What Does “Change of Definition” Mean for My Long-Term Disability Benefits?
In a long-term disability claim, “
change of definition” usually refers to a change in the definition of disability at the applicable time (very often 24 months).
The change of definition usually refers to a transition from an "
own occupation" definition, to an "
any occupation" definition. During the initial disability period, benefits are payable if you are unable to work at your “
After the change, benefits are payable only if you cannot work at "any occupation" for which you have the required
education, skill, or experience. There are variations on the wording, but this summarizes the typical "change of definition".
Typically, this means that in order to qualify for LTD benefits in the any occupation period, you must be totally or substantially disabled from the duties of any occupation for which you have the requisite education, skills or experience.
You may think that it is impossible, or extremely difficult to persuade your insurance company that you qualify for LTD benefits after this change of definition, but you should not give up hope. With supportive medical evidence, you may have a strong case to fight against the termination of your LTD benefits based on the “change of definition”.
How Can I Change My Insurance Company’s Mind?
This is difficult, short of taking formal legal action, unless there is some dramatic medical evidence or change in your condition that makes it clear that you are totally disabled from working in any capacity. Many insurers believe that very few people can actually qualify for benefits in the “
any occupation” period. However, our legal system is not quite so strict. We are very successful in winning these claims on behalf of our clients.
Once you reach the change of definitionpoint, it can be difficult to change your insurer’s mind, short of taking formal legal action, unless there is some dramatic medical evidence or change in your condition that makes it clear that you are totally disabled from working in any capacity. Keep in mind that the initial denial is only their interpretation of your case, using the expertise of their team of doctors to review your medical records, none of whom have your best interests in mind. Their concern is the savings they have if they don’t pay your claim.
Many insurers believe that very few people can actually qualify for benefits in the “
any occupation” period. However, our legal system doesn’t look at this the same as an insurance company. At Share Lawyers, we are often successful in winning these claims on behalf of our clients. Our concern is getting you the benefits you deserve in order to live without financial worry while you look after your health. Therefore, the reason for denial needs to be reviewed carefully by reading the insurance policy and by reviewing your individual circumstances. Let us put our years of experience to work for you and help you win back the benefits you deserve!
Click here to see what
David Share, President of Share Lawyers, and Adjunct Professor at Osgoode Hall Law School has to say about “
own occupation”, “
any occupation” and “
change of definition” as it related to long-term disability insurance claims.
It is always best to consult an experienced disability lawyer to help you during your case. Share Lawyers will fight to help you win the benefits you deserve!
Has your long-term disability claim been denied?
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This searchable database contains information about disability, critical illness and life insurance claims, and what you can do if you are denied or cut
off of your benefits. It is a collection of the most common questions we receive from our clients. General answers have been provided by our lawyers.
Here are some commonly asked questions to get you started:
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