Own Occupation Vs. Any Occupation — How the Disability Standards in Ontario Can Affect Your Benefits

Long-term disability in Ontario has been a crucial lifeline for individuals who cannot work due to a physical or mental disability. But it is critical to understand the terms by which you are covered and whether that may change during the course of your disability. 

In Ontario, disability is measured by two standards. These standards will be set out in the terms of your individual policy. One is if you are unable to work in your own occupation, and the other if you cannot work in any occupation. Being unable to work in your own occupation may be the first standard you are measured against, but you may later be measured against the any occupation standard. 

In other words, you may have qualified for long-term disability benefits only to find that you will need to requalify under different conditions in the future if you are still collecting disability. 

How Courts Have Defined Both Standards

When it comes to insurance laws and policies, the courts have had to define the difference between the two standards for purposes of long-term disability.

For disability under the Own Occupation standard, the court has defined that to mean that 

• You may be able to work, but you cannot do the essential duties of the occupation in which you were working. 
• You may be able to perform some tasks of that occupation, but you are not able to do them in their entirety. 
• A reasonable person in your circumstances would not be able to perform the tasks of your occupation

When the Own Occupation period has ended, usually after two years of disability, your insurance company may want you to meet the Any Occupation standard. The courts define this to mean

• You cannot work in any occupation that you are reasonably qualified for given your education and experience. 
• You may be able to work in another occupation given a period retraining but substantial retraining may be required. 
• You have returned to work but were found to be incapable of doing your job due to your disability.

What standards you will be required to meet and how you will be required to meet them is critical to getting the disability benefits you need and deserve. These, however, will be entirely dependent on the precise terms of your individual disability policy. This is when you need the guidance of a Cambridge long-term disability lawyer. At Hilborn and Konduros, we can help you understand the terms of your long-term disability insurance. Contact us or call us at (519) 658-6341 to schedule a consultation.