What is the difference between the “own occupation” and “any occupation” test when determining whether you qualify for disability benefits?

Every long-term disability insurance policy is different. However, most policies require that you satisfy the “own occupation” test to qualify for the first stage of benefits, usually lasting one to two years. Generally speaking, you meet the own occupation test if you are unable to perform substantially all of the important elements of your regular occupation.

After one or two years, again depending on the policy, the test to qualify for benefits usually changes to what insurance companies refer to as the “any occupation” test. Under that test, you may be entitled to continue to receive benefits if you can establish, on the strength of the medical evidence you submit to the insurer, an inability not only to perform your own occupation but any other occupation for which you are reasonably suited by education, training, or experience.

It is not unusual for claimants to have their benefits terminated once the policy transitions from the “own occupation” to the “any occupation” standard. It is essential to consult with a lawyer as soon as you receive a letter from an insurance company indicating that it intends to terminate your benefits due to the change in entitlement definition from own to any occupation.