Do you know your definition of disability in your Long-Term Disability (LTD) and/or Short-Term Disability (STD) Insurance policy? If you don’t, go to your policy now and read it. It’s a small, but critically important detail that schools, cities and counties should be intimately familiar with. Why? Because it affects how claims are paid and how much or little your plan costs.
There are two main types of definitions: own occupation (“own occ”) and any occupation (“any occ”).
Under the “own occ” definition of disability, an employee is considered disabled if s/he is unable to perform a majority of the material duties of the job s/he routinely performs at the time the disability began. The insurance carrier may look at this occupation as it is normally performed in the national economy, instead of how it is performed for a specific employer/location.
For example, to qualify for benefits under the “own occ” definition, a teacher must be able to answer ‘no’ to the following question, “Can I work as a teacher?”
Under the “any occ” definition, an employee is considered disabled if s/he is unable to perform a majority of the material duties of any occupation. This means any job for which s/he is qualified by education, training or experience.
For example, to qualify for benefits under the “any occ” definition, a teacher must be able to answer ‘no’ to the following questions: “Can I work as a teacher?” and “Can I work in any other occupation for which I am fitted by education, training or experience?” It doesn’t matter whether s/he chooses to work somewhere else or not. If the employee can work in another occupation for which s/he is qualified then s/he is not eligible to receive disability benefits under the “any occ” definition of disability.
It is common for schools, cities and counties to have a combination of both disability definitions mentioned above in their policy. For example, the employee may be eligible for benefits under the “own occ” definition for an initial period of time (typically 2 years). After 2 years, the definition of disability changes to “any occ.”
Interested in a disability insurance quote? Do you have questions about “any occ” vs. “own occ”? Fill out our contact form or contact your NIS representative at 800.627.3660.