Own Occupation Disability – What Does That Really Mean?

What does it mean when someone refers to “Own Occupation Disability” while disputing benefits? We’re sharing the details below.

In a dispute over Long Term Disability benefits, the term “own occupation disability” can start to take on more meaning that those two words seem to imply at first glance. The general gist of this examination is that a claimant is found to be disabled if they become unable to perform the material and substantial duties of their own occupation. Typically, the own occupation period of analysis covers the first two years during which benefits are owed.  Later, the standard changes to any occupation.

For purposes of analysis of what the substantial duties of your own occupation, many of our clients come to us wondering what basis will be used to decide what their own occupation and its duties entail. Governing case law tells us that the duties of your own occupation that should be considered in this analysis are the actual duties that you handle on a day to day basis in the position that you held. A national standard for what is required for a position similar to yours would not be applied.

This point can be the difference between winning and losing your claim.  In the national economy, your specific position can be described as sedentary when the case may be that in your specific role, many facets of your job included light, medium or even heavy-duty work. As sedentary work can be done in a seated position without much movement required, the standard is much higher to overcome to prove the disability. 

If you believe that the incorrect standard is being applied to your claim in an effort to wrongfully deny your Long Term Disability benefits, please contact our firm. After discussing your case, we can set an office conference, if you would like.

 Herbert M. Hill, P.A. is a law firm located in Orlando, Florida with a practice extending throughout the state of Florida.  While the vast majority of cases handled are for disability insurance benefits, areas of practice include employee benefit claims of all sorts.  The firm handles any claims arising under the Employee Retirement Income Security Act (“ERISA”) for disability benefits, medical benefits, retirement benefits of any sort, including pension, 401k, termination agreements or the like as well as claims arising under private disability policies.