UNUM Group – the Tennessee-based Fortune 500 insurance company that includes UNUM US, UNUM UK, and Colonial Life – defines disability in its own unique way. This means that the most commonly-accepted interpretations of “disabled” or “disability” may not quite gel with what UNUM considers disabled. What should long term disability insurance claimants know about how UNUM defines “disability”?
If a UNUM Claimant Can Still Perform Normal Daily Activities Are They Entitled To Benefits?
One of the most common questions UNUM disability claimants ask is this – if you’re still able to perform most activities of daily living, are you entitled to long term disability benefits with UNUM? The answer is often yes, but depends on how closely these daily activities are tied to your work duties. In other words, someone whose job requires them to sling 40-pound boxes onto the back of a truck may no longer be able to work after a rotator cuff tear, but might still have no problem tinkering in their garden or going on a jog around the block. It’s important to note that UNUM can (and often will) engage in video surveillance and can use this sort of evidence against you. But in most cases, as long as you can show that your disability prevents you from engaging in work activities, you should be protected.
UNUM’s Definition of “Own Occupation”
UNUM defines a claimant’s “own occupation” or “regular occupation” broadly, and uses definitions and parameters from the national economy, not the claimant’s individual situation. (For example, if you can’t perform your former job because it requires you to assemble widgets while standing, while other widget-assemblers across the U.S. are often allowed to sit, UNUM may consider you able to perform your “own occupation” – since standing isn’t an essential function of the job.)
How Can a Claimant Prove What Their “Own Occupation” Is?
Proving a disability insurance claimant’s “own occupation” will depend on factors like the job title, the job description, and the job’s essential duties. Some occupations are common enough (and some disability insurance companies are big enough) to have their own classifications that are simply plugged into UNUM’s systems, while other occupations may need to be finessed a bit to reflect the claimant’s true duties and position.
What Is “Any Gainful Occupation”?
During the beginning of a UNUM disability claim, a disability insurance claimant will generally be qualified to receive long term disability benefits if they’re considered “unable to perform the material and substantial duties of your regular or own occupation” due to illness or injury. But after about two years, this definition shifts – 24 months into a claim, UNUM will consider a claimant disabled only if they’re unable to perform the material or substantial duties of any gainful occupation based upon their training, education, or experience. This is a much stricter standard, and simply being unable to perform the job you were doing when you became disabled may not be enough. UNUM can rely on a claimant’s work history, resume, and other data to create a profile in its vocational databank to see what other jobs, if any, the claimant is qualified to do even with their disability.
If you need to apply for long term disability benefits, appeal a denial of benefits, or even sue UNUM to receive the disability insurance benefits to which you’re entitled, give Dell & Schaefer a call. Our disability lawyers can provide you with a free consultation to see how we can assist with your disability claim.