function allLTDFieldsOK() {
	if (document.getElementById('job_class').value!='' && document.getElementById('age').value!='' && document.getElementById('gender').value!='' && document.getElementById('is_smoker').value!='') {
		return true;
	} else {
		return false;
	}
}
function get_ltd_quote() {
	if (allLTDFieldsOK()==true) {
		document.getElementById('get_quote').disabled = 'disabled';
		document.getElementById('ltd_quote_result').innerHTML = '<img alt=\"searching...\" src=\"/images/loading.gif\" style=\"display:inline;visibility:visible;\" />';

		var xmlLib = new SoftXMLLib();
		xmlLib.load("ltd-rate-list.xml");

		if (xmlLib.loadError!=0) {

			alert("XML file is invalid!");
			return;

		} else {

			var xpath = "//rate[@job_class='" + document.getElementById('job_class').value.toString() + "' and @age='" + document.getElementById('age').value.toString() + "' and @gender='" + document.getElementById('gender').value.toString() + "' and @is_smoker='" + document.getElementById('is_smoker').value.toString() + "']";
			//alert(xpath);
			matchedNodes = xmlLib.selectNodes(xpath)
			//alert(matchedNodes.length);
			if (matchedNodes.length > 0) {
			for(var i = 0;i < matchedNodes.length;i++){
				//output value of id and idref attributes
				document.getElementById('ltd_quote_result').innerHTML = "Your monthly premium will be $" + matchedNodes[i].attributes[0].monthly_premium + "/month.";
				document.getElementById('get_quote').disabled = '';
				document.getElementById('proposal_btn').style.visibility = '';
			}
			} else {
				document.getElementById('ltd_quote_result').innerHTML = 'We do not have the requested data.  Please contact us to get a quote.';
			}

		}
	} else {
		document.getElementById('ltd_quote_result').innerHTML = "All fields are required to receive an accurate quote.";
		return false;
	}
}
function outputLTDForm() {
	document.write("<form id=\"ltd_quote_form\" style=\"margin:0px 0px 0px 0px; padding:0px 0px 0px 0px;\"><b style=\"font-size:16px;text-align:left;\">Instant LTD Estimate</b><br /><table class=\"ltd_quote_form\">");
	document.write("<tr>");
		document.write("<td class=\"form_header\">* Occupation</td>");
		document.write("<td class=\"ltd_quote_form_input\">");
			document.write("<select id=\"job_class\" class=\"ltd_quote_dropdown\">");
			document.write("<option value=\"\"></option>");
			document.writeln("<option value=\"3A\">Abstractor</option>");
			document.writeln("<option value=\"3A\">Accountant - Other</option>");
			document.writeln("<option value=\"4A\">Accountant - W/4 Yr Accounting Degree</option>");
			document.writeln("<option value=\"4A\">Actuary - Other</option>");
			document.writeln("<option value=\"3A\">Administrative Assistant</option>");
			document.writeln("<option value=\"3A\">Advertising, Sales</option>");
			document.writeln("<option value=\"4A-M\">Anesthesiologist</option>");
			document.writeln("<option value=\"3A-M\">Anesthesiologist, CA Only</option>");
			document.writeln("<option value=\"3A\">Anesthetist</option>");
			document.writeln("<option value=\"3A\">Appraiser</option>");
			document.writeln("<option value=\"3A\">Art Gallery Manager</option>");
			document.writeln("<option value=\"3A\">Artist - Commercial Artist, Graphic Designer</option>");
			document.writeln("<option value=\"3A\">Audiologist</option>");
			document.writeln("<option value=\"3A\">Auditor</option>");
			document.writeln("<option value=\"4A\">Biochemist - Office & Consulting</option>");
			document.writeln("<option value=\"4A\">Biologist - Office & Consulting</option>");
			document.writeln("<option value=\"3A\">Bookkeeper</option>");
			document.writeln("<option value=\"4A\">Botanist - Office & Consulting</option>");
