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Long Term Disability: Own Occupation vs. Any Occupation

Long term disability insurance plans provide benefits to employees who have become "disabled." Initially, most plans define disabled as the inability to perform your own occupation. After a period of time (usually between 6 months and 3 years) the plan changes the definition of disabled to the inability to perform any occupation.

A large number of disability claims are denied when the definition changes from "own occupation" to "any occupation." To appeal such determinations, you must demonstrate to the insurance company that you do not have ability to perform any job for which you are reasonably qualified. Key evidence for these appeals will involve your level of education, former jobs, and the skills you learned while you were employed. It is also important to present your current medical restrictions and the medications that you take. If you have been approved for Social Security Disability benefits, this is strong evidence that you cannot perform any occupation. Finally, you may want to hire a vocational expert to provide an opinion as to your employability.

Remember, you may only have one opportunity to build the record for your appeal. It is important to understand your rights before filing the appeal and to make sure that the administrative record is as complete as possible.

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