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Own Occupation vs. Any Occupation Disability Claims

Understand How Disability Occupation Standards Change Over Time

Our disability attorneys have helped clients pursue long-term disability claims with many of the major disability insurance providers, including Hartford, Cigna, Unum, Met Life, Prudential, Principal Financial Group, Northwestern Mutual, Sedgwick, Madison National Life, Aetna, Disability RMS, and Lincoln Financial Group. One common feature of disability insurance plans across the board is the application of two distinct standards of disability – the “own occupation” standard of disability followed by an “any occupation” standard – depending on the duration of the claim. Most disability insurance plans apply the “own occupation” standard initially, then transition to the “any occupation” standard after disability benefits have been paid for two years.

“Own Occupation” Disability Claims

Under the “own occupation” standard of disability, a person is typically considered disabled if unable to perform the material and substantial duties of the job they were working at the time they became disabled. To support a disability claim under this standard, it is important to consider the specific physical requirements of the job – for example, the standing, walking, or lifting requirements – and then gather evidence demonstrating why the person cannot perform those specific requirements. The evidence needed to support an “own occupation” disability claim varies from case to case, but will almost always include medical records and medical opinion evidence from treatment providers. Additionally, we often refer our clients to a specialist who performs functional capacity evaluations. A functional capacity evaluation provides objective evidence of an individual’s physical capabilities. After we’ve gathered sufficient medical evidence, we draft an appeal letter of legal arguments explaining why the claim should be approved.

“Any Occupation” Disability Claims

The “any occupation” standard of disability is more difficult to meet. Under this standard, a person is considered disabled if they are unable to perform the material and substantial duties of any job for which the person may earn a certain percentage of their pre-disability earnings. Therefore, the evidence needed to support an “any occupation” disability claim includes vocational as well as medical evidence.

Our firm represents clients at all stages of the disability insurance benefits claim process. If you have been denied disability benefits under either the “own occupation” or “any occupation” standard of disability, we’re ready to help. Contact one of Hawks Quindel’s experienced disability attorneys for a free case evaluation to discuss your claim. In Madison, WI call (800) 610-0040 or (608) 257-0040. In Milwaukee, WI call (800) 236-3348 or (414) 271-8650, or send us an email.