{"id":11966,"date":"2020-10-21T19:50:07","date_gmt":"2020-10-21T19:50:07","guid":{"rendered":"https:\/\/grillo.ca\/any-occupation-test-for-long-term-disability-benefit\/"},"modified":"2023-02-24T14:52:52","modified_gmt":"2023-02-24T19:52:52","slug":"any-occupation-test-for-long-term-disability-benefit","status":"publish","type":"post","link":"https:\/\/grillo.ca\/zh-hans\/any-occupation-test-for-long-term-disability-benefit\/","title":{"rendered":"\u2018Any Occupation\u2019 Test for Long Term Disability Benefits"},"content":{"rendered":"

In this section, we will go over the \u2018any occupation\u2019 test for long term disability benefits, what it means, and why it is required before benefits are paid out. We will explain when this test is required and what the courts look at before considering whether a person meets the ‘any occupation’ test. Let\u2019s take a look at the \u2018any occupation\u2019 test for long term disability benefits in Ontario. This article will also provide the difference between \u2018own occupation\u2019 and \u2018any occupation\u2019 as described in disability matters.<\/p>\n

What Is \u2018Any Occupation\u2019?<\/h2>\n

\u2018Any occupation\u2019 definition of disability states that benefits will only be awarded if an injury or sickness has interfered with the insured\u2019s ability to work in any occupation that they are reasonably qualified for depending on their level of education or previous experience. This test usually becomes a governing test after two years of disability that determine whether the insured still qualifies for benefits.<\/p>\n

There are two factors that the courts consider when interpreting this provision for \u2018any occupation\u2019. First, the insured\u2019s injuries must be looked at as a whole. This simply means that, if the person is not suffering any physical injuries, it shouldn\u2019t be assumed that he\/she is able to return to work by ignoring the emotional and cognitive problems they may be experiencing.<\/p>\n

Secondly, the court will look at whether the occupation is something that the insured is reasonably qualified for. For instance, a former CEO cannot be denied benefits because he\/she can work as a tele-marketer. The court will consider whether the employment is reasonable by determining the duties, type of job as well as compensation offered compared to the person\u2019s previous work before the disability.<\/p>\n

Difference Between \u2018Any Occupation\u2019 and \u2018Own Occupation\u2019<\/h2>\n

If the provision in your policy is an own occupation test, on the other hand, you may qualify for benefits if the injury or sickness directly interferes with your ability to perform a substantial part of your own occupation. This provision is usually the most lenient because it considers the insured\u2019s ability to perform their specific job. Unlike \u2018any occupation\u2019 which is more difficult to meet, interpreting the \u2018own occupation\u2019 clause is usually clearer.<\/p>\n

Why You Need Legal Help<\/h2>\n

If you have been denied benefits because of failure to pass these tests, it\u2019s important to get independent advice to ensure your rights are fully protected. Insurers are known to terminate benefits unfairly by interpreting \u2018any occupation\u2019 too narrowly. The judge will consider other factors when interpreting the \u2018any occupation\u2019 provision. For instance, the court will look at the availability of work for the insured, how much compensation they\u2019re likely to be paid as well as their mental wellbeing.<\/p>\n

An experienced long-term disability lawyer will work hand in hand with the right medical experts to gather evidence that supports their client\u2019s inability to work. For instance, if you are diagnosed with depression, a qualified psychiatrist may be a more suitable expert witness than a doctor to support your case.<\/p>\n

Understanding Short-Term and Long-Term Disability Policies with a Hybrid Definition<\/h2>\n

Your insurance policy may have a \u2018hybrid\u2019 definition of disability. This means that it combines some aspects of \u2018\u2019own occupation\u2019\u2019 and \u2018\u2019any occupation.\u2019\u2019 In general, such policies allow the insured to prove that they cannot perform their occupation for a specific time, after which they must prove that they cannot perform any other occupation. For instance, if the insured finds a job in a new occupation, their earnings can be reduced from the benefit amount. For example, an accountant who was receiving a benefit amount of $8000 a month may have started a new role as a salesperson receiving compensation of $6000 every month. Their new benefit amount could decrease to $2000 if they have a hybrid policy.<\/p>\n

The insured needs to understand when the definition of disability is likely to shift again if the policy has a hybrid definition of disability. The typical period is often 24 months. Before this time lapses, the insurer will often re-review the insured\u2019s file to determine if they still qualify for the benefits under the new applicable definition of disability. In many cases, the long-term disability benefits<\/a> may be terminated when the definition of disability shifts.<\/p>\n

An example of a shift in the definition of disability<\/h2>\n

An employee may be considered disabled if their injuries or illness prevents him\/her from:<\/p>\n