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    How Different Occupations Impact Long-Term Disability Claims

    How Different Occupations Impact Long-Term Disability Claims

    Long-term disability (LTD) insurance can cover a percentage of your pre-disability earnings when you cannot work for an extended period due to a medical condition or injury. Unfortunately, it can often be difficult to convince insurers that your conditions prevent you from fulfilling the duties of your occupation.

    Your profession may be a factor when it comes to proving your entitlement to long-term disability benefits, either because the job requires certain unique skills or because the role is commonly associated with specific health challenges. This article will explore how different occupations may affect the outcome of a long-term disability claim.

    CCK Law will explain:

    • The definition of disability
    • General factors affecting LTD claims across different occupations
    • Challenges and risks from different professions that could impact a long-term disability claim
    • Professionals who may need LTD benefits
    • And more
    Who We Are: Chisholm Chisholm & Kilpatrick is a leading public interest law firm based in Providence, Rhode Island. Since 1999, we have been helping long-term disability claimants across the United States receive the benefits they need, through educational materials and vigorous advocacy.

    Understanding the Definition of Disability

    One of the premier components of a long-term disability claim—regardless of profession—is the definition of disability. All long-term disability insurance policies contain one, and it is vital that individuals understand what it means and how it can impact their claims.

    Definition of Disability in Long-Term Disability Policies Explained

    There are two types of definitions of disability that an LTD claimant may typically find in their policy. They are commonly known as “own occupation” or “any occupation” definitions, though some policies may label them differently. Often, LTD policies provide that a claimant must meet the “own occupation” definition initially, but then must meet the “any occupation” definition after a specified period of time, in order to continue receiving benefits.

    These definitions can be understood as follows:

    • Own Occupation: considers the job the claimant had at the time they became disabled (typically how it is performed in the national economy), and examines whether the claimant is capable of performing the duties of that job. Often, this definition is easier for claimants to prove that they meet.
    • Any Occupation: considers any job at all that the claimant is qualified for, regardless of its similarity to the claimant’s current position, and examines whether the claimant is capable of performing the duties of those other occupations.

    Now, some any occupation definitions also include what is known as a “gainful component” that can sometimes make the definition easier to meet. The gainful component provides that if the claimant cannot perform an occupation that they are reasonably qualified for and that pays a certain percentage of their pre-disability earnings (usually around 60 percent), then they can receive benefits.

    All long-term disability claimants must prove to their insurers that they are disabled under the definition present in their policy to receive LTD benefits. For more information on the definition of disability, you can read our article on the subject.

    An example of an occupation impacted by the definition of disability: If a doctor has an own occupation policy, they may be eligible for benefits due to a medical condition that only interferes with a handful of highly specific duties. But if the doctor has a policy with an any occupation definition, and the doctor can still perform the duties of a different sedentary job, then the insurance company may deny their claim.

    Components of an Occupation

    Given that LTD policies typically define disability based on a claimant’s ability to perform either their own or another occupation, it is important to understand what the components of an occupation are.

    Insurance companies typically use the O*Net Database to define what the duties of an occupation are. In the past—and even in some cases today—they would use the Dictionary of Occupational Titles, or DOT. In many cases, insurers also look at how a job is performed in the national economy, not at a specific employer.

    However, whether an insurance company uses the O*Net Database or the DOT, these resources do not tell the whole story of an occupation. Often, the descriptions are outdated or lacking in depth. Moreover, they often do not consider many other duties that a person has in their position.

    Nonetheless, all occupations have certain components, namely, the physical and the cognitive duties a person must complete. If a medical condition prevents them from carrying out these duties, then they may be eligible for long-term disability benefits.

    Physical Demands of a Job

    The physical demands of a job can vary widely. Industry, job function, and workplace conditions all play a role. Nonetheless, the ability to perform these duties can affect an individual’s eligibility for LTD benefits.

    The physical demands of a job refer to the physical tasks that are required to carry out the job’s duties. For example, among other things, physical demands can include the amount of a time a person must spend sitting, standing, or walking during a typical workday, the amount of weight they must be capable of lifting or carrying, the amount of time they must use their hands for fine manipulation, or whether climbing ladders or crawling on the ground is required.

    Some jobs require lifting, standing for extended periods, or repetitive motions—such as construction, nursing, or assembly line work. But other jobs are more sedentary and involve prolonged sitting, fine motor skills, and the ability to remain stationary for extended periods.

    Sedentary Work and Long-Term Disability

    Certain conditions, such as musculoskeletal conditions, can make it impossible for a worker to lift significant weight or stand for extended periods, but such conditions could also negatively impact a worker’s ability to engage in prolonged sitting.

    Likewise, a neurological disorder that causes hand tremors could interfere with a worker’s ability to perform repetitive motions in assembly line work or another worker’s ability to type on a computer.

    When filing a long-term disability claim, supplemental medical evidence, such as physician reports and functional capacity evaluations, can help corroborate the extent of a person’s disability and its impact on their ability to work. Insurance companies often require objective evidence. Claimants may also be subject to independent medical examinations (IMEs) to verify their limitations.

