Definitions of Disability

In a long-term disability claim, there are 2 definitions of disability (2 “tests”) used to determine if you qualify for disability benefits. First, you are assessed as to whether you can perform the essential duties of your own occupation and then you are assessed to see if you can perform the duties of any occupation. In most policies, the “Own Occupation” period lasts for 2 years, but it can be less or more, depending on the policy. It is important to read your own policy to find out what tests are applicable and when they apply.

OWN OCCUPATION

Own occupation refers to your pre-disability occupation (the job you held at the time your disability occurred). During the “own occupation” period of your long-term disability claim, “totally disabled” means, that as a result of injury or illness (physical or psychological), you are unable to perform the regular (essential) duties of your own occupation. This test applies to the first 24 months of disability (or the period set out in your policy). Not every group policy has an own occupation test- some policies have only any occupation test.

ANY OCCUPATION

During any occupation period, the definition of total disability changes to mean that, as a result of injury or illness (physical or psychological), you are unable to perform the regular duties of any occupation for which you are suited for (or could become qualified for) by reason of education, training or experience.