Long Term Disability Law BlogAttorneys Helping Disabled Claimants Nationwide

Disability Denial Reason #2 – What Disability Claimants Should Know About the Vocational Review Process

Being approved for long term disability insurance benefits can be a huge relief for anyone worried about how they’ll pay their bills when they’re not able to perform full-time work. But even for disability policies that claim to offer a “lifetime” of benefits, this approval may not be permanent. For group long term disability policies that change the definition of “disability” after 24 months of benefits, a claimant’s ability to continue to receive benefits will depend on whether they meet the standard set by this new definition. Read on to learn more about what goes into a disability insurance carrier’s vocational review and how claimants can maintain their long term disability benefits well beyond the 24-month mark.

The Change of Disability Definition is the Second Most Common Reason for Disability Benefit Denial

After 24 months of being on claim under a group long term disability policy, you’ll be able to continue to receive benefits only if you meet the “any occupation” standard. Unlike the initial definition of disability, which allows for benefits if the claimant can’t perform their “own occupation,” the “any occupation” standard allows for benefits only if the claimant can’t perform any occupation. In conjunction with this change in definition, the disability insurance company may conduct a vocational review, in which a company representative evaluates your skills and abilities and decides whether you still meet the policy criteria.

The Vocational Review May Begin Six Months Before the Change of Disability Definition

Because the vocational review is often quietly started before the policy’s definition of disability officially changes, it’s important to have your ducks in a row well before the 24-month mark. Claimants should continue to see their doctors and document their symptoms so that their medical files are as complete as possible when the vocational review begins – waiting until the definition of disability changes may make it too late to fill in any gaps or inconsistencies in your claim file before your benefits are terminated.

What Must the Disability Company Consider When Evaluating the “Any Occupation” Disability Definition?

Many claimants worry that, under the “any occupation” definition, they’ll be expected to return to an entry-level job they would not ever have considered taking before their disability. Fortunately, this isn’t the case – the vocational review considers each claimant’s education, skills, and abilities when assessing what jobs they might be able to perform. Generally, the disability insurance carrier will also only consider a job for a particular claimant if the average wage is at least 60 percent of the claimant’s pre-disability earnings. Since long term disability benefits often only pay out at 60 percent of pay, this means that a claimant won’t be expected to take a pay cut if their disability benefits end – as long as the proposed position is one the claimant can actually perform.

Hiring a Vocational Consultant Can Boost Your Chances of Success on Appeal

It’s important for long term disability claimants to be able to fight back against a vocational review that overstates their physical abilities or understates their limitations. What many disability insurance carriers don’t understand is that a claimant’s ability to walk, stand, sit, or focus for a certain period of time doesn’t necessarily translate into the ability to perform these tasks for 40 hours or more a week. By hiring your own vocational consultant, you’ll be able to present a far more nuanced – and accurate – view of your abilities to the disability insurance company.

At Dell Disability Lawyers, we have extensive experience with the vocational review process and know exactly what the disability insurance companies are looking for. We work closely with claimants to ensure your medical records are in order and will support your continued receipt of benefits. If you’d like to discuss your claim or have concerns about hitting the 24-month mark, don’t delay – give us a call today to schedule your FREE consultation with a member of our legal team.

Contact Information