How does a disability insurance company determine my Regular Occupation?
The overwhelming majority of employer provided ERISA group disability policies provide disability benefits for a certain period of time if you are unable to perform the material and substantial (or similar language) duties of your “own” or “regular” occupation. Although the semantics may differ from policy to policy, under the own/regular occupation period is intended to provide benefits if you cannot do the job you were performing prior to going on disability. The “own/regular occupation” period usually lasts anywhere from 12 to 24 months, and sometimes as long as 60 months or until age 67. One thing that many people become aware of after they have already filed for disability is the fact that the disability insurance carrier does not necessarily review their occupation as it is performed for a specific employer, but rather how it is performed in the national economy.
How an Insurance Company determines your Own/Regular Occupation
When a claim for disability insurance benefits is filed, the insurance company normally, but not always, obtains a copy of your job description from your employer; or in the alternative will send a claim form to be completed by you, the claimant, or by your employer as to the duties of your occupation. However, as noted above, this does not mean that the insurance company will take this information on face value. Often a vocational review is conducted to determine what occupation your actual job most resembles according to the Department of Labor (normally by way of the Dictionary of Occupational Titles (DOT) or O*Net) or some similar occupational resource. This is why if your claim has ever been denied and you say to yourself, “They got my job wrong. That isn’t what my job required.” Insurance companies usually have vocational consultants on staff and they will conduct their own vocational analysis.
The Dictionary of Occupational Titles (DOT) and O*Net
Chances are if your claim has been denied during the own/regular occupation period the denial letter contains some wording along the lines of, “Pursuant to the DOT, your occupation is classified as ____ physical demand level.” So what is the DOT? The DOT was a codification of occupations as set forth by the Department of Labor. Review of the DOT website indicates that the information contained in the DOT is dated, especially since the Department of Labor has no updated the definitions since the mid 90’s.
If you click to the O*Net link contained on the DOT website, it states that O*Net has replaced the DOT. Review of the job descriptions as identified on O*Net are much more in depth and provide a better comparison as to the actual demands of one’s occupation. However, more often than not insurance carriers rely solely on the DOT job description and not the O*Net. This is why when filing administrative appeals for clients under an ERISA Group Disability policies we always research the job descriptions for both the DOT and O*Net among other sources we rely upon. We routinely retain vocational consultants to conduct employability analysis and labor market analysis.
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Very satisfied with the work of this team. Took well care of my case and took all the necessary time to be responsive and attentive when I had questions. Guided me through recovery and returning to normalcy. All thanks to Jason & Tabitha, thank you!
I’m extremely satisfied with the experience I have had with this firm from day one. The lawyer who has handled my case, Alex, is very efficient and attentive to all my questions and concerns. They are always aware of how my case has gone and they care about my health. I feel optimistic with them because they are very attentive during the process of my claim. I would not hesitate to recommend families and friends if in any situation they need their services. Kathleen as well has been very well and assisted me with this case. I highly appreciate everything they have done for me.
It’s unfortunate when disability insurance companies come after older disabled policyholders just to help their bottom line. It can be a living nightmare the damage they can do to a family. Dell Disability Lawyers are polite, understanding and knowledgeable. They call you back and answer any question you have no matter how unimportant it can be. The amount of stress they took off of myself and family was incalculable. I recommend them highly to take care of any disability case whether it be filing for benefits or reversing a claim decision. They are outstanding.
I could not have been happier or more appreciative of the hard work they performed on my behalf. I was well briefed on my case and it was closed in a timely manner with a financially successful resolution.
Mr. Symonds and Sonia as well as everyone else we have worked with throughout this process have been very helpful, professional and caring to our situation. We are very thankful to have this great team on our side.
Without them my LTD company was dropping my plan with me still suffering from my accident, even with doctor’s statements I’m still disabled. The LTD company didn’t want to advance my policy to the next stage of years of pay. Dell Disability Lawyers saved my policy, and helped to enforce the LTD company’s own policy (for its policy holder, me) that I would be covered still under the LTD policy I had paid for at my previous job, when my accident occurred. These lawyers know what they are doing and can help you too. LTD companies will try to drop you when you still need coverage just because they don’t want to pay on your policy anymore. Don’t let them break contract with ya because they are trying to get out of it. Hit em with legal action to ensure the continuation of your policy you paid for. Dell Disability worked very well for me and continue to do so.
I was denied long term disability benefits from The Hartford after being on it for years. I found Dell Disability Lawyers after doing research online. In a matter of days they responded and explained to me everything that would be done. Dell Disability Lawyers were able to settle my suit against The Hartford very quickly and responded to me quickly. I would definitely recommend this team of lawyers for anyone that is fighting for their disability insurance.
I have had nothing but a great experience with Dell Disability Law Firm. Mr. Alex Palamara and his team went above and beyond my expectations. They will respond to emails and phone calls in a timely manner. Thank you once again for taking my case.
This law firm is the best so far. MetLife denied me two times, they appealed two times for me and they won of course. So if you are on disability and want a chance at winning your case use this firm Dell disability lawyers, kind courteous understanding and they get the job done. You won’t be disappointed.