Is Age a Factor in Long Term Disability Claims?

Reaching the Maximum Age for Benefits

Age is a factor in most long term disability claims as most long term disability policies have an age limit. Most disability insurance policies end either at age 65 or at the claimant’s Social Security Normal Retirement Age – which currently ranges between 65 and 67 years old. There are some exceptions to this – like if you apply for benefits over the age of 60, your benefits may have a “minimum benefit period” that may extend into your retirement years. Check your policy for the exact wording on age out dates and restrictions.

Change in Definition of Disability After 24 Months: Transition from “Own Occupation” to “Any Occupation”

Age is also a factor when there is a change in the definition of disability. Most group LTD policies contain a provision that changes the definition of the term “disability” after 24 months. In order to be eligible for long term disability benefits during the first 24 months, most LTD insurance policies employ an “Own Occupation” standard. Namely, the claimant must be unable to perform the Material and Substantial Duties of his or her regular occupation due to a physical or psychological impairment.

After the initial 24-month period, a claimant may be eligible for continued benefits if he or she is unable to perform, with reasonable continuity, the Material and Substantial Duties of Any Occupation. A typical LTD policy defines “Any Occupation” as “any occupation that the claimant is or becomes reasonably fitted by training, education, experience, age, physical and mental capacity” to perform. Most courts have interpreted such language to mean that if you’re medically capable of performing virtually any job that exists in the economy, your LTD benefits may be terminated. This determination does not usually take into account whether such jobs are available, only that they exist.

Even if an LTD insurance company agreed to pay benefits because it found the claimant could not perform the material duties of his or her own occupation, the insurance company may find that the claimant can perform other work and cut-off benefits at the 24-month mark under the broader “any occupation” standard.