Understanding the difference between “Own Occupation” and “Any Occupation” Disability Standards.

When evaluating disability claims, the language of the policy plays a critical role in the outcome. One distinction often causes confusion: “own occupation” versus “any occupation.”

Here’s a simple breakdown:

Own Occupation Standard

This standard looks at whether the individual can perform the specific job they were doing at the time the disability began. It focuses on:

• The claimant’s actual job duties

• The physical and mental demands of their role

• Whether their condition prevents them from doing that particular job

Any Occupation Standard

This standard shifts the focus. It asks whether the individual can perform any job for which they are reasonably qualified, based on their:

• Education

• Training

• Work experience

This is typically a stricter standard and often comes into play after a certain period of benefits under the “own occupation” definition.

Why It Matters

Understanding this distinction is essential for both claimants and administrators. It influences:

• The type of medical documentation needed

• How functional capacity is evaluated

• The direction of clinical reviews

By aligning medical evidence with the correct standard, reviews can be more accurate, fair, and clinically accurate.