Partial Disability vs Total Disability: What’s The Difference?
Did you suffer a disability? Are you unable to work in any capacity, or can you work in some occupations—just not in the same profession as before your disability? For most insurance companies, whether you qualify as partially or totally disabled is determined by the specific language in the policy.
Your level of disability can determine the disability insurance benefits you receive.
How do you know if you’re partially disabled, totally disabled, or not disabled at all? In the latest video of our Disability FAQ series, we explain what each policy definition means and how each of them may relate to your occupation and potential disability benefits.
Each disability insurance company has its own policies and specific policy language. Still, the basic ideas are universal. Despite the differences, disability insurance providers will describe a distinction between partial and total disabilities.
Put simply, partial disability means that, following a debilitating illness or injury—you are unable to perform some of the substantial and material duties of your occupation at the onset of disability.
Private insurance companies usually use language such as “own occupation” and “any occupation” to distinguish between requirements and benefits for total disabilities. They often offer a residual or part-time benefit if you can do some of the important duties but not all of them.
- “Own occupation” policies cover disabilities that prevent the insured from performing the important duties of their occupation which they engaged in before their disabilities—hence the term own occupation. Partially disabled people cannot perform all the important duties of their occupations—but could possibly do some of their prior work or work part-time doing something for gain or profit.
- “Any occupation” policies provide benefits for people with disabilities that prevent them from performing the duties of any occupation by which they have been trained, educated, or suited, taking into consideration what they made in the 12 months or two years before they became disabled.
Common causes of partial disabilities may include:
- Heart attacks
- Neck and back problems
- Gastrointestinal problems
Total disabilities are, indeed, the more debilitating and often longer lasting disabilities.
Total disabilities render the disabled person unable to work in their “own occupation” and depending on policy language also unable to do any occupation, considering their training, education, experience and their financial station in life.
SSDI only provides benefits for total disabilities but does have a trial nine-month return to work opportunity. To prove total disability for SSDI, claimants must show that:
- They can no longer work in their previous occupations
- They cannot adjust or learn to do any new professions
- Their disabilities will prevent them from returning to work for at least a year
Significant Terms to Remember
Certain terms recur, with respect to disability insurance (whether SSDI or private). Understand your disability policies so that you can appropriately document your disability claim. Ensure that your policies cover what you think they do, so that when and if you need to file a claim, your policy will provide benefits. Engaging one of the experienced lawyers at the top-rated disability insurance law firm of DarrasLaw at the outset can help, both with filing your disability claim and analyzing your policy.
Look in your disability insurance policy for the following important terms, see how they’re defined, and learn how your policy covers them:
- “True own” occupation: The most liberal definition of disability, it generally covers a disability that leaves someone unable to perform the material and substantial duties of the occupation held at the time the sickness or injury took place (even if the claimant can be gainfully employed in another occupation).
- “Modified own” occupation: Covers a disability that leaves the insured unable to perform the material and substantial duties of the occupation held at the time of the sickness or injury and the insured is not working at any occupation for gain or profit.
- “Any” occupation: You are unable to perform the material and substantial duties of any gainful employment for which you are qualified by training, experience, or education taking into consideration what you earned before your disability.
- Hybrid definitions: Some individual and long-term group disability policies will qualify a person as disabled based on true own or modified own occupation definitions of disability for a certain amount of time, generally 24 months or more. Then, to receive disability benefits past the initial “own occupation period,” the qualifying definition shifts from an own occupation definition to the any occupation definition.
If You Have More Questions, or if Your Disability Claim Was Wrongfully Denied, Please Contact America’s Top-Rated Disability Insurance Law Firm, DarrasLaw, Today!
If you filed a partial or total disability claim and received a denial of benefits, we can help determine whether your insurance company wrongfully delayed or denied your claim. If your insurer lets you down, our nationwide disability insurance law firm and ERISA attorneys are here to assist and fight for the disability benefits you deserve. We evaluate disability cases throughout the United States.
The experienced, top-rated disability insurance lawyers and ERISA attorneys at DarrasLaw can help you understand and weigh your claim options. Call DarrasLaw today at (800) 458-4577 or contact us online for more information.