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“Own” vs “Any” Occupation in Long Term Disability Insurance Plans

Almost every Long Term Disability Insurance Policy I have ever reviewed contains a limited period (usually 24 months) of time that it will pay benefits if a claimant is unable to perform the duties of  his/her “Own” (see prior post on how “Own” occupation is misleading) occupation.  The plans most commonly contain a change in the definition of disability from “Own”occupation to “Any” occupation after the 24 month period runs.  So, after 24 months the claimant must be able to establish that they are unable to perform the duties of “Any” occupation in order to continue to receive benefits.  A few caveats-there is also usually a qualifier for “Any” occupation that the claimant may be qualified to perform the identified occupation by education, training or experience.   There is also usually an earnings qualified that the identified “Any” occupation  must usually pay some percentage (commonly 60 or 80%) of the  claimants “Own” occupation.

We see many claims where the Long Term Disability insurer refuses payment past the 24 month “Own” occupation period by identifying some less demanding occupation it asserts the claimant can perform.