Definitions of Total Disability

True Own-Occupation Definition:
You will be considered totally disabled if, solely due to injury or sickness, you are not able to perform the material and substantial duties of your occupation, even if you are employed in another occupation.

Modified Own-Occupation Definition:
You will be considered totally disabled if, solely due to injury or sickness, you are not able to perform the material and substantial duties of your occupation and are not gainfully employed elsewhere.

Any-Occupation Definition:
You will be considered totally disabled if, solely due to injury or sickness, you are unable to perform the material and substantial duties of any occupation for which you are reasonably fitted, with regard to education, training, experience and prior earnings.

In addition to the three most commonly used definitions of total disability, there are two additional definitions of disability to be aware of.

Presumptive Total Disability:
You are considered to be totally disabled, even if gainfully employed, if an injury or sickness causes the complete loss of: use of both your hands, both your feet or one hand and one foot; sight of both your eyes; your speech; or your hearing in both ears. Some companies may require this loss to be irrecoverable.

Residual Disability:
You are considered to be residually (partially) disabled if, solely due to an injury or sickness, you experience at least a 15-20% loss of prior income, and are gainfully employed. Some companies may require that you experience a loss of time or duties as well.