What Does “Any Occupation” in LTD Really Mean? (Part 1)
Under most disability insurance policies in Ontario, the test for whether you are eligible for benefits is whether you are totally disabled from doing your “own occupation” or “any occupation”.
During the first two years of being on LTD, the test of whether you’re totally disabled is whether you can do the main duties of your own occupation. Please note that own occupation (the type of role and work you do) is not the same as own job (the position you work in for a specific employer).
But after two years, the test changes to whether you can do the main duties of any occupation. This is known as the “change of definition.” In effect, this change of definition makes it harder to qualify for LTD, because the range of job tasks and duties is significantly broadened.
On first glance, this could be alarming. One minute you were covered, and the next you’re cut off from your benefits because you could in theory do any job, even one you’re completely overqualified for?
Not at all. Here’s a look at what “any occupation” really means in the context of LTD. (These are general guidelines; please remember that your individual LTD policy may vary.)
Reasonably Suited
Being totally disabled from any occupation means any occupation that you are reasonably suited to, based on your education, training, or experience.
It does not mean any occupation or job that exists, or one that you are over- or under-qualified for. The status and nature of work, hours of work, salary, length and type of work experiences, your age and the current job market must also be considered.
Note also the term “reasonable.” If you could do a job, but it would take every ounce of your energy and leave you unable to manage other aspects of your life, that’s not reasonable.
Or, if you could do the key duties of your job but doing so would result in significant pain, that’s also not reasonable.
There are other elements that make up the “any occupation” test. We’ll take a look at them in our next post.
If your LTD benefits have been cut off because the insurer says you don’t pass the “any occupation” test, we understand how stressful this is, and we’re here to help. Get in touch with us to arrange your free consultation today.