During a long-term disability (LTD) claim, your medical records and history get a lot of attention. Your lawyer and the insurance company will pore over every diagnosis, test, and recommendation in your files. However, there’s more to an LTD claim than medical evidence.
Your vocational experience and skills can also dramatically impact your eligibility for LTD benefits. That’s why our experienced disability insurance lawyers frequently work with vocational experts.
Why Does the LTD Insurance Company Care About My Work and Education?
Disability insurance pays benefits when your medical conditions, illnesses, and injuries prevent you from working. There are two primary considerations in an LTD claim:
- Do you have serious medical diagnoses?
- Can you work?
While these questions may sound simple, the insurance company won’t be satisfied with simple answers. They will perform a detailed evaluation of both your medical and vocational information.
Let’s dig deeper into how insurance companies define “disability.” Your LTD plan probably includes one of two definitions:
- Own occupation: You cannot perform your own job due to an illness, injury, or chronic condition.
- Any occupation: You cannot perform any job that you’re qualified for due to an illness, injury, or chronic condition.
While it may be relatively easy to determine whether you can do your own job, most LTD policies apply the more complicated “any occupation” definition.
With an “any occupation” policy, the insurance adjuster will assess your education, work experience, and skills to look for possible jobs that you can do. If they find even one position that you’re capable of, they will deny your LTD claim.
- Related Article: 5 FAQs About Private Disability Insurance Claims
What Does a Vocational Expert Do?
Vocational experts (VEs) are specially trained professionals who help people understand their abilities, their wage-earning capacity, and whether they can transition to other work. Most VEs are not medical professionals. Instead, they have backgrounds in human resources, rehabilitation counseling, or social work.
Typically, a vocational expert’s evaluation will involve several steps, which include:
- Reviewing your resume and job descriptions
- Interviewing you about your abilities, skills, and background
- Considering your doctors’ recommended restrictions
- Identifying skills and experiences that may transfer to other jobs
- Determining whether you can compete with other applicants for a job given your combined abilities and limitations
A credible VE’s opinion can strengthen your LTD claim and provide essential insight into your capabilities.
For example, suppose you receive a cancer diagnosis and file a long-term disability claim. Initially, the insurance company approved your short-term disability benefits. However, when you applied for LTD, the company denied your claim because the policy included an “any occupation” definition. The adjuster argues that you could do simple, unskilled work, such as greeting customers at a grocery store.
To fight back against this argument, your attorney hires a VE. During their evaluation, the vocational expert notes that while you have good days, you often experience severe nausea and flu-like symptoms for a week after each chemotherapy treatment. They also note that you’re experiencing severe fatigue and “chemo brain,” which makes it difficult for you to concentrate on even simple tasks. Finally, the expert notes that your doctors suggest you avoid contact with large groups of people due to your compromised immune system.
Based on these challenges, the VE determines you could not maintain a job due to absenteeism, health risks, and excessive time off task. While the insurance company and federal courts will not be bound by the vocational expert’s opinion, they must consider this powerful evidence as part of your claim.
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Are There Other Ways I Can Avoid Vocational Issues in an LTD Claim?
While vocational experts are sometimes necessary, there are other simple ways you can reduce vocational issues in your claim.
Don’t Overstate Your Credentials
Perhaps you’ve learned to reframe your job titles and duties on a resume to make them sound prestigious and impressive; most job seekers do this to some extent. However, the same skills that can help write a standout resume can hurt you during an LTD claim. The insurance company may use your flattering descriptions of your job duties and responsibilities against you. Instead, outline what you did at each of your jobs in the most straightforward terms possible.
Get Clear and Detailed Work Restrictions From Your Doctors
A note from your doctor that simply says “disabled” or “no work” may not be as convincing as a detailed list of limitations. Insurance adjusters typically dismiss blanket statements about disability from treating physicians.
Instead, ask for specific information about your ability to lift, walk, stand, and concentrate as well as your need for breaks. Alternatively, your medical and legal team may consider scheduling a functional capacity evaluation.
Consult an Experienced LTD Lawyer
Without guidance from a knowledgeable disability insurance lawyer, it’s easy to make mistakes that can endanger your LTD benefits. Rather than navigate the disability insurance system alone, it’s best to work with a lawyer who can oversee the details of your claim, manage your filing deadlines, and document your complex vocational issues.
Bryant Legal Group: Discover Our Sophisticated Approach to LTD Claims
At Bryant Legal Group, we’ve been helping people with disabilities for decades. We use our combined knowledge and experience to build effective and practical legal strategies for our clients, which is why we frequently consult with vocational experts.
What Are Functional Limitations? (And How Do They Affect a Disability Claim?)
How Much Is My Long-Term Disability Claim Worth?
Contact Bryant Legal Group
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