			document.writeln("<option value=\"3A\">Buyer</option>");
			document.writeln("<option value=\"4A\">Chemist - Office & Consulting</option>");
			document.writeln("<option value=\"3A\">Claims Adjuster, Examiner - Office Duties Only</option>");
			document.writeln("<option value=\"3A\">Clergy</option>");
			document.writeln("<option value=\"4A\">College Professor ($50K Last 2yrs & Grad. Degree)</option>");
			document.writeln("<option value=\"3A\">Commercial Artist</option>");
			document.writeln("<option value=\"5A\">Computer, Consultant, Systems Analyst, Programmer (earning over $70K)</option>");
			document.writeln("<option value=\"4A\">Computer, Consultant, Systems Analyst, Programmer - other</option>");
			document.writeln("<option value=\"3A\">Computer, Operator</option>");
			document.writeln("<option value=\"4A\">Consultant (Computer)</option>");
			document.writeln("<option value=\"3A\">Consultant (Financial, Mgt, PR)</option>");
			document.writeln("<option value=\"3A\">Copy Writer</option>");
			document.writeln("<option value=\"3A\">Counselor - MSW Degree</option>");
			document.writeln("<option value=\"4A\">Dean Of College or University</option>");
			document.writeln("<option value=\"4A-M\">Dentist</option>");
			document.writeln("<option value=\"3A-M\">Dentist, CA Only</option>");
			document.writeln("<option value=\"5A-M\">Dermatologist</option>");
			document.writeln("<option value=\"3A-M\">Dermatologist, CA Only</option>");
			document.writeln("<option value=\"3A\">Dietician - Not Preparing Food</option>");
			document.writeln("<option value=\"3A\">Draftsman</option>");
			document.writeln("<option value=\"4A\">Education - Dept. Head ($50K Last 2 Yrs & Grad Degree)</option>");
			document.writeln("<option value=\"4A\">Education - Full College Prof ($50K Last 2 Yrs & Grad Degree)</option>");
			document.writeln("<option value=\"3A\">Education - Other Education Administrator</option>");
			document.writeln("<option value=\"4A\">Education - Principal ($50K Last 2 Yrs & Grad Degree)</option>");
			document.writeln("<option value=\"4A\">Education - Superintendent ($50K Last 2 Yrs & Grad Degree)</option>");
			document.writeln("<option value=\"3A\">Education - Teacher Of Academic or Commercial Subjects</option>");
			document.writeln("<option value=\"4A-M\">Emergency Room Physician</option>");
			document.writeln("<option value=\"3A-M\">Emergency Room Physician, CA Only</option>");
			document.writeln("<option value=\"3A\">Employment Recruiter</option>");
			document.writeln("<option value=\"4A-M\">Endodontist</option>");
			document.writeln("<option value=\"3A-M\">Endodontist, CA Only</option>");
			document.writeln("<option value=\"3A\">Engineer - Field or Lab Duties (Chemical, Mechanical, Electrical)</option>");
			document.writeln("<option value=\"3A\">Entertainment, Motion Picture - Director (not self employed)</option>");
			document.writeln("<option value=\"3A\">Entertainment, Motion Picture - Management (office only)</option>");
			document.writeln("<option value=\"3A\">Entertainment, Motion Picture - Producer (not self employed)</option>");
			document.writeln("<option value=\"3A\">Entertainment, Motion Picture - Talent Agent</option>");
			document.writeln("<option value=\"3A\">Executive ($30K Last 2yrs or 4yr College Deg) - Office Duties Only</option>");
			document.writeln("<option value=\"4A\">Executive ($45K Last 2yrs & 10+ EEs) - Office Duties Only</option>");
			document.writeln("<option value=\"3A\">Financial Planner ($30K Last 2yrs)</option>");
			document.writeln("<option value=\"4A\">Financial Planner (5+ Yrs Exp $75K Last 2yrs, Full-Time)</option>");
			document.writeln("<option value=\"3A\">Funeral Director - No Embalming</option>");
