Totally Disabled Clause Samples

The 'Totally Disabled' clause defines the conditions under which an individual is considered completely unable to perform the duties of their occupation due to illness or injury. Typically, this clause outlines specific criteria, such as the inability to work for a certain period or the need for ongoing medical care, and may require certification from a medical professional. Its core practical function is to establish clear eligibility for disability benefits, ensuring that only those who meet the defined standard receive coverage, thereby preventing disputes and clarifying the insurer’s obligations.
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Totally Disabled. For Subscribers and Adult Dependents: In the judgment of a Medical Group Physician, a person is totally disabled by reason of injury or sickness if the Member is unable to perform each and every duty pertaining to his or her occupation during the first fifty-two (52) weeks of the disability. After the first fifty-two (52) weeks, a person is totally disabled if the Member is unable to perform each and every duty of any business or occupation for which the Member is reasonably fitted by education, training and experience. For Dependent Children: In the judgment of a Medical Group Physician, an illness or injury which makes the child unable to substantially engage in any of the normal activities of children in good health and like age. Urgent Care Services: Services required as the result of a sudden illness or injury, which require prompt attention, but are not of an emergent nature.
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Totally Disabled. PROMISTAR may terminate Executive's employment upon his becoming "Totally Disabled." For purposes of this Agreement, Executive shall be "Totally Disabled" if Executive is physically or mentally incapacitated so as to render Executive incapable of performing his usual and customary duties under this Agreement. Executive's receipt of disability benefits under PROMISTAR's long-term disability benefits plan (the "LTD Plan") or receipt of Social Security disability benefits shall be deemed conclusive evidence of being Totally Disabled for purpose of this Agreement; provided, however, that in the absence of Executive's receipt of such long-term disability benefits or Social Security benefits, PROMISTAR's Board of Directors (the "Board") may, in its reasonable discretion (but based upon appropriate medical evidence), determine that Executive is Totally Disabled.
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Totally Disabled. 16 Unit members sixty (60) years of age or older who are not eligible for disability 17 protection pursuant to STRS guidelines and who have exhausted all accrued sick leave 18 may opt to waive the substitute pay differential benefit, as described in Paragraph 13.2.5, 19 and select one of the following options: 21 (1) Regular retirement pursuant to STRS guidelines; or 22 23 (2) Receive an additional 100 days substitute pay differential provided by the District. 24
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Totally Disabled. The inability to perform sustained remunerative employment or other activity(ies) that are consistent with his/her medical/psychological restrictions while receiving OIL benefits due to the allowed conditions of the claim.
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Totally Disabled. With respect to an Employee, the inability of the Employee because of an injury or disease to perform the duties of any occupation for which he is suited by reason of education, training or experience, and, with respect to an Eligible Dependent, the inability of the Eligible Dependent because of an injury or disease to engage in substantially all of the normal activities of persons of like age and sex in good health.
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Totally Disabled. The definition of Totally Disabled is tied to Social Security disability, unless otherwise specified in (a), (b), (c), (d), or (e) below. a) x Tied to the Employer's long-term disability plan.
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Totally Disabled. Unit members sixty (60) years of age or older who are not eligible for disability protection pursuant to STRS guidelines and who have exhausted all accrued sick leave may opt to waive the substitute pay differential benefit, as described in Paragraph 13.2.5, and select one of the following options: (1) Regular retirement pursuant to STRS guidelines; or (2) Receive an additional 100 days substitute pay differential provided by the District. Unit members electing option two (2) shall receive full salary less the amount paid a substitute employed to fill his/her regular position. If no substitute is employed, the unit member shall receive full salary less the amount which would have been paid a substitute had one been employed.
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Related to Totally Disabled

  • Disabled If an employee becomes disabled with the result that he is unable to carry out the regular functions of his position, the Hospital may establish a special classification and salary with the hope of providing an opportunity of continued employment.

