drugs or to perform surgery; or - a person with a doctoral degree in Psychology (Ph.D. or Psy.D.) whose primary practice is treating patients; or - a person who is a legally qualified medical practitioner according to the laws and regulations of the governing jurisdiction. Unum will not recognize you, or your spouse, children, parents or siblings as a physician for a claim that you send to us. PLAN means a line of coverage under the policy. PRE-EXISTING CONDITION means a condition for which you received medical treatment, consultation, care or services including diagnostic measures, or took prescribed drugs or medicines for your condition during the given period of time as stated in the plan. RECURRENT DISABILITY means a disability which is: - caused by a worsening in your condition; and - due to the same cause(s) as your prior disability for which Unum made a disability payment. REGULAR CARE means: - you personally visit a physician as frequently as is medically required, according to generally accepted medical standards, to effectively manage and treat your disabling condition(s); and
GLOSSARY-3 (1/1/2025)
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