David Allen & Associates Blog

Social Security Disability Law Firm

Long Term Disability Policies: OWN OCCUPATION VS. ANY OCCUPATION POLICY

    As you became aware when you watched some of the other video blogs dealing with long-term disability policies, policies provided through your employer are treated differently than policy issued purchased individually from an insurance agent.

    Both employer-provided policies and policies you by yourself are similar in coverage which is provided. An important distinction in coverage is own occupation coverage and any occupation coverage.

    OWN OCCUPATION POLICY

    Under an own occupation policy you are considered disabled if you cannot perform the substantial and material tasks of your own occupation. An example: someone works as an executive assistant. Typing is extremely important. If the executive assistant suffers a crush injury to a hand and the loss of two fingers the executive assistant can no longer type. The person is prevented from performing her own occupation. As such, they are considered disabled under an own occupation policy. Under in any occupation policy the same person for the same injury may not be considered disabled because the person can perform jobs which did not require typing. It could be a job as simple as a Walmart greeter.

    Most policies provided through employer provide own occupation coverage for a specific period of time. The period of time can be anywhere from a one-year to five years. It is usually two years. At the end of that time the standard for disability changes. The policy becomes in any occupation policy. The executive assistant with a crushed hand would be considered disabled under the own occupation provisions of the policy. When the policy terms change at the end of the own occupation period the insurance company will generally consider the person no longer disabled. The insurance company will point to other jobs in the economy the person can perform, once again, such as a Walmart greeter.

    Many people who received long-term disability benefits from an insurance company for two years are surprised when they are then terminated. The reason for the termination is the provisions of the policy provide a different standard for disability at the end of two years. The standard becomes any occupation.

    Is extremely important to contact a law firm who handles long-term disability cases when you receive a termination notice from an insurance company which states you are no longer disabled because the policy now requires disability from any occupation. Even though the insurance company argues you are no longer disabled from performing any occupation the condition you are suffering may actually disable you from any occupation. This requires careful reading of your medical records and the policy which applies. It is something best left to an expert in the field.

    ANY OCCUPATION POLICY

    Disability policy issued purchased from an insurance agent usually consist of one of two kinds of policies. They are usually either any occupation disability policies or own occupation disability policies. Unlike policies provided by an employer they don’t change from own occupation to any occupation have to become disabled. That is usually the case but occasionally there is an individual policy which changes from own occupation to any occupation.

    The best policy to purchase is an own occupation policy. There are many policies, particularly in the medical professions, which provide that the person will be considered disabled if they cannot perform the substantial and material pass of their own employment. The employment may be that of a dental technician, a dentist, an ophthalmologist, a cardiac surgeon or a podiatrist. While own occupation policies are common for medical professionals they also are available for other professions, and frankly any profession.  Policies can be purchased for all kinds of professions, such as architects, building Contractors, stage performers, acrobatics, and race-car drivers.  Someone can also purchased a policy which simply states they are considered disabled if they are unable to perform the substantial and material tasks of their own occupation at the time of disability. As such they can get a policy which will provide coverage for their disability irrespective as to what their job is if they can no longer perform that job.

    Individual own occupation policies are the best long-term disability policies to purchase. They provide the most extensive coverage. Under the law may also provide the best opportunity to get fully reimbursed for all difficulties that arise should an insurance company wrongfully deny coverage.
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