Long-term disability (LTD) benefits provide financial support when you are unable to work due to a disability. But what if you are considering returning to work, even part-time? The answer depends on your policy, medical condition, and work capacity.
Many insurers use your return to work as a reason to reduce or deny benefits, even if you are not fully recovered. Understanding your policy and seeking professional guidance can protect your financial stability.
At Kantor & Kantor, we know the questions to ask, the documentation to prepare, and how to stand up to insurance companies if your benefits are unfairly denied. Our goal is to help you regain control of your life while protecting the financial stability that your LTD benefits provide.
The Difference Between “Own Occupation” and “Any Occupation”
If you have ever investigated LTD insurance, you have likely come across two important terms: “own occupation” and “any occupation.” These terms are foundational in determining under what circumstances you qualify for benefits. Here is what they mean:
The “Own Occupation” Definition
Most LTD policies initially define total disability under an “own occupation” standard. This means you are considered totally disabled—and eligible for benefits—if you cannot perform the specific duties of your own profession, even if you could work in another field. This definition is particularly relevant for high-income professionals such as doctors, dentists, and lawyers.
However, in the vast majority of policies, the definition of disability changes after a certain period, typically 24 months. After this initial phase, the policy transitions to an “any occupation” standard, which applies a stricter test for continuing benefits.
The “Any Occupation” Definition
After the own occupation period ends, most policies shift to an “any occupation” standard. Under this definition, you will qualify as totally disabled only if you are unable to perform any job for which you are reasonably suited based on your education, experience, and skill set. Some policies specify that “any occupation” includes jobs where you can earn a certain percentage—typically 60% or 80%—of your pre-disability income.
This transition from “own occupation” to “any occupation” often leads to increased scrutiny from insurance companies and, in many cases, a termination of benefits. If you are approaching this transition, it is essential to understand how your policy applies these definitions and consider consulting with an attorney to ensure you receive the benefits you deserve.
Exceptions: Own Occupation Only or Any Occupation Only Policies
While most policies follow the standard transition from own occupation to any occupation, there are exceptions. Some policies are strictly “own occupation only,” meaning benefits continue indefinitely as long as you cannot perform your specific job. Others are “any occupation only,” applying the stricter standard from the outset. These types of policies are less common but can significantly impact benefit eligibility.
How Many Hours Can You Work with an “Any Occupation” Disability Policy?
Many disability insurance policies offer partial disability payments, enabling you to work part-time while still receiving benefits. Generally, your benefits will decrease as your earnings increase. Here is a basic guideline for how partial disability benefits are typically adjusted:
- For the first year, benefits are reduced by a percentage of your earnings, usually 50 cents for every dollar earned.
- After the first year, benefits are reduced dollar for dollar based on your earnings.
- If you earn 80% or more of your pre-disability income, your benefits will typically be discontinued.
Since hourly wages can vary greatly, you will need to calculate how many hours you can work before it impacts your disability benefits. You must also provide monthly proof of your earnings and hours worked to your disability insurer.
How Kantor & Kantor Can Help You
Here is how we can assist you throughout the process:
1. Understanding Your Policy
The first step in any LTD claim is understanding the intricacies of your policy. Our attorneys will dissect complex policy language, identifying key provisions related to employment capabilities, and explaining them in a way that is easy to understand.
We will help you understand the implications of the “own occupation” versus “any occupation” standards, earnings caps, and trial work periods, providing clarity on how these terms directly impact your potential to work.
2. Filing Your Claim
Filing an LTD claim involves much more than filling out paperwork. It requires a strategic presentation of your case, including gathering medical evidence, expert opinions, and detailed documentation of your employment history and limitations. Our team will guide you through every step, ensuring that your application is strong and thorough.
3. Fighting Denials or Terminations of Benefits
If your insurer denies or terminates your benefits because of your work activity—or for any other reason—we are here to fight back.
Our experienced attorneys understand the tactics insurers use to deny claims, and we know how to counter them. We will build a strong case to appeal the decision and, if necessary, take the matter to court.
4. Resource and Network Access
Our extensive network includes medical professionals, vocational experts, and financial advisors who can provide additional support. This ensures you have a robust team behind you as you navigate your disability and employment journey.
5. Negotiating With Insurance Companies
Insurance companies often have their own interests in mind, which can mean minimizing payouts or denying claims. Our attorneys are skilled negotiators who understand the tactics these companies may use. We will advocate on your behalf, ensuring that the insurance company treats your claim fairly and respects your rights.
Contact Our Skilled LTD Attorneys Today
Returning to work while on LTD benefits does not have to mean losing everything you have worked for. It is about finding the right balance that allows you to explore your potential.
Whether it is working fewer hours, trying a different role, or testing the waters during a trial work period, there are ways to transition. We will help you understand what is possible and advocate for your right to make choices that reflect your capabilities.
It is important to remember that insurers do not always make this process easy. They may challenge your decisions, scrutinize your activities, or create unnecessary roadblocks. At Kantor & Kantor, we are people helping people, and we look forward to helping you.
If you are contemplating returning to work or have questions about your LTD benefits, contact us at 818-886-2525 for a consultation.
