California Disability Help

"Any occupation" disability insurance claim discussed by a California Disability Lawyer

Most disability insurance policies will contain both an “own occupation” and “any occupation” definition of disability. The own occupation definition is usually only for the first 24 months of disability. After 24 months, the claimant must re-qualify for disability benefits under the any occupation definition.

While most claim denials take place during the any occupation period, it is important for a claimant governed by California law to understand how “any occupation” has been defined by the court. Our California disability lawyers have helped thousands of claimants to receive disability insurance benefits during the any occupation stage of a disability claim. Let’s take a look at a case that goes back to 1938.

California Court Discusses “Substantial And Material Duties” In A Disability Policy

In 1938 Mr. Erreca was thrown from a horse, sustaining multiple fractures in his right leg, and tearing several ligaments in his knee. He remained in the hospital for two months, suffered a pulmonary embolism, needed crutches for several weeks, developed varicose veins, developed lesions and ruptured varicose ulcers. At trial he required the use of a cane, but could only walk for short periods of time without his legs swelling. He also had a permanent instability in his knee. Because of his forced inactivity, he gained 40 pounds and suffered from shortness of breath and an increased heart rate.

Mr. Erreca argued that he was totally disabled because he could no longer perform any of the manual labor required of him, nor could he manage or supervise farm operations. Western States Life argued that the Mr. Erreca was not totally disabled because he could do a long list of verbal duties (i.e. negotiations, signing of agreements, talking with employees). However, the court found that “[a]lthough such activities are neither trivial nor inconsequential, they are the type of duties that are infrequently and intermittently performed and cannot be said to constitute the substantial and material duties of the occupation of farming.”

Claimant Must Be Able To Work With “Reasonable Continuity” Or He Or She Is Disabled

The Erreca court also defined total disability in an any occupation policy as being, “a disability which prevents [the insured’s] working with reasonable continuity in his customary occupation or in any other occupation in which he might reasonably be expected to engage in view of his station and physical and mental capacity… such a disability as renders the insured unable to perform the substantial and material acts necessary to the prosecution of a business or occupation in the usual and customary way.” Absolute helplessness is not required; thus an insured’s ability “to perform sporadic tasks, or give attention to simple or inconsequential details incident to the conduct of business” does not preclude recovery. “Conversely, the insured is not totally disabled if he is physically and mentally capable of performing a substantial portion of the work connected with his employment. He is not entitled to benefits because he is rendered unable to transact one or more of the duties incidental to his business.”

The above law has been applied countless times by California courts. If you would like assistance with your disability insurance claim, then please contact us for a free phone consultation.

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Disability Company Reviews

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Sedgwick

Don't trust them, they like to play games

Reviewed by Bob on November 14th 2024 Verified Policyholder | June 2024 date of disability

They suck the life out of people that need help. They falsely advertise for helping people that they care. Sorry to tell you it's all about money, they do not care for any... read more >

New York Life

Lyme Disease Disability Claim Denial

Reviewed by Bob C. on November 13th 2024 Verified Policyholder

I have had repeat claims for genuine medical leave and they have repeatedly been denied by NY Life. I have even been diagnosed with Lyme and going through treatments and t... read more >

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Disappointed with NY Life Disability Excuses

Reviewed by Carina S. on November 12th 2024 Verified Policyholder

I am beyond disappointed with NY Life Disability Insurance’s handling of my father’s claim. My father, a 66-year-old man who has suffered two strokes and continues to ... read more >

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New York Life is a joke!

Reviewed by Heather on October 3rd 2024 Verified Policyholder | August 2024 date of disability

This company sucks when it comes to disability claims. They are slow at processing stuff, then they always say they didn't recieve the doctors information. You spend your ... read more >

MetLife

They FULL OF ****

Reviewed by KM on October 3rd 2024 Verified Policyholder | August 2024 date of disability

MetLife is what everyone on this review are saying. They don't contact you to let you know what's going on with your claim or to let know you need additional info. I had a... read more >

Sedgwick

Worst Company Ever

Reviewed by RobRob on September 23rd 2024 Verified Policyholder | August 2024 date of disability

If something happens to you at work you better hope you die, my son is going through HELL because this company is handling his work comp. NO RETURN PHONE CALLS, TEXTS, EMA... read more >

MetLife

MetLife for disability? Avoid the surgery unless it's life-threatening

Reviewed by Jeff on August 22nd 2024 Verified Policyholder | August 2024 date of disability

The worst company I ever dealt with, never received a call from my claim manager.

Reliance Standard

Short Term Disability Claim/Inconsistent to NO Communication

Reviewed by GaKRN on August 22nd 2024 Verified Policyholder | June 2024 date of disability

When I did call & reach a live person they were kind & helpful. The person assigned to my claim left one phone message & I have not spoken to her since. Information she re... read more >

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Reviews from Our Clients

S.S.

I am a physician in my 30s who was practicing in my hospital based medical specialty until my Multiple Sclerosis diagnosis began to severely limit my physical ability to work.

My husband and I were obviously in distress at these very unwanted life changes and frankly overwhelmed with the possibility of a long and traumatizing legal battle ahead of us. We knew we were legally entitled to benefits through the separate private individual and employer based ERISA disability insurance policies we had, but even cursory research and discussion with colleagues made it clear that insurance companies will strategize with their own legal teams to find ways to not pay out benefits. We found many before us who had fallen unwittingly into legal pitfalls that prevented them from ultimately obtaining benefits. We realized we needed to seek legal counseling.

