Long Term Disability Change of Definition

Posted on Jun. 24, 2024

If you’re dealing with an injury or illness that prevents you from working, long term disability benefits can be a crucial lifeline. However, the situation can become more challenging if your insurance company claims that you no longer meet the definition of disability at the change of definition.

If this happens, know that there is hope. This change doesn’t have to mean you’ll lose your benefits. At Share Lawyers, we’re here to help you navigate these complexities and secure the benefits you deserve.

Need more information on what a long term disability change of definition is? Share Lawyers’ experienced team can answer your questions.

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Long Term Disability Change of Definition: What To Know

A long term disability change of definition occurs when the insurance policy shifts the criteria that determines whether you are eligible for disability benefits. This change typically occurs after a specific period, usually two years from the start of your policy. It often involves transitioning from the "own occupation" definition to the "any occupation" definition.

It will typically look something like this:

This letter informs the insurer of adjustments to their policy from the “own occupation” definition to the “any occupation” definition, a standard change in disability insurance policies. This distinction is important because it affects the criteria used to determine eligibility for disability benefits:

Own Occupation Definition: You qualify for benefits if you cannot perform the essential duties of your current job due to injury or illness.
Any Occupation Definition: You qualify for benefits only if you cannot perform the essential duties of any job for which you are reasonably qualified by education, training, or experience. The stricter criteria dictate that you cannot work in any suitable job for which you are qualified, have the training, and at the same pay scale as before.

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However, it’s important to understand that the “any occupation” definition must meet some baseline requirements for it to be valid.

The hypothetical new job definition must be appropriate for your qualifications, ensuring that you are not place in an unsuitable position.
The job must provide an income equivalent to what you were earning before you stopped working, preventing insurers from offering low-paying jobs to deny benefits

Why Do Insurance Companies Change Definitions?

There are a few reasons why long term disability change of definitions occur.

Cost Reduction: Stricter definitions reduce the number of claims insurance companies have to pay, reducing their overall costs.
Risk Adjustment: Updating definitions allows insurance companies to align existing policies with their current risk environment.
Regulatory Compliance: Changes may be necessary to comply with new laws or regulations governing disability insurance policies.

What To Do When You Experience a Change of Definition

Even though you won’t necessarily lose your benefits, there are some key steps you should take when you experience a change of definition.

Review the Notice Carefully: Read the letter or notice from the insurance company and ensure that you understand the specifics of the change, such as the new definition of disability and the effective date.
Compare Definitions: Compare the old and new definitions to understand how the change will affect your coverage and eligibility for long term disability benefits.
Contact Your Insurer: If you have any questions or need clarification, ask the insurer for a detailed explanation of how the new definition may impact your benefits.
Seek Professional Help: Consulting with an experienced disability lawyer like Share Lawyers can provide expert advice on the implications of the change, help you understand your rights and options, and create a path forward.

Share Lawyers Helps You Navigate Changes of Definition

If you’re facing a long term disability change of definition, there is no need to panic. We understand how crucial your disability benefits are, and this change doesn’t necessarily mean you’ll lose them. With the proper legal guidance, you can navigate this challenge effectively.

How We Help With a Change of Definition
Understand Your Policy Details	We’ll help you fully comprehend your policy's specifics and the implications of this change.
Collect and Present Medical Evidence	We’ll assist in gathering and presenting the necessary medical documentation to support your claim.
Build a Strong Case	Our team will build a robust case to demonstrate your continued eligibility for benefits.
Navigate the Appeals Process	We’ll guide you through the appeals process if your benefits are denied.
Deal with the Insurance Company	We’ll handle all communications and negotiations with the insurance company on your behalf.
Provide Legal Advice and Support	We’ll be by your side to offer ongoing legal advice and support throughout the process.
Maximize Your Chances of Keeping Benefits	Our expertise will significantly enhance your chances of maintaining the disability benefits you depend on.

Share Lawyers Won’t Let Your Insurance Company Win

If you’re facing a long term disability change of definition, don’t lose hope. Contact Share Lawyers today for a free case assessment. We understand how disheartening it can feel when the definition of your disability changes, so we’re here to help.

At Share Lawyers, we are dedicated to advocating for Canadians like you, ensuring you remain eligible for the disability benefits you rely on. With over 35 years of experience as a leading disability law firm, we have successfully challenged insurance companies, taking the burden off our clients so they can focus on their health.

We work on a contingency-fee basis, so you won’t owe us anything until we secure your benefits. Let us handle the heavy lifting and fight for the benefits you deserve. Reach out to Share Lawyers today.

What makes you qualified for disability benefits? Now that you know that any illness or injury that prevents you from performing the duties outlined in your policy makes you eligible for benefits, it’s time to start your claim.

Still need more information on a long term disability change of definition? A quick conversation with one of our lawyers will help you understand your situation and provide a path forward.

Contact Share Lawyers today and let our 35+ years of experience work for you. We can help you win your case againstCanada Life, Desjardins, Manulife, RBC Insurance, Sun Life, and other insurance companies. Our legal team offers a free consultation and works on a contingency basis. There are no fees unless you win your case.