  • Special Maternity Allowance for Totally Disabled Employees (a) An employee who: (i) fails to satisfy the eligibility requirement specified in subparagraph 17.02(a)(ii) solely because a concurrent entitlement to benefits under the Disability Insurance (DI) Plan, the Long term Disability (LTD) Insurance portion of the Public Service Management Insurance Plan (PSMIP) or the Government Employees Compensation Act prevents her from receiving Employment Insurance or Québec Parental Insurance Plan maternity benefits, and (ii) has satisfied all of the other eligibility criteria specified in paragraph 17.02(a), other than those specified in sections (A) and (B) of subparagraph 17.02(a)(iii), shall be paid, in respect of each week of maternity allowance not received for the reason described in subparagraph (i), the difference between ninety-three per cent (93%) of her weekly rate of pay and the gross amount of her weekly disability benefit under the DI Plan, the LTD Plan or via the Government Employees Compensation Act. (b) An employee shall be paid an allowance under this clause and under clause 17.02 for a combined period of no more than the number of weeks during which she would have been eligible for maternity benefits under the Employment Insurance or Québec Parental Insurance Plan had she not been disqualified from Employment Insurance or Québec Parental Insurance maternity benefits for the reasons described in subparagraph (a)(i).

  • Total Disability During a period of total disability an employee must be under the regular and personal care of a legally qualified doctor of medicine. (a) Total disability, as used in this Plan, means the complete inability because of an accident or sickness of a covered employee to perform all the duties of his/her own occupation for the first two (2) years of disability. Thereafter, employees able by reason of education, training or experience to perform the duties of a gainful occupation for which the rate of pay is not less than seventy-five percent (75%) of the current rate of pay of their regular occupation at date of disability will not be considered totally disabled and will therefore not be eligible for benefits under this Long Term Disability Plan. (b) Total disabilities resulting from mental or nervous disorders are covered by the Plan in the same manner as total disabilities resulting from accidents or other sicknesses, except that an employee who is totally disabled as a result of a mental or nervous disorder and who has received twenty-four (24) months of Long Term Disability Plan benefit payments must be confined to a hospital or mental institution or where they are at home, under the direct care and supervision of a medical doctor, in order to continue to be eligible for benefit payments. (1) If an employee becomes totally disabled and during this period of total disability engages in rehabilitative employment, the regular monthly benefit from this plan will be reduced by twenty-five percent (25%) of the employee's earnings from such rehabilitative employment. In the event that income from rehabilitative employment and the benefit paid under this Plan exceed eighty-five percent (85%) of the employee's earnings at date of disability, the benefit from this Plan will be further reduced by the excess amount.

  • Special Parental Allowance for Totally Disabled Employees (a) An employee who: (i) fails to satisfy the eligibility requirement specified in subparagraph 17.05(a)(ii) solely because a concurrent entitlement to benefits under the Disability Insurance (DI) Plan, the Long-term Disability (LTD) Insurance portion of the Public Service Management Insurance Plan (PSMIP) or via the Government Employees Compensation Act prevents the employee from receiving Employment Insurance or Québec Parental Insurance Plan benefits, and (ii) has satisfied all of the other eligibility criteria specified in paragraph 17.05(a), other than those specified in sections (A) and (B) of subparagraph 17.05(a)(iii), shall be paid, in respect of each week of benefits under the parental allowance not received for the reason described in subparagraph (i), the difference between ninety-three per cent (93%) of the employee's rate of pay and the gross amount of his or her weekly disability benefit under the DI Plan, the LTD Plan or via the Government Employees Compensation Act. (b) An employee shall be paid an allowance under this clause and under clause 17.05 for a combined period of no more than the number of weeks during which the employee would have been eligible for parental, paternity or adoption benefits under the Employment Insurance or Québec Parental Insurance Plan, had the employee not been disqualified from Employment Insurance or Québec Parental Insurance Plan benefits for the reasons described in subparagraph (a)(i).

  • By Disability If Executive becomes eligible for the Company’s long term disability benefits or if, in the sole opinion of the Company, Executive is unable to carry out the responsibilities and functions of the position held by Executive by reason of any physical or mental impairment for more than ninety consecutive days or more than one hundred and twenty days in any twelve-month period, then, to the extent permitted by law, the Company may terminate Executive’s employment. The Company shall pay to Executive all compensation to which Executive is entitled up through the date of termination, and thereafter all obligations of the Company under this Agreement shall cease. Nothing in this Section shall affect Executive’s rights under any disability plan in which Executive is a participant.