Disability Insurance Benefits: Understanding Own Occupation vs. Any Occupation

Aug 24, 2020 - Articles by

Being disabled and unable to work is a difficult and trying time, full of medical and financial uncertainty. Long-term disability insurance can help provide some financial stability when you are unable to work. With a wealth of experience in helping medical professionals secure their disability insurance benefits, the Philadelphia disability insurance attorney team at Seltzer & Associates is ready to help you secure your disability insurance benefits.

One of the challenges of securing long-term disability insurance benefits is understanding the terms and definitions used in the insurance policies. Understanding your coverage is essential in crafting a record and highlighting your limitations in order to successfully obtain your benefits. Relying on a Philadelphia disability insurance attorney with nationwide experience is crucial to success in your long-term disability case. 

In making a determination on your disability insurance benefits claim, your disability insurance company will analyze your entire record, including examining the medical evidence to determine potential limitations in the workplace. 

Disability insurance policies may apply different definitions of disability at different times depending on the terms of your coverage: these are “own occupation” and “any occupation.”

Understanding “Own Occupation” 

The own occupation definition considers the essential or material and substantial duties of the occupation you were performing just prior to the onset of disability; this could be your specialty or subspecialty if you were engaged in the practice of medicine, dentisty or law. The insurance company then evaluates whether the claimant’s medical condition(s) warrant restrictions and/or limitations on work capacity, and whether the claimant is able to perform the essential duties of his or her own occupation. The insurance company will examine your occupation as your were performing it for your employer, and also how the occupation is performed in the greater national economy. Seltzer & Associates has nationwide experience working with disability insurance companies to obtain disability insurance benefits for medical professionals, including physicians, surgeons, dentists and others.

Understanding “Any Occupation” 

Insurance companies continually review the cases they have approved for disability insurance benefits. Insurers will request additional medical records to confirm treatment and prove continuing disability. Depending on the policy terms, the standard or definition of disability may transition from “own occupation” to “any occupation,” which means that the insurance company will determine whether the insured is able to perform any occupation for which they qualify based on education, training, experience and pre-disability income level.

For example, a surgeon who is no longer able to perform surgeries due to medical limitations may be able to use his or her skill in another capacity that is not affected by the disabling condition(s). Under the “any occupation” definition, the insured will face a heightened standard, often making it more difficult to prove disability.

A Philadelphia Disability Insurance Attorney Can Help You

Do not let your disability insurance company terminate your disability insurance benefits just because your claim transitions from “own occupation” to “any occupation.” If you are facing a change in occupation status, contact a Philadelphia disability insurance attorney at Seltzer & Associates to secure your disability insurance benefits. Call our nationwide disability insurance law practice today at 888-699-4222.