Opinion ID: 2790080
Heading Depth: 4
Heading Rank: 2

Heading: You suffer a loss of at least 20% in your

Text: Indexed Predisability Earnings when working in your Own Occupation. The Maximum Benefit Period allowed Dutkewych to receive benefits to age 65. Certain disabilities, however, are subject to a limited benefits period (Limited Conditions Provision). Specifically, [p]ayment of LTD Benefits is limited to 24 months during your entire lifetime for a Disability caused or contributed to by any one or more of the following . . . : (1) Mental Disorders; (2) -4- Substance Abuse; or (3) Other Limited Conditions. Mental Disorders is defined to include any mental, emotional, behavioral, psychological, personality, cognitive, mood or stressrelated abnormality, disorder, disturbance, dysfunction or syndrome, regardless of cause . . . or the presence of physical symptoms. Other Limited Conditions is defined to include chronic fatigue conditions and chronic pain conditions, such as fibromyalgia. The Plan provides two Rules for Disabilities Subject to Limited Pay Periods: 1. If you are Disabled as a result of a Mental Disorder or any Physical Disease or Injury for which payment of LTD Benefits is subject to a limited pay period, and at the same time are Disabled as a result of a Physical Disease, Injury, or Pregnancy that is not subject to such limitation, LTD Benefits will be payable first for conditions that are subject to the limitation. 2. No LTD Benefits will be payable after the end of the limited pay period, unless on that date you continue to be Disabled as a result of a Physical Disease, Injury, or Pregnancy for which payment of LTD Benefits is not limited. Standard specified in the Plan that it ha[s] full and exclusive authority to control and manage the Group Policy, to administer claims, and to interpret the Group Policy and resolve all questions arising in the administration, interpretation, and application of the Group Policy. -5-