When you are applying for long-term disability benefits, you are required to undergo any occupation test. Matters relating to disability can sometimes be confusing. In a lot of cases, one does get confused between own occupation and any occupation. Filing for long-term disability benefits is never an easy task. There are a lot of tiny details which need to be paid close attention to. Grillo Law | Personal Injury Lawyers, is well experienced in long-term disability claims and will help you through the whole process.
What is understood by ‘any occupation’?
According to ‘any occupation’ disability, the benefits are awarded only to those whose injury or sickness is interfering with the insured’s ability to work in any occupation that they are qualified for depending on their level of education or previous experience. It is usually a governing test that is undertaken after two years of disability, which determines whether the insured is still qualified for the benefits or not.
When the court is interpreting the provision for any occupation, it takes two factors into account. First, the injuries have been looked on as a whole, which implies that if the person isn’t suffering any physical injuries, it shouldn’t be assumed that they can work. The emotional and cognitive problems the insured is facing shouldn’t be ignored. Secondly, the occupation is considered something which the insured is qualified to do. Employment is deemed reasonable only after determining whether the duties and the type of job and compensation offered are similar to what was provided to the person before their disability.
What is the difference between ‘any occupation’ and ‘own occupation’?
In case the provision in your policy is an own occupation test. In contrast, you would qualify for benefits if the injury or sickness directly interferes with your ability to perform your occupation. This provision is the most lenient as it considers the insured’s ability to perform the person’s specific job. Whereas the clauses in any occupation are more challenging to meet, it is easier to interpret the clauses of ‘own occupation.’
When would you require legal help?
If you have sustained injuries that have caused long-term disability and have been denied benefits due to failure in the past tests, then don’t lose heart. You must get independent advice that will help to ensure that your rights are protected. The insurers usually terminate benefits unfairly by interpreting it as ‘any occupation’ too narrowly. These factors are also considered by the judge when interpreting ‘any occupation’ provision. For example, the court will look into the availability of work for the insured and the compensation they are likely to get paid, and their mental well-being.
Hiring a well-experienced and long-term disability lawyer is a great decision to make. They will collaborate with the right medical experts to gather evidence that would support the client’s inability to work. For example, if you have been diagnosed with depression or anxiety, a qualified psychiatrist would be a suitable expert witness to support your case.