Understanding the Difference Between Own Occupation Disability and Total Disability or Any Occupation Disability Benefits

Have you suffered a disability that limits your ability to perform your current job or that stops you from working altogether? The severity of the disability in question and the terms included in the applicable insurance policy will guide your coverage, which is likely to play a key role in your future. Because obtaining disability benefits is crucial, you shouldn’t wait to consult with the experienced Nova Scotia disability insurance lawyers at Preszler Injury Lawyers.

What is Own Occupation Disability?

Navigating the complexities of disability benefits in the context of your legal rights is extremely challenging, but it is also necessary to help protect you into the future. To begin, it’s important to distinguish between the definitions of disability under your contract of disability insurance.

If you suffer a disability, it means that you face limitations in relation to certain tasks, which – in turn – limits your earning power and affect your ability to continue at your current employment. While total disability refers to the complete inability to work at any job, or occupation.

Evaluating the extent of a disability comes down to determining the effects it has on your ability to perform specific tasks of your employment. Factors such as the severity of the disability you’ve acquired, your level of professional expertise, and the degree to which alternative employment options are available to you will all play a role in the level of disability.

The goal is facilitating your ability to actively participate in the workforce to the degree possible – in light of the limitations you’re facing. Own occupation definitions of disability under a contract of insurance are usually for the first two years following a finding of disability. While the own occupation disability is only assessed after the two year mark.

What is Total Disability?

If you’re totally disabled, it means that your physical or mental impairments leave you completely unable to work – whether that means performing the important duties associated with your former career or with any other career that requires a similar level of experience, education, or training.

Those who experience total disabilities are left unable to earn a living, and they often require assistance with the activities of daily life, which correlates with immense vulnerability. Because the financial and emotional impact of a total disability is profound, total disability benefits can sometimes involve other types of insurance coverage such as medical.

Eligibility Criteria for Own Occupation

Eligibility for own occupation disability benefits in Nova Scotia is based on the recipient’s incapacity to perform their job. Proving that you have a disability requires you to clearly demonstrate your vocational skills, your functional limitations, and your inability to perform work related tasks.

Own occupation disability is associated with having limited functional capacity in relation to specific tasks or activities relating to your employment for a set period of time.

All of this will be considered in the context of the job-related restrictions you face, which will guide the reasonable accommodations needed to support your return to work. In order to qualify for benefits, your disability will need to meet certain duration requirements, which depend on the insurance policy in question but generally involve a significant amount of time.

The benefits associated with a own occupation disability finding will cover a percentage of your pre disability employment earnings, depending on the policy. They can also, however, include employment support services, such as job training programs or vocational rehabilitation, which are designed to bolster employability and to ease integration back into the work world.

Eligibility Criteria for Total Disability

The criteria for satisfying total disability eligibility is more exacting. To qualify, you’ll need to succinctly demonstrate that you not only have a severe impairment but that it is also permanent in nature. This generally comes down to documenting your functional limitations and inability to perform critical job-related duties as well as providing documentation of your medical condition.

The requirements for total disability benefits include having a severe impairment that stops you from engaging in substantial gainful employment. The disability itself can be mental, physical, or any combination of the two.

For your disability to qualify as total, in most cases, according to the wording of the policy (some policies pay more than the standard 66%), it must have lasted at least two years and it must interfere with your ability do any kind of work. This includes your former occupation as well as any other jobs that your experience, training, and education leave you reasonably well qualified to perform.

Proving Disability

Proving disability in Nova Scotia can be exceptionally challenging, but a dedicated disability insurance lawyer will skillfully gather and compile the evidence necessary to accomplish this pivotal task. The kind of evidence involved can include all the following:

• Your related doctor’s reports and medical records
• Your medical test results
• Objective signs of disability, such as any anatomical, physiological, or psychological indicators
• Certification from a counselor who has the authority to issue disability benefits

Some disabilities are more challenging to prove than others. For example, mental health concerns, chronic pain disorders, and autoimmune disorders tend to be more difficult to establish – based on the fact that their symptoms are more subjective in nature.

Barriers to Employment and Daily Life

If you have a disability, you’re likely to experience unique barriers to employment, and regardless of the type of disability, you’re dealing with challenges that undoubtedly directly affect your daily life. Overcoming these obstacles requires a systemic approach that includes policy shifts, greater understanding on the part of employers, improved accessibility, and increased awareness regarding the important contributions those with disabilities make and their need for enhanced opportunities to participate.

Several primary barriers that those with disabilities face include all the following:

• Inaccessibility in the workplace
• Physical and cognitive limitations that interfere with the performance of specific job duties
• Prejudice and discrimination in the workplace
• Inaccessibility to job training and education programs
• Challenges related to accessible transportation
• Financial disincentives that relate to benefit cliffs

Support Systems and Rehabilitation Services

Canada has a range of support systems in place for those who suffer disabilities, including rehabilitative services. The idea is achieving higher levels of independence, enhanced participation in society, and improved quality of life. Benefits include supplemental income as well as tax credits, assistive technology, accessibility to health care, and programs like Canada Pension Plan Disability Benefits, which is based on the employee’s contributions to the Canada Pension Plan and the Nova Scotia Disability Support Program.

Filing a Disability Claim

There are several important steps when it comes to filing a disability claim. To begin, you’ll need to confirm that you have coverage. This generally means through your employer, but it can also come from an independent broker. You’ll also need to establish that your disability has kept you off the job for the requisite duration, which will depend on your policy.

One of the most important steps that anyone in your difficult situation can take is consulting with a knowledgeable Nova Scotia disability insurance lawyer early in the process. They know the ins and outs of these challenging claims and will leave no stone unturned in their focused efforts to obtain the benefits you deserve, including guiding you through each of the following primary steps:

• Obtaining a clear diagnosis of your disability
• Gathering the necessary medical documents
• Accurately completing the application process
• Skillfully following up on the status of your application
• Reviewing the claim decision and taking well-considered next steps – as applicable

Disability Benefits and Compensation

There are several disability benefit programs available to those who are eligible in Nova Scotia. They each serve their own purpose by providing specific amounts that are based on their own eligibility criteria, which generally relate to the duration and severity of the disability. Prime examples include long term disability insurance, employment insurance sickness benefits, workers’ compensation insurance, and the Nova Scotia Disability Support Program.

Common Challenges and Denials of Disability Insurance Claims

While obtaining the benefits to which you are entitled is important to your health and well-being, navigating the path forward is riddled with challenges. A common reason for claim denials is failing to qualify under the policy’s specific definition of disability. Another primary issue is failing to adequately comply with the medical treatment and rehabilitation plans prescribed for you. Claim denials can also be triggered by mistakes or inconsistencies in the application or in relation to supporting documentation.

You can expect the insurance company handling your claim to be on the lookout for any discrepancies it can find. In fact, even missing a filing deadline can mean an automatic denial – regardless of your claim’s overall merit.

Why You Need a Disability Insurance Lawyer for Total or Partial Disability Claims

If you’ve suffered an illness or injury that interferes with your ability to do your job or that keeps you off the job for a considerable amount of time, the compassionate Nova Scotia disability insurance lawyers at Preszler Injury Lawyers are committed to unleashing the full force of our imposing experience and skill in focused pursuit of fair benefits that support your rights. Our seasoned legal team is standing by to help, so please don’t delay contacting or calling us at 833-586-8282 for more information about what we can do to help you today.