What Does “Any Occupation” in LTD Really Mean? (Part 2)

In our previous post, we started looking at the “any occupation” test in long-term disability insurance and what it actually means.  Contrary to how it sounds, being disabled from working in “any occupation” doesn’t mean you’re incapable of doing any job.

As we discussed, “any occupation” means any occupation that you’re reasonably suited to by education, training and experience. But there are also other aspects of this “any occupation” test that are also important to understand. Let’s look at them here.

The Employment Must Be Gainful

This “any” occupation must also be gainful relative to how much you earned before your disability. Generally, the threshold for what’s considered to be gainful is about 60% of your pre-disability salary.

A job that you’re capable of doing, but pays significantly less than what you were previously earning, will not be considered to be suitable.

The Insurer Must Consider Your Circumstances On the Whole

Insurers must take into account your individual circumstances as a whole when determining what work you are able to do. In addition to considering your work abilities and experience, they must also take into account your health circumstances.

That is, they must look at all aspects of your health, not just your physical abilities.

Sometimes your emotional or cognitive disabilities are the major factor in you not being able to work, and they are just as valid as physical limitations.

Retraining May Open Up More Types of Work

Remember: the insurer is highly motivated for you to get back to earning an income, so that they can stop paying you benefits as soon as possible. To that end, they may suggest that with some additional training, you would be able to work again in a different (“any”) occupation.

If asked to, and if your doctor supports the idea, you should keep an open mind and try your best to participate.  Even if this is not successful, it will show that you’re unable to work and that you should continue receiving LTD benefits.

Every insurance policy is slightly different, so it’s important to see what your actual policy says.

We know how difficult it is to go up against an insurance company in Ontario, and we’re here to help. Contact us today to arrange for a free consultation.