One of the most confusing aspects of individual disability insurance policies is the distinction between total disability and residual disability.
- Total disability is typically defined as being unable to perform the substantial and material duties of your occupation at the onset of your claim.
- A residual disability, also known as a partial disability, is typically defined as being unable to do one or more of the duties of your occupation, leading to a loss of earnings of 20 percent or more.
Most disability policies offer benefits for both total and residual disability. However, it is important to understand that these terms may be defined differently from one policy to the next. At DarrasLaw, America’s top disability firm, our attorneys will conduct a free disability insurance policy analysis to determine whether you meet your policy’s definition of being either totally or residually disabled.
The Definition of Disability
With more than 100 years of experience, our lawyers understand the different types of disabilities and how they are defined by insurance companies. We also understand the complex issues that spring out of these definitions, such as when residual disability must follow total disability and when residual disability cancels out lifetime disability benefit riders.
You can trust us to sort through the definitions and the complex issues related to total and residual disability in order to understand what your policy means and what you are entitled to.
Example of Total Disabilities
A total disability is a condition that prevents you from performing the essential duties of your occupation—or perhaps any occupation at all. This can devastate you, especially if you are not near retirement age and your disability began early in your working life.
One example of this situation is a surgeon who loses their eyesight due to an illness or a vehicle mechanic who cannot use their hands due to rheumatoid arthritis or another debilitating wrist or hand condition. These conditions prevent people from performing the important duties of their occupation—and sometimes, any occupation by which they have been trained, educated or suited.
Other possible total disabilities include:
- Mental nervous, substance and alcohol issues
- Loss of vision
- Inability to speak, cancer, respiratory issues
- Loss of the use of your hands, feet, or limbs
- Hearing loss
- Paralysis from a spinal cord injury
- Cognitive impairment from a severe traumatic brain injury (TBI)
- Heart attacks, brain injuries, cognitive deficits, migraines
- Neck, back, upper and lower extremity issues
If you cannot perform your occupational duties due to a total disability, you will lose your source of income. If you learn that you have a totally disabling condition, act fast to apply for total disability benefits from your insurance company. This process can take time, so you want to consult with a disability lawyer and start your claim as soon as you can.
Example of Residual Disabilities
While a total disability prevents you from performing the material and substantial occupational duties, a residual disability means you can do some but not all of the important duties of your occupation. Your condition might allow you to work part-time or in a lesser capacity than you did before your disability. These residual disabilities might include a back condition that prevents you from heavy lifting or physical tasks but that allows you to perform sedentary work.
While you might not lose all of your income, you might lose a significant portion of what you usually earn. This can still cause serious financial difficulties, and you might need supplemental support and assistance. Discuss how to qualify for residual disability benefits with an individual disability attorney or our ERISA lawyers.
Misclassifying Your Disability
There are major differences between these two designations of disabilities, and you cannot trust that your insurance company will fairly or properly categorize your disability issues. In fact, many insurance companies use wrongful and unfair classifications to save money on benefit payments.
The adjuster might use a policy with ambiguous language regarding total versus residual disabilities to classify you with a residual disability. This means that you will receive fewer benefits than if they properly classified you as totally disabled. If they can justify paying residual benefits for a total disability, the company can save a significant amount of money.
Never risk having an adjuster misclassify your disability or undervalue your disability insurance benefits. Instead, hire the right legal representation to get the full benefits that you deserve based on your policy and your disability. Contact a disability attorney for a case evaluation as soon as possible, and we can advise you of the best course of action in your case.