The lawyers in our firm are focused on helping people with disability policies and ERISA claims. We want to give you the edge in understanding your policy. Today, we want to help you understand what the term “own occupation” means in your disability policy.
Your common sense tells you that your “own occupation” is the job you're doing when you become disabled. That is not the case with many group disability policies, and it's not the case in some private policies. Some private policies may follow that common sense definition or may reference a very specific occupation such as if you are a physician or a specialist, and you are certified in that.
Group disability policies and some private policies will likely define your “own occupation” by an occupational title assigned to your job as it is performed in the national economy. Those policies may not consider the job duties which are now impossible for you to perform. And that can be very unfair, so let's talk about that.
Let's say your job requires you to lift 50 lbs. off of a conveyor belt and load it into a truck. You are now injured, and you cannot lift 50 lb. boxes. You can lift and carry 10 lb. boxes, but that's not good enough to do your job. However, in the national economy, that same occupation, as it is titled, may be performed by equipment that does not require the employee to lift and carry 50 lb. boxes. The ability to carry 10 lb. boxes is enough, so a group disability insurer may deny your claim using that national economy description of your job in that situation.
That puts you in a very difficult position. You are unable to perform your job, but the insurance company refuses disability benefits. That is a regular trap for the unwary. You need to read your policy. And, remember our ERISA attorneys and long-term disability lawyers are here to help if you run into problems. Contact us at the first sign of trouble with your disability claim.