When you start receiving temporary, short-term disability, you know that you could either return to work after a certain period of time or that you will be moved up to long-term disability if your injuries are permanent. One of the phrases that you see thrown around in long-term disability dealings is known as a ‘gainful occupation’ but what does this mean and how does it apply to your case? Many people are permanently disabled to the point where they are unable to perform the duties of their own occupation. A gainful occupation, on the other hand, gives some people a chance at staying employed even though they suffer from a disability. This depends on what they are able to handle and what training, experience, and education they have received for the job.
Gainful occupations are occupations that provide you with 60% of your wages that you were making before you were considered disabled. Sometimes, insurance companies will require you to show the standard that you absolutely cannot work and earn 60% of your prior earnings before they qualify you for long-term disability and state that you will no longer be able to work officially. However, 60% is not standard, and some plans require a 20 or 80% wage payout, depending on the policy. In the end, it all boils down to your ability to maintain employment and how much of an impact your disability has left on your life. If you are a surgeon, for example, and now you have a tremor-causing disease, you may not be able to perform your job at all due to the fact that your job requires a slick hand in the workplace. In this case, you would probably qualify.
There are some other requirements that make it so that a job is considered to be “unreasonable,” given your disability. This applies in cases where there are no occupations available in your area that you can perform, job requirements above your skill level, your job keeping you from medical appointments that you absolutely must attend, or the fact that your doctor will not release you to work.
Sometimes, your claim will take a turn past a ‘vocational expert,’ which is a person who will state that they believe there are other jobs that you are able to perform. Perhaps you have sustained a spinal injury and you are required to sit many hours of the day. Maybe a certain job in the area also requires you to sit and you can meet all the demands of the job because there are shortened hours. If you qualify, you will have to show that you can either work that job or have a reason why you are unable to do so as mentioned above. Long-term disability insurers and vocational experts tend to work with one another, which means that you and your attorney must have your own experts to show why you are unable to work and why the vocational expert they have hired is incorrect about your disability and ability to work.
You should always have an experienced attorney on your side when you are working toward long-term disability. We will be able to cross-examine and build your claim from the ground up, getting you the benefits you deserve in your time of need. At Edelstein Martin & Nelson, we can help you with every aspect of your disability claim. Call us today for more information at 800-300-0909.