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Defining “Regular” or “Own Occupation” for the Purposes of ERISA Long-Term Disability Claims

Defining “Regular” or “Own Occupation” for the Purposes of ERISA Long-Term Disability Claims

Long-term disability insurance policies are designed to provide you with benefits to replace a specific percentage of your income when you are unable to work. These policies often make you eligible for long-term disability insurance benefits when you are unable to work in your “regular” or “own” occupation. In contrast, some policies limit eligibility for benefits to an inability to work in “any” profession. Furthermore, the definitions in your plan may change over time or after you have been receiving benefits for a specific period or have received a certain amount of benefits.

Under a “regular” or “own” occupation policy, you may be eligible for long-term disability benefits if you cannot perform the material and substantial duties of your own occupation at the time of disability. In other words, if your medical condition prevents you from doing the job that you were doing at the time that you became ill or injured, then you may qualify for benefits. You might be eligible for benefits under this type of policy even if your medical condition allows you to perform a different kind of work or job. You also could qualify for these benefits if you find work in another field or occupation that you can perform.

Since it contains a more lenient eligibility standard, you have a higher chance of being approved for long-term disability benefits under a “regular” or “own occupation” policy. As a result, this type of policy is likely the type that best protects your income, as it has the most flexibility.

One aspect of the definition of “regular occupation” that may differ among policies is the distinction between the tasks that you perform at your particular job as opposed to the functions that might typically be part of a position of that type in the national economy. In some cases, insurers may rely on overly generalized, generic job descriptions that don’t honestly describe the demands and skills required that are unique to your position. In this instance, you may have to show the differences between your daily tasks and those in a generic job description for a similar job.

Obtaining long-term disability coverage can be essential to protecting your future. When you initiate a claim under this coverage, however, you need to be aware of your rights and responsibilities, which may necessitate the assistance of legal counsel. At Bonnici Law Group, we offer you client-centered representation at all stages of the long-term disability benefit claims process. When you need the kind of help that only an experienced long-term disability benefits attorney can offer you, contact Bonnici Law Group at 858-261-5454 or help@bonnicilawgroup.com.

1704, 2024

Navigating Long-Term Disability ERISA Denials: What to Expect with Bonnici Law Group

April 17, 2024|Categories: Law, Long-Term Disability, Vlog|Tags: |

Long-term disability can be a crucial support system for individuals facing significant challenges due to health issues or injuries. However, not everyone may be aware of the signs that indicate they could be a good candidate for long-term disability benefits.

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