    Cognitive Demands of a Job

    Another key component of an occupation is the cognitive demands a person must perform. Not all occupations are purely physical. Some positions require a certain level of mental acuity to perform adequately.

    Examples of common cognitive demands include prolonged concentration, memory retention, problem-solving, analytical thinking, and multitasking. Professionals in law, finance, engineering, and medicine (among others) rely heavily on cognitive functions. Their cognitive abilities allow them to meet deadlines, analyze information, and make critical decisions.

    Conditions such as traumatic brain injuries (TBIs); neurological disorders, such as multiple sclerosis or Parkinson’s disease; and severe migraines, can impair a person’s ability to sustain the focus and mental acuity they need for these roles.

    While the cognitive demands of a job are equally important as the physical, when filing for LTD benefits, it is often more challenging to prove that a person’s ability to perform a job’s cognitive demands is affected. This is because cognitive impairments are often not as easily measured through objective medical tests. Many conditions that affect a person’s cognitive abilities also rely on subjective evidence, such as self-reported symptoms.

    However, obtaining a neuropsychological evaluation from an outside expert can help quantify the extent of a person’s cognitive impairments and strengthen these LTD claims. Moreover, gathering supplemental evidence like witness statements from friends, family, and co-workers can also help a claimant demonstrate that they meet the applicable definition of disability within their insurance policy.

    Mental and emotional stress play a part in LTD claims, too. Professions that come with elevated levels of stress can contribute to the need for such benefits. Mental health conditions, which often impair a person’s cognitive abilities, can qualify for long-term disability. Examples include anxiety, depression, and burnout. These conditions are often found in legal practices and the healthcare industry.

    Challenges and Risks Specific to Certain Professions

    There are certain hazards that are common to specific professions. When filing for long-term disability benefits, claimants must provide their insurer with information on the duties of their job.

    The insurance company reviews this information alongside evidence of the claimant’s medical condition to determine if they qualify for LTD benefits. Therefore, understanding the challenges and risks common to your profession can help prove your claim to your insurer.

    Healthcare Workers

    Healthcare workers like physicians and nurses often suffer from musculoskeletal injuries. These painful conditions arise from long hours on their feet, bending and twisting repetitively, and lifting patients and other equipment throughout the workday.

    Burnout is also common because healthcare workers often work in high-stress environments like emergency and operating rooms.

    Note that filing LTD claims for these conditions can still be difficult, however. Insurance companies will scrutinize the claimant’s ability to work under high stress. It may be necessary to submit extensive documentation of the claimant’s inability to work.

    Office Workers, Software Developers, Tech Workers, and Corporate Employees

    Carpel tunnel syndrome and back pain are common medical conditions amongst office and tech workers and corporate employees. This is a result of the repetitive duties of their jobs, such as typing on a keyboard or sitting for extended periods.

    LTD claims for office workers and corporate employees often involve conditions that develop gradually rather than sudden injuries.

    Anxiety and depression are common medical conditions that lawyers and other legal professionals suffer from. These professionals must work long hours, sometimes in high-stress environments. These aspects of their jobs add to the frequency of mental health disabilities.

    Despite how common these conditions are among professionals in these fields, it is still challenging to collect objective evidence of a mental health condition, which insurers prefer. Therefore, those with a mental health condition—such as anxiety—should consider collecting supplemental evidence (e.g., a neuropsychological evaluation).

    Vocational Evidence in Long-Term Disability Claims: Why It's Important

    Banking and Financial Professionals

    There are many types of banking and financial professionals, including corporate financial analysts, actuaries, traders, investment bankers, and others. Each has its own responsibilities and occupational duties.

    Any medical condition or injury that could diminish their cognitive abilities could warrant long-term disability benefits. The cognitive duties of these positions are vital to their success, so conditions such as depression or Alzheimer’s disease may render them eligible for LTD benefits.

    Manual Laborers

    Construction workers, oil workers, and other tradespeople face an elevated risk of injuries and medical conditions that prohibit physical activity. Injuries can occur from falls, equipment accidents, and repetitive motions. Likewise, if a manual laborer develops a medical condition, such as Parkinson’s disease, which impairs their physical abilities, then they may be unable to work. LTD benefits can help cover those in these situations.

    Professionals Who May Need Long-Term Disability Benefits

    As we have mentioned in this article, every job is different. Each occupation has its own duties, and a medical condition can affect one professional differently from the next. Below, you will find some of the articles with more details about different professions and how a person in these roles may come to need to file for LTD benefits.

    Note: You may have a long-term disability policy either through your employer or directly from an insurance company. To find out, you can contact a member of your company’s HR department. If you have a policy through them, then they can provide you with more information about your coverage.

    Struggling With an LTD Claim? Call CCK Law

    CCK Law has been helping long-term disability claimants since 1999. We’ve gone up against all the big-name insurance companies in the United States, and we know how they operate. We tailor our approach for each individual client based on their situation.

    Call us today at (800) 544-9144 for a free case evaluation with a member of our team. We’ll analyze your case and determine if we can assist.