Many long-term disability insurance policies will specify the amount of compensation that would make a comparable occupation “commensurate” or “gainful.” The percentage varies from policy to policy, but often the “commensurate amount” is 60% of the claimant’s pre-disability income.
In a long-term disability claim, a gainful occupation may be defined as any occupation that would provide a certain percentage of the individual’s pre-disability wage or income. This percentage can vary depending on the specific terms of the long-term disability insurance policy.
For example, a policy may define gainful occupation as any occupation that would provide 60% or more of the individual’s pre-disability wage or income. If the individual is able to perform an occupation that would generate an income equal to or greater than 60% of their pre-disability wage or income, the insurance company may determine that the “commensurate amount” has been met and that the claimant is not eligible for long-term disability benefits.
It’s important to note that the percentage of pre-disability wage or income used to define gainful occupation can be subject to interpretation and may be influenced by other factors such as the individual’s education, training, and experience. Additionally, the insurance company may take into account the availability of suitable gainful occupations in the local job market when determining whether the individual is able to perform a gainful occupation.
If an individual is unable to perform a gainful occupation based on the terms of their long-term disability insurance policy, they may still be eligible for benefits if their policy includes a definition of disability that recognizes their inability to perform their own occupation, rather than any gainful occupation.
