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Own Occupation Disability Insurance

Last updated: April 12, 2023

An insurance company's language and terms for defining "disability" are critical to the success of a policy on long-term disability. Long-Term Disability (LTD) insurance companies use only one or two types of disability definitions: 

  • Own occupation
  • Any occupation

Own occupation disability insurance protects physicians from being unable to perform their specialized daily work. In the US, income insurance protection for qualified medical practitioners has increased in the last year as a result of this provision.

How Does An “Own Occupation” Policy Define Disability?

Own occupation disability coverage is tailored to the specific profession in medicine or dentistry. Suppose your insurer examines your disability claim based on its "own occupation" standard. 

In that case, you only need to prove you cannot perform the substantial and material duties associated with your particular occupation or specialty to be eligible for benefits.

A high caseload of routine procedures is common in medical, dental, or chiropractic practices. Whether it's an injury to the hand, impairment to the back, or Parkinson's disease, these factors can affect a dentist or surgeon's skill or stamina to perform routine surgery or clinical dentistry. 

Own Occupation Disability Insurance In Private Policies

Many private disability insurance companies cover "own occupation" as a benefit. You can include the provision in your policy or add it as an own occupation benefit. It is important to note that although the language may vary from policy to policy, a realistic own occupation policy will define total disability as follows. 

In case you are unable to perform the material and substantial duties of your medical specialty as a result of an injury or illness. Your monthly benefit will remain unchanged no matter how much income you earn in another field, whether:

  • Your regular occupation will be the occupation you are engaged in at the time of onset of disability.
  • You will still receive the full monthly benefit even if you’re employed in another role.

"Regular Occupation" In A Private "Own Occupation" Policy

Specialty-specific policies typically define regular occupations as follows:

  • The occupation you held at the time you became disabled.
  • Generally, if your practice is limited to a professionally recognized specialty in medicine, you will be regarded as having a regular occupation in the specialty.

Identify and classify the insured's occupational duties; otherwise, it can lead to a denial or a reduction of benefits.

Consulting With A Disability Claim Lawyer

Insurers can find many reasons to deny a claim and challenge them. You should consult a lawyer before filing a disability claim, regardless of whether you have a group or individual policy.

Do not accept a denial decision from the insurance company if you have a claim that has been denied. To determine whether your disability claim has been unfairly denied, you need the knowledge and insight of a lawyer with considerable experience in dealing with the insurance industry.

If you’re curious about learning about SSI back pay maximum, read this article to learn your options and benefits. 

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Chloe Powers
Chloe works with policymakers on behalf of Disability Help to support their work at a strategic level, ensuring the conditions are in place for creative individuals and organizations to grow, reach their potential and effect relevant, sustainable change.
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