			document.writeln("<option value=\"4A\">Geologist - Office & Consulting</option>");
			document.writeln("<option value=\"3A\">Government, Auditor</option>");
			document.writeln("<option value=\"4A\">Government, Immigration Official - Official Duties Only (earning over $75K last 2 yrs)</option>");
			document.writeln("<option value=\"3A\">Government, Interpreter</option>");
			document.writeln("<option value=\"3A\">Government, Librarian</option>");
			document.writeln("<option value=\"3A\">Government, Social Worker - Office Duties Only and MSW</option>");
			document.writeln("<option value=\"3A\">Government, Tax Agent/Auditor</option>");
			document.writeln("<option value=\"3A\">Graphic Designer</option>");
			document.writeln("<option value=\"3A\">Hedge Fund Manager</option>");
			document.writeln("<option value=\"3A\">Insurance Adjustor, Examiner - Office and Consulting Duties Only</option>");
			document.writeln("<option value=\"3A\">Insurance Agent - $30K Last 2 Yrs</option>");
			document.writeln("<option value=\"4A\">Insurance Agent - Full Time, 5+ Yrs Exp, $75K Last 2 Yrs</option>");
			document.writeln("<option value=\"3A\">Interior Designer - Office & Consult Duties - (4 Yr Interior Design Degree)</option>");
			document.writeln("<option value=\"3A\">Interpreter</option>");
			document.writeln("<option value=\"4A\">Investment Banker (earning over $75,000)</option>");
			document.writeln("<option value=\"3A\">Investment Banker, other</option>");
			document.writeln("<option value=\"3A\">Jeweler - Sales, Administration Only</option>");
			document.writeln("<option value=\"4A\">Landscape Architect - No Manual Labor, 4yr Professional Degree, less than 20% field</option>");
			document.writeln("<option value=\"3A\">Landscape Architect - Other</option>");
			document.writeln("<option value=\"3A\">Legal Assistant</option>");
			document.writeln("<option value=\"3A\">Legal Secretary</option>");
			document.writeln("<option value=\"3A\">Librarian</option>");
			document.writeln("<option value=\"3A\">Lobbyist</option>");
			document.writeln("<option value=\"3A\">Magazine, Copywriter - Office Duties Only</option>");
			document.writeln("<option value=\"3A\">Magazine, Editor - Office Duties Only</option>");
			document.writeln("<option value=\"3A\">Magazine, Manager - Office Duties Only</option>");
			document.writeln("<option value=\"3A\">Magazine, Publisher - Office Duties Only</option>");
			document.writeln("<option value=\"3A\">Magazine, Writer - Office Duties Only</option>");
			document.writeln("<option value=\"3A\">Manager, Art Gallery</option>");
			document.writeln("<option value=\"3A\">Manufacturing, Designer</option>");
			document.writeln("<option value=\"3A\">Manufacturing, Draftsman</option>");
			document.writeln("<option value=\"3A\">Manufacturing, Sales Representative</option>");
			document.writeln("<option value=\"4A\">Manufacturing, Sales Representative - Earning over $75K</option>");
			document.writeln("<option value=\"3A\">Market Research Analyst</option>");
			document.writeln("<option value=\"3A\">Minister</option>");
			document.writeln("<option value=\"3A\">Mortgage Loan Originator</option>");
			document.writeln("<option value=\"3A\">Mortician - Not Embalming</option>");
			document.writeln("<option value=\"3A\">Newspaper, Copywriter - Office Duties Only</option>");
			document.writeln("<option value=\"3A\">Newspaper, Editor - Office Duties Only</option>");
			document.writeln("<option value=\"3A\">Newspaper, Manager - Office Duties Only</option>");
			document.writeln("<option value=\"3A\">Newspaper, Publisher - Office Duties Only</option>");
			document.writeln("<option value=\"3A\">Newspaper, Writer - Office Duties Only</option>");
