Own Occupation Definition In Disability Insurance Claims

When considering the “own occupation” standard for disability plans, courts should begin by reviewing the employee’s job description. When making an eligibility determination under an ERISA covered policy, a plan fiduciary must use an “objectively reasonable” description of the insured’s occupation which includes duties comparable to those actually performed by the insured.

Occupations that may be evaluated based on the specific duties and responsibilities of that occupation include:

  • Actuary
  • Business Operations Manager
  • Dentist
  • Financial Advisor
  • Financial Manager
  • IT Manager
  • Lawyer
  • Manager
  • Marketing Manager
  • Medical and Health Services Manager
  • Nurse
  • Nurse Anesthetist
  • Optometrist
  • Orthodontist
  • Petroleum Engineer
  • Pharmacist
  • Physician, including
    • Anesthesiologist
    • Cardiologist
    • Dermatologist
    • Emergency Room Physician
    • Endocrinologist
    • Family Medicine Doctor
    • Gastroenterologist
    • Hematologist
    • Hospitalists
    • Internist
    • Neurologist
    • Obstetrician and Gynecologist
    • Oncologist
    • Ophthalmologist
    • Oral and Maxillofacial Surgeon
    • Orthopedic Surgeon
    • Otolaryngologist
    • Pain Management Physician
    • Pediatrician
    • Podiatrist
    • Psychiatrist
    • Pulmonologist
    • Radiologist
    • Surgeon
    • Urologist
  • Podiatrist
  • Political Scientist
  • Prosthodontist
  • Sales Manager
  • Veterinarian

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