With most employer-sponsored disability policies, you first need to prove you can no longer work in the occupation you had at the time you became disabled. This definition of disability usually applies only to the first 24 months of benefits and is known as the “own occupation” period.
After you’ve received 24 months of benefits, the definition of disability changes to “any occupation,” a standard that is much harder to meet. You must be unable to perform any occupation which may exist in the national economy for which you are educated, trained or suited.
For example, consider a surgeon whose disability restricts them from repetitive use of their hands but who’s in good health otherwise. While the doctor is unable to perform surgeries, the insurance company will argue that they have other options such as teaching, telemedicine, or even simple jobs outside the medical profession.
And it is your burden to prove that you meet this new “any occupation” definition of disability. However, proving that you cannot work in any occupation (to the insurance company that may have denied your claim in the first place) is a burden made more challenging by complex laws and procedures.
Providing Substantial & Compelling Evidence of Disability from Any Occupation
For several reasons, it is very important to stack the record with evidence of your disability while your claim (or appeal, if your claim is denied) is still pending. A successful strategy for approval of disability benefits requires vocational, medical, and non-medical evidence that solidly supports your claim and proves you meet the policy’s “any occupation” definition of disability.
Though every individual’s case is unique, common examples of such evidence include:
- Vocational export reports;
- Functional Capacity Evaluations (FCE);
- Independent Medical Examinations (IME);
- Peer reviews from independent doctors with expertise in your condition(s);
- Letters and questionnaires from your treating physician(s); and
- Claimant affidavits and statements/testimony from friends, family, work colleagues, and other lay witnesses
Approach your claim or appeal from a critical perspective and have a comprehensive plan of action. You can count on the fact that your insurance company has one, and it’s not necessarily one designed to result in your disability benefits being approved.
Because federal law applies to most disability insurance claims, we can help clients across the country. Disability insurance companies have lawyers. You should too. Call Dabdoub Law Firm to get experienced disability lawyers on your side.
We can help with:
- Submitting a disability insurance claim;
- Appealing a long-term disability denial;
- Managing an ongoing claim for disability benefits;
- Negotiating a lump-sum settlement; or
- Filing a lawsuit against your disability insurance company.
Call for a free consultation with an experienced disability attorney. No fees or costs until you get paid.
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