Long-term disability insurance is something no one wants to think about. Both employers and employees alike dread the idea of an employee going on disability insurance, but it is a vital part of a benefits package to understand for both parties.
The insured’s rights can vary greatly from policy to policy, so each plan should be carefully reviewed to ensure the language benefits both the employee and the employer.
Let’s examine the differences between own and any disability insurance.
The difference between an “own-occupation” policy and an “any occupation” policy is simply the insurance coverage of being able to do a specific job or any job.
In other words, own-occupation disability insurance (or OCC disability) defines total disability as an employee suffering an injury or illness that prevents them from performing the normal responsibilities of their regular position.
In contrast, any disability insurance defines total disability as an inability to work any job or occupation.
It’s important to note, if the insured is still capable of working, even if it is at a lower-paying job, an any-occupation policy will not pay any benefits.
Therefore, any occupation policy is more sweeping in the scope of coverage and is more accessible for employees to collect benefits, regardless of injury or illness.
In the United States, it is not uncommon for almost all long-term disability insurance plans to define long-term disability as own occupation as the standard for coverage, then transition to any occupation after two years of benefits have been paid out to the insured.
Employees making a disability claim will need to determine whether they are insured under an own occupation or any occupation disability policy to get the appropriate benefits.
Once this is determined, the claim will need to be legally presented with factual support to initiate the benefit.
If an employee is approved for long-term disability benefits, they will also need to file for social security disability benefits. You can find out more about that here.
Employees must obtain well-documented medical evidence of their disability by a qualified physician to get their benefits started.
Here are some of the conditions that qualify for long-term disability in the U.S.:
This list is in no way comprehensive but gives you a better idea of the kinds of conditions that qualify for long-term disability insurance. Looking for more exclusive content? Check out what’s trending on the Mployer Advisor blog, and be sure to catch the latest episode of This Week in Benefits.
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