So what if you can do some parts of your job, but you can’t do all of your job? That’s a great question, and every insurance policy has a different definition for long-term disability. What does it mean to be disabled? Most policies have some definition that’s saying something to the effect of, that you’re unable to perform each of your main duties of your occupation. So the first question is, what is your own occupation? What are the main duties of your occupation? And can you perform each one of those duties?
How Important Are The Duties You Can’t Do?
Now let’s say that there are 10 duties and you can do six of them. Ultimately, it’s going to come down to a fact specific question as to how important those four duties are to your job in particular. Are there any accommodations that could be put in place that would enable you to do those things? If there are some accommodations that could be put into place that would enable you to do those things, perhaps you do not meet the definition of disability. But the question is, what are the main duties of your occupation? How many of them can you do, and how many of them can’t you do? Are they essential functions of your job, or are they tangential parts of your job that someone else could really pick up without any problem? Those are all questions that are fact specific to your case. So you have to figure out and write down, write this stuff out so you can answer the questions, solidifying them in your mind, and then you can provide that information to the insurance company.
Are there certain parts of your job that you absolutely, 100%, physically cannot do or mentally, cognitively cannot do? And if that’s true, are those parts of your job, are those so essential that now your employer can’t have you in that position anymore?
A True Story of a Client
I once had a client who had cognitive difficulties after a car accident, and her employer worked with her and provided every form of accommodation that was known to man. They even built out new offices and new desks and all kinds of things for this person to help her get to the place where she could function within that environment, but she was still missing things. She was still ignoring details. She wouldn’t do things when they needed to be done. She couldn’t remember certain things. She couldn’t work under stress.
All of those things combined along with some emotional and personality issues that were affected by a traumatic brain injury that rendered her unable to do her job. Ultimately, her employer had to lay her off because she was unable to perform the main duties of her job. Not surprisingly, the insurance company denied her long-term disability claim, even though the employer themselves said, “You cannot perform the main duties of your job.” So fortunately she came to me, she was able to do a couple of extra things. We were able to get some additional information. We were able to talk to her doctors and get them to put the information down in a specific way so that the insurance company really understood what was going on. We also got statements from her direct supervisor and her employer, which actually supported her claim for long-term disability, and ultimately the insurance company reversed its position.
It’s very important that you follow the definitions of your long-term disability policy and make sure that you understand what the main duties of your job are and how important those things are in the grand scheme of things. If that job cannot be done without those functions, then under the definition, under most definitions provided in long-term disability policies, you are considered disabled.
I hope this information has been helpful for you. If it was helpful for you, please share this on social media or via email with your family and friends or anyone else who you think might benefit from this information. Again, if you have any problems that you would like to talk to us about, we’re happy to provide more information and even perhaps an in person phone call or a meeting or a virtual meeting over the internet or Zoom to help you understand whether you qualify under your long-term disability policy.