			document.writeln("<option value=\"3A\">Nurse Anethetist</option>");
			document.writeln("<option value=\"3A\">Nurse Practitioner - Not Functioning As An RN</option>");
			document.writeln("<option value=\"3A\">Nursing Director</option>");
			document.writeln("<option value=\"3A\">Nursing Instructor</option>");
			document.writeln("<option value=\"3A\">Nutritionist - Not Preparing Food</option>");
			document.writeln("<option value=\"4A-M\">Obstetrician/Gynecologist</option>");
			document.writeln("<option value=\"3A-M\">Obstetrician/Gynecologist, CA Only</option>");
			document.writeln("<option value=\"3A\">Office Worker (Earning over $30K)</option>");
			document.writeln("<option value=\"4A-M\">Opthalmologist</option>");
			document.writeln("<option value=\"3A-M\">Opthalmologist, CA Only</option>");
			document.writeln("<option value=\"3A\">Optician - Not Grinding Lenses</option>");
			document.writeln("<option value=\"5A\">Optometrist</option>");
			document.writeln("<option value=\"4A-M\">Oral Surgeon</option>");
			document.writeln("<option value=\"3A-M\">Oral Surgeon, CA Only</option>");
			document.writeln("<option value=\"4A-M\">Orthodontist</option>");
			document.writeln("<option value=\"3A-M\">Orthodontist, CA Only</option>");
			document.writeln("<option value=\"4A-M\">Otolaryngologist</option>");
			document.writeln("<option value=\"3A-M\">Otolaryngologist, CA Only</option>");
			document.writeln("<option value=\"4A-M\">Otologist</option>");
			document.writeln("<option value=\"3A-M\">Otologist, CA Only</option>");
			document.writeln("<option value=\"3A\">Paralegal</option>");
			document.writeln("<option value=\"3A\">Pastor</option>");
			document.writeln("<option value=\"5A-M\">Pathologist</option>");
			document.writeln("<option value=\"3A-M\">Pathologist, CA Only</option>");
			document.writeln("<option value=\"3A\">Perfusionist</option>");
			document.writeln("<option value=\"4A-M\">Periodontist</option>");
			document.writeln("<option value=\"3A-M\">Periodontist, CA Only</option>");
			document.writeln("<option value=\"3A-M\">Physician - CA Only</option>");
			document.writeln("<option value=\"5A-M\">Physician - Other</option>");
			document.writeln("<option value=\"3A\">Physicians Assistant</option>");
			document.writeln("<option value=\"4A\">Physicist - Office & Consulting</option>");
			document.writeln("<option value=\"3A-M\">Podiatrist</option>");
			document.writeln("<option value=\"4A\">Principal ($50K Last 2 Yrs & Grad Degree)</option>");
			document.writeln("<option value=\"5A-M\">Psychiatrist</option>");
			document.writeln("<option value=\"3A-M\">Psychiatrist, CA Only</option>");
			document.writeln("<option value=\"4A-M\">Psychologist - Other Graduate Degree</option>");
			document.writeln("<option value=\"5A-M\">Psychologist - Phd Degree</option>");
			document.writeln("<option value=\"3A\">Purchasing Agent</option>");
			document.writeln("<option value=\"3A\">Rabbi - Synagogue Only</option>");
			document.writeln("<option value=\"3A\">Radio, Director (not self employed)</option>");
			document.writeln("<option value=\"3A\">Radio, Producer (not self employed)</option>");
			document.writeln("<option value=\"3A\">Radio, Station Manager</option>");
			document.writeln("<option value=\"5A-M\">Radiologist - All other states</option>");
			document.writeln("<option value=\"3A-M\">Radiologist - CA Only</option>");
			document.writeln("<option value=\"3A\">Real Estate Appraiser</option>");
			document.writeln("<option value=\"3A\">Real Estate Property Manager (earning over $50K for last 2yrs) - no manual or maintenance duties</option>");
			document.writeln("<option value=\"3A\">Recruiter (Employment)</option>");
