LTD Benefits are payable only if you meet the occupation test.
If you are Covered under the Plan, the next question to address is whether you are considered disabled. This is not a simple question to answer in many instances.
The test for disability is defined by the Plan and is separated into two phases: Own Occupation and Any Occupation.
The bar to meet is “Total Disability”. The definition of Total Disability changes based on the period of time during the long-term disability period.
Total Disability definition during the Own Occupation period:
During the elimination period and the following 30 months of disability, an Employee is completely unable due to illness or injury to perform the Regular Duties of his/her own occupation based on the position held with the Employer immediately prior to the commencement of the Elimination Period;
Total Disability definition during the Any Occupation period:
he/she is unable due to illness or injury to engage in any occupation
for which he/she is qualified or could reasonably become qualified by
education, training or experience, considered collectively or separately.
As you can see from the definition above, the assessment for disability takes into consideration a works job duties. The question is whether the worker can complete the principle duties of their own occupation and later whether they can do any reasonable job for which they are suited. The any occupation test is a harder test to meet because you must show that you cannot do your own job or any other job that you could be trained and aligns with your experience.
Some examples to understand the own occupation and any occupation distinction:
- A blood lab worker may be considered unable to do her own job due to forward neck bending issues, but she may be able to do another type of lab job where her ability to work does not require the same next movement.
- A pharmacist has anxiety attacks from a chaotic and poorly managed work environment. The pharmacist may not be able to return to his former work environment (own occupation, but he may be well suited to complete the duties of a pharmacist teaching capacity within the hospital system.
- A nurse is unable to complete bed transfers in the inpatient ward will be totally disabled from his occupation being able to complete bed lifts is a main duty of the job. The nurse may not be deemed to be totally disabled in the any occupation period because other nursing positions are available that do not require any heavy lifting (tele-health nurse, educator, etc.)
Denied benefits because of the Disability Test?
Contact a lawyer immediately to learn your legal rights and options. Jeff Mitchell is an experienced Long Term Disability Benefits Lawyer who has successfully advanced his client’s interests before the Nova Scotia Public Service Trust Fund. To book your free consultation, call toll-free: 1-855-670-1345 or 902-702-3452. Prefer to email? Email Jeff at email@example.com.