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What does your policy say about your own occupation?

On Behalf of | Jan 21, 2022 | ERISA

If you are filing a claim because you believe that you are disabled, there are a lot of factors to consider. You need to know the exact definition of a disability in your policy, you need to know how to get the medical records to prove that you’re disabled, you need to consider the long-term costs and financial losses, and much more. A diagnosed illness or injury alone is not enough. You must show that you are restricted and limited from working because of the illness or injury.

One other thing to think about as you work through this process, though, is just how your policy defines a disability. Two of the broad categories are for a disability within your own occupation or within any occupation. These may sound similar, but there’s a stark difference that can have a massive impact on your case.

Disabled from your own occupation

If your policy says that the disability can apply to your own occupation, this means that you’ll qualify if you simply can’t do the job that you were doing previously. It doesn’t matter if your disability still makes it possible for you to do a different job or change careers. You’re still covered based on that wording. You had a specific career that you wanted to follow, it is now impossible to do so, and your disability is the reason why.

Disabled from any occupation

On the other hand, if the policy says that you have to be disabled from any occupation, that leaves the door open to changing jobs. Maybe you can no longer work a physically demanding job, for instance, but you can switch to a desk job. This wouldn’t even be a consideration in an “own occupation” claim, but it does matter for any occupation.

That said, it’s important to remember that this doesn’t even mean any occupation at all. It still has to be one that is reasonable for you, based on things like your age, the experience you have and your level of education. You can’t simply be told that you need to do a job that you’re entirely unfit for, even if it would technically be possible with your disability. It has to be a realistic job that you could hold.

Working through a complex process

This is just scratching the surface of how complex these claims can become. Even things like the definition of a single word can have a big impact on your case and your claim. Make sure you know exactly what steps you need to take, from a legal standpoint, and what you can do to set yourself up for success.