			document.writeln("<option value=\"3A\">Respiratory Therapist</option>");
			document.writeln("<option value=\"4A\">Sales Manager - Earning Over 75K</option>");
			document.writeln("<option value=\"3A\">Sales Manager - Other</option>");
			document.writeln("<option value=\"3A\">Sales, Bond Trader</option>");
			document.writeln("<option value=\"3A\">Sales, Broker (Full Time, 5+ Yrs, $50K Last 2 Yrs)</option>");
			document.writeln("<option value=\"3A\">Sales, Insurance Agent ($30K Last 2 Yrs)</option>");
			document.writeln("<option value=\"4A\">Sales, Insurance Agent (Full Time, 5+ Yrs, $75K Last 2 Yrs)</option>");
			document.writeln("<option value=\"4A\">Sales, Manufacturers Representative - Earning over 75K</option>");
			document.writeln("<option value=\"3A\">Sales, Manufacturers Representative - Other</option>");
			document.writeln("<option value=\"3A\">Sales, Real Estate Agent, Broker, Developer (Full Time, Active for 4 Yrs & 50K Last 2 Yrs)</option>");
			document.writeln("<option value=\"4A\">Scientist - Office & Consulting</option>");
			document.writeln("<option value=\"3A\">Secretary</option>");
			document.writeln("<option value=\"3A\">Social Worker - Office Duty Only & MSW</option>");
			document.writeln("<option value=\"3A\">Speech Therapist</option>");
			document.writeln("<option value=\"3A\">Stockbroker ($30K Last 2 Yrs)</option>");
			document.writeln("<option value=\"4A\">Stockbroker (5+ Yrs Exp, $75K Last 2 Yrs)</option>");
			document.writeln("<option value=\"4A\">Superintendent ($50K Last 2 Yrs & Grad Degree)</option>");
			document.writeln("<option value=\"4A-M\">Surgeon</option>");
			document.writeln("<option value=\"3A-M\">Surgeon, CA Only</option>");
			document.writeln("<option value=\"3A\">Tax Agent, Auditor</option>");
			document.writeln("<option value=\"3A\">Teacher, Choir Director</option>");
			document.writeln("<option value=\"3A\">Teacher, Driver Education</option>");
			document.writeln("<option value=\"3A\">Teacher, Guidance Counselor</option>");
			document.writeln("<option value=\"3A\">Teacher, Private Music Instructor</option>");
			document.writeln("<option value=\"3A\">Teacher, Special Education</option>");
			document.writeln("<option value=\"3A\">Television, Director</option>");
			document.writeln("<option value=\"3A\">Television, Producer</option>");
			document.writeln("<option value=\"3A\">Television, Station Manager</option>");
			document.writeln("<option value=\"3A\">Theater, Director (not self employed)</option>");
			document.writeln("<option value=\"3A\">Theater, Producer (not self employed)</option>");
			document.writeln("<option value=\"4A-M\">Urologist</option>");
			document.writeln("<option value=\"3A-M\">Urologist, CA Only</option>");
			document.writeln("<option value=\"3A\">Venture Capitalist</option>");
			document.writeln("<option value=\"3A\">Veterinarian - Other</option>");
			document.writeln("<option value=\"4A\">Veterinarian - Small Animal, in Clinic</option>");
			document.writeln("<option value=\"3A\">Writer - Not Free Lance or Working From Home</option>");
			document.write("</select>");
		document.write("</td>");
	document.write("</tr>");	
	document.write("<tr>");
		document.write("<td class=\"form_header\">* Age</td>");
		document.write("<td class=\"ltd_quote_form_input\">");
			document.write("<select id=\"age\" class=\"ltd_quote_dropdown\">");
			document.write("<option value=\"\"></option>");
			document.write("<option value=\"18\">18</option>");
			document.write("<option value=\"19\">19</option>");
			document.write("<option value=\"20\">20</option>");
			document.write("<option value=\"21\">21</option>");
			document.write("<option value=\"22\">22</option>");
