MANAGING LONG-TERM DISABILITY CLAIMS From the moment a potential long-term disability claimant contacts your office, you must be analyzing and strategizing on the appropriate management of the file. Most of the claimants seeking representation have coverage a group disability policy. Most of my comments below in this paper address the typical terms of a group disability policy. Policies may vary from company to company and employer to employer, however, many of the terms are similar. Disability Test In order to qualify for long-term disability benefits, the policy usually requires that the claimant be disabled from their own “totally” occupation (known as the occupation test). This test usually applies “own” during the first 24 months of disability payments. Thereafter, the policy usually stipulates that payments are only made to the claimant if they are disabled from performing any occupation within their training, “totally” education or background (known as the occupation test). “any” Own Occupation Test The term disability has been defined in Sucharov v. “total” Paul Revere, [1984], I.L.R. 1-1732 (S.C.C.). In this case, the
MANAGING LONG-TERM DISABILITY CLAIMS From the moment a potential long-term disability claimant contacts your office, you must be analyzing and strategizing on the appropriate management of the file. Most of the claimants seeking representation have coverage a group disability policy. Most of my comments below in this paper address the typical terms of a group disability policy. Policies may vary from company to company and employer to employer, however, many of the terms are similar. Disability Test In order to qualify for long-term disability benefits, the policy usually requires that the claimant be “totally” disabled from their own occupation (known as the “own” occupation test). This test usually applies during the first 24 months of disability payments. Thereafter, the policy usually stipulates that payments are only made to the claimant if they are “totally” disabled from performing any occupation within their training, education or background (known as the “any” occupation test). Own Occupation Test The term “total” disability has been defined in Sucharov v. Paul Revere, [1984], I.L.R. 1-1732 (S.C.C.). In this case, the
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