We found Dell Disability Lawyers through their YouTube channel where their partners have videos discussing the legal intricacies and latest developments in private disability law. I was impressed by their dedication to the field and reached out through their website to request a free consultation.

We were delighted to hear that Mr. Steven Dell himself would be willing to take our case and felt assured that we would be represented by the best of the best.

We have not been disappointed in our expectation and have, in fact, been consistently very impressed. Steven Dell is clearly both knowledgeable and wise about dealing with these issues but more importantly, has shown kindness and impeccable honesty at each step of the way.

Merlin has demonstrated a very high capacity for organizing and handling the endless myriad of documents and communications between us and the insurance companies. She has also been very compassionate, accessible and forthcoming in dealing with our many anxiety fueled emails and telephone calls to her and we are very grateful for her involvement.

For over 7 months, we have been working closely with Steven Dell and Merlin Bryan from Dell Disability Lawyers as they have guided us through the process of review and initial application for benefits from our two insurance policies (Hartford and Ameritas).

We are happy to announce we just received approval of claim from the Hartford insurance company.

At this time we are still working with this firm as we await the final decisions from Ameritas policy that we are hopeful will have a similar outcome.

As anyone with a chronic and progressive illness can tell you, time becomes a very precious commodity. Through their representation, Dell Disability Lawyers has allowed us to focus the majority of our time enjoying the time and function I have left while resting assured that our disability case laid in competent and caring hands.

The truth is that no amount of money can make up for what we have lost, but it is a huge comfort to have a team like Dell Disability Lawyers at our sides to help us ensure we will be able to continue to care for ourselves and our families.

We highly recommend Dell Disability Lawyers, Mr. Steven Dell and Ms. Merlin Bryan to handle your disability insurance claim.

Thank you Steven, thank you Merlin!

We will certainly plan on leaving another review for completeness once we have our final decision from Ameritas.

Paula B.

I have been working with Dell Disability Lawyers for the past 5 years concerning my disability as it pertained to my employer. I have been more than pleased with them the entire time. They have always kept me informed of any paperwork needing completed or any changes coming ahead. Nothing has been a surprise. I would recommend them to you to help with your disability case if you’re trying to dip into the policy you’ve been paying for.

Michael M.

I am a physician who has been disabled for over 10 years. During this time I have been represented by Cesar Gavidia and his assistant, Danielle Lauria. Their representation on my behalf has allowed me to concentrate on dealing with my disability/disease process and all associated complications and not having to deal with all the things that are necessary in a disability insurance claim. Based on my personal experience from many years of practicing medicine I would consider their work product, insight and effort in the disability insurance claim procedures to be superior. I would recommnend them, which I have done, with my highest level of confidence. In short, you will be well served with this practice.

Dan P.

I had to retire from my career due to a bad back that restricted me from performing my duties. I had LTD insurance and after a few years of receiving monthly benefits from this insurance company, they notified me that my benefits were terminated stating that I don’t qualify due to my duties not fitting into some “national job description” and a nurse had deemed me eligible to go back to work. It’s a crushing feeling to have this told to you over the phone with hardly any information given. Luckily, I came across Dell Disability Lawyers and spoke with Attorney Palamara who calmed me down and stated they would take my case. Within a couple of months my benefits were restored, and I had piece of mind. I cannot thank Attorney Palamara and the staff at Dell Disability Lawyers enough for their professionalism, no nonsense approach, personal and timely communication and quick ability to litigate my case.

Jen S.

I wanted to thank Mr. Symonds and his legal assistant Sonia for their professionalism, guidance and dedication towards my LTD insurance claim. Going through the denial process on my own was going to get me sicker and I knew it was time for help right away. I reached out to Dell Disability Lawyers for assistance and not too long after my call, I was connected with Sonia. Soon after that, I was talking about my case with Mr. Symonds. After a long and tedious process with the LTD insurer, we won the case. The wait can absolutely be lengthy, but in the end, it was all very much worth the fight. Thank you both so much for all that you have done for me! I also want to thank those who assisted in keeping me updated, as needed. Highly recommended for anyone who is going through the brutal process of an LTD denial.

Carl G.

I would like to thank Dell Disability Lawyers for taking care of my case and help me get the insurance coverage that I was rightfully in need of. Specially, I would like to thank Attorney Alexander Palamara and right-hand legal assistant, Sonia Nogueira, who made this process less stressful. They answered all my questions and kept me informed every step of the way.

Don’t get me wrong. They never promised or told me that I was going to win my case, as no one can guarantee that for you. What they did do, was letting me know that they were working hard for me and to keep positive. Something that I recommend everyone to do is to subscribe to their YouTube channel. That will give you an idea on how they operate and why they (for most of their cases) win their cases.

Since I was awarded disability, I am still having surgeries and thanks to them, I’ve been able to cover all those expenses.

Warm regards to everyone at Dell Disability Lawyers!

Clarisa B.

I’m so very Grateful and Thankful for the team at Dell Disability Lawyers. They worked tirelessly to get the best outcome for me. I’m so glad that I found them!!

Carole S.

Exceptional, efficient and professional service from Jay Symonds and Sonia Nogueira. They were both so helpful and knowledgeable and navigated me through a very stressful and difficult situation with New York Life.

K. S.

Awesome team. Jay and his team, Sonia and Francesca, truly care. This team is very professional and quick to respond. Jay always provided answers in detail to my questions. I strongly recommend Jay Symonds.

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