			document.write("<option value=\"23\">23</option>");
			document.write("<option value=\"24\">24</option>");
			document.write("<option value=\"25\">25</option>");
			document.write("<option value=\"26\">26</option>");
			document.write("<option value=\"27\">27</option>");
			document.write("<option value=\"28\">28</option>");
			document.write("<option value=\"29\">29</option>");
			document.write("<option value=\"30\">30</option>");
			document.write("<option value=\"31\">31</option>");
			document.write("<option value=\"32\">32</option>");
			document.write("<option value=\"33\">33</option>");
			document.write("<option value=\"34\">34</option>");
			document.write("<option value=\"35\">35</option>");
			document.write("<option value=\"36\">36</option>");
			document.write("<option value=\"37\">37</option>");
			document.write("<option value=\"38\">38</option>");
			document.write("<option value=\"39\">39</option>");
			document.write("<option value=\"40\">40</option>");
			document.write("<option value=\"41\">41</option>");
			document.write("<option value=\"42\">42</option>");
			document.write("<option value=\"43\">43</option>");
			document.write("<option value=\"44\">44</option>");
			document.write("<option value=\"45\">45</option>");
			document.write("<option value=\"46\">46</option>");
			document.write("<option value=\"47\">47</option>");
			document.write("<option value=\"48\">48</option>");
			document.write("<option value=\"49\">49</option>");
			document.write("<option value=\"50\">50</option>");
			document.write("<option value=\"51\">51</option>");
			document.write("<option value=\"52\">52</option>");
			document.write("<option value=\"53\">53</option>");
			document.write("<option value=\"54\">54</option>");
			document.write("<option value=\"55\">55</option>");
			document.write("<option value=\"56\">56</option>");
			document.write("<option value=\"57\">57</option>");
			document.write("<option value=\"58\">58</option>");
			document.write("<option value=\"59\">59</option>");
			document.write("<option value=\"60\">60</option>");
			document.write("</select>");
		document.write("</td>");
	document.write("</tr>");	
	document.write("<tr>");
		document.write("<td class=\"form_header\">* Gender</td>");
		document.write("<td class=\"ltd_quote_form_input\">");
			document.write("<select id=\"gender\" class=\"ltd_quote_dropdown\">");
			document.write("<option value=\"\"></option>");
			document.write("<option value=\"Male\">Male</option>");
			document.write("<option value=\"Female\">Female</option>");
			document.write("</select>");
		document.write("</td>");
	document.write("</tr>");	
	document.write("<tr>");
		document.write("<td class=\"form_header\">* Smoker?</td>");
		document.write("<td class=\"ltd_quote_form_input\">");
			document.write("<select id=\"is_smoker\" class=\"ltd_quote_dropdown\">");
			document.write("<option value=\"\"></option>");
			document.write("<option value=\"1\">Yes</option>");
			document.write("<option value=\"0\">No</option>");
			document.write("</select>");
		document.write("</td>");
	document.write("</tr>");	
	document.write("<tr>");
		document.write("<td align=\"left\">");
			document.write("<input type=\"button\" id=\"get_quote\" class=\"ltd_quote_submitbtn\" value=\"Calculate\" onclick=\"get_ltd_quote();\" />");
		document.write("</td>");
		document.write("<td align=\"left\">");
			document.write("<div id=\"ltd_quote_result\" visible=\"false\"></div>");
		document.write("</td>");
	document.write("</tr><tr><td colspan=\"2\">This estimate is for a $1,000 monthly benefit; 90 day waiting period; payable to age 65</td></tr>");
	document.write("</table></form>");
}
outputLTDForm();