This is the moment most group disability claims are lost, and most people do not know it is coming until the letter arrives.
What the change is
Many group long term disability policies define disability in two stages. For an initial period, the question is whether you can do your own job. After that period, the question becomes whether you can do any job, and the benefit continues only if you meet the second, stricter test.
Nothing about your health has to change for you to be cut off at that point. The test changed, not you.
“Any occupation” does not mean any job at all
This is the part insurers and claimants read differently, and it is where these cases are won. The second test is not usually whether you could theoretically perform some task somewhere. Policies generally tie it to work that is reasonably suited to your education, training and experience.
What makes the difference at the changeover
- Evidence about function, not just diagnosis. A diagnosis says what you have. A functional assessment says what you can do for how long, which is what the policy actually asks.
- Your real work history. Education, training and experience are the policy’s own words. They are specific to you.
- Consistency. What you told your doctor, what you told the insurer and what you can be seen doing all need to tell the same story, because they will all be compared.
- Timing. If you know the changeover date is coming, the evidence can be assembled before the decision rather than after it.
If you can see the date coming
Look at your policy now and find the date. If it is within the next few months, that is the moment to get advice, not after the benefit stops. It is far easier to support a claim before a decision than to overturn one afterwards, and the first conversation costs nothing.
Read more
- Long term disability: the main page
- Benefits approved, then cut off
- Your claim was denied: what to do first
Speak to a lawyer about the change to the any occupation test
Initial consultations are free. Our fee schedule is published in full, by stage of the case, on our Fair Fees page. Call 905-409-2438, send a text, message us on WhatsApp, or use the contact form.
Steven Polak is licensed as a lawyer in Ontario and practises with Lerners LLP at 123 Athol Street, Whitby.