There are a number important occupational analysis tools to prove long term disability in order to win & maintain benefits. These are important for proving disability and willing and maintaining long term disability benefits.
Helpful Occupational Analysis Tools to Prove Long Term Disability
Dictionary of Occupational Titles (DOT)
The DOT delivers valuable occupational analysis tools. It is a listing of occupations published by the United States Department of Labor. It was last updated by the Department of Labor in 1991, and, therefore, in many ways, is outmoded and does not reflect jobs in the modern economy. Nonetheless, insurers continue to use it as their main resource and a number of policies reference it as being the authoritative source for classifying the claimant’s occupation. Having the DOT in your library is, therefore, highly recommended. It could be purchased on Amazon.com and is quite expensive.
The DOT classifies occupations in various ways, but the insurance companies focus primarily on the strength classifications. The DOT provides for five strength classifications: sedentary, light, medium, heavy and very heavy. Sedentary work involves sitting most of the time, but may involve walking or standing for brief period of time. Light work is more physically demanding than sedentary work. A job is classified as light work when it requires walking or standing to a significant degree. Medium work involves exerting 20-50 pounds of force occasionally. Heavy work involves exerting 50-100 pounds of force occasionally. Very heavy work involves exerting in excess of 100 pounds occasionally and in excess of 50 pounds frequently.
In the modern economy, outside of manufacturing and construction, most jobs are either sedentary or light. The vast majority of office jobs are sedentary, unless they involve significant travel or time outside the office.
The insurers like the DOT because instead of having to analyze the requirements of each occupation as required by the policy, they default to either sedentary or light depending on the DOT classification. In doing this, they often overlook the cognitive and stress demands of the job and pay little attention to the other classifications within the DOT.
Other than classifications concerning strength, the DOT also classifies occupations in other important ways. The DOT classifies occupations into broad categories: Professional, Technical and Managerial Occupations; Clerical and Sales Occupations; Service Occupations; Agricultural, Fishery, Forestry and Related Occupations; Processing Occupations; Machine Trades Occupations; Benchwork Occupations; Structural Work; and Miscellaneous Occupations.
Among the occupations classified by the DOT are lawyers. It has a generic description for “lawyer,” but also has sub-classifications for Criminal Lawyer, District Attorney, Insurance Attorney, Admiralty Lawyer, Corporation Lawyer, Patent Lawyer, Probate Lawyer, Real Estate Lawyer, Tax Attorney, Title Attorney and Bar Examiner. To better understand the information that the DOT provides for each occupation, let’s review the DOT description for “Insurance Attorney” as an example:
110.117-014 INSURANCE ATTORNEY
Advises management of insurance company on legality of insurance transactions; Studies court decisions, and recommends changes in wording of insurance policies to conform with the law or to protect company from unwarranted claims. Advises claims department personnel of legality of claims filed on company to ensure against undue payments. Advises personnel engaged in drawing up legal documents, such as insurance contracts and release papers. May specialize in one phase of legal work, such as claims or contracts.
GOE:11.04.02 STRENGTH: S GED: R6 M4 L6 SVP: 8 DLU:77
The line in italics under the description is written in code but provides a lot of helpful information. To understand the code, reference should be made to Appendix C of the DOT, appearing at pages 1009-1014. “GOE” stands for “Guide for Occupational Exploration,” which is of interest primarily to guidance counselors and could be skipped for disability purposes. STRENGTH for this job is “S,” which stands for sedentary. “GED” stands for “General Educational Development.” GED assesses the occupation’s requirements for reasoning development (R), mathematical development (M) and language development (L). GED is assessed into six levels 1 to 6, with 6 being the highest. In this case, the levels are R6 M4 L6. Therefore, the reasoning and language requirements are at the highest level. The mathematical requirements are at an intermediate level. The DOT defines each level at pages 1010-1011. “SVP” stands for Specific Vocational Preparation. SVP, which is expressed in levels 1 through 9, assesses the level of training required for the job. Here, the SVP is 8, which means “over 4 years up to and including 10 years.” The DOT defines each level on page 1009. Lastly “DLU” stands for Date of last Update. Here, the description for Insurance Attorney was last updated in 1977.
This information may be used to assess whether you are able to do the occupation. For instance, even if you client could perform the physical requirements of the job, you may not be able to because of cognitive deficits, which prevent you from performing the high level of reasoning and language development required for the job.
Occupational Analysis Tools: Resources to Prove Long Term Disability
O*NET is an online resource found at www.onetonline.org, sponsored by the United States Department of Labor. It is much more up to date than the DOT, but does not supersede the DOT. Both should, therefore, be consulted. O*NET was last updated in 2010.
O*NET provides more information about individual occupations than the DOT, particularly regarding the cognitive demands of the occupation. To illustrate, let’s use the description of “Lawyer” provided by O*NET as an example (please note that unlike the DOT, O*NET does not provide a specific description for Insurance Attorney or any other specific subspecialty):
23-1011.00 – Lawyers
Represent clients in criminal and civil litigation and other legal proceedings, draw up legal documents, or manage or advise clients on legal transactions. May specialize in a single area or may practice broadly in many areas of law.
Under this generic description, O*NET provides a “Details” tab, which is broken down into the following categories: tasks, tools & technology, knowledge, skills, abilities, work activities, work context, job zone, education, interests, work styles, work values, related occupations, wages & employment, job openings and additional information. Within each category O*NET will classify the importance of each item on a scale of 1 to 100, with 100 being the highest. For instance, if you look at the tab for “Abilities,” the most important ability for a lawyer is “oral expression” with a rating of 91, next following with “oral comprehension at 85. If you look at “Skills,” the most important skill is “active listening” with a rating of 88.
The O*NET classifications are very important because they provide a lot more detail than the DOT. You could then use the detail to establish that your client is unable to satisfy important aspects of the occupation.
Occupational Outlook Handbook (OOH)
The OOH is a helpful occupational analysis tool that is an online resource published by the United States Department of Labor Bureau of Labor Statistics. The OOH describes various requirements and characteristics of thousands of occupations. For each occupation, it describes “what they do,” the “work environment,” “how to become one,” the “pay,” the “job outlook,” and “similar occupations.” The data on this website is helpful, particularly when the client has reached the “any occupation” portion of his benefit. You could quickly use this site to help determine other occupations you may be able to do given his education, training and experience.
Insurance companies tend to focus on three specific strength requirements of an occupation: sitting, standing and walking. If an individual could sit for six hours, stand for one hour and walk for one hour they usually will assert the claimant is capable of performing the material duties of a sedentary occupation. If the individual could stand and walk for more than one hour each, then the insurer will usually find you are capable of performing the material duties of a light occupation. In today’s service and information economy, the vast majority of occupations are either sedentary or light.
This mode of limited analysis makes it easy for an insurer to find that your client is not disabled. As a result, you must focus on the other requirements of these occupations, such as the requirements for travel, long hours, work stress, cognitive tasks and other physical tasks.
More occupational analysis tools
The travel requirements of an occupation are- very important to a disability claim. If a job requires periodic travel, particularly overseas travel, it may transform a sedentary job into a light or medium job. Business travel often is very taxing because it requires long confinement in an airplane seat, adjusting to multiple time zones, long days with meetings and entertainment, and the carrying and lifting of often heavy luggage.
If your occupation requires a lot of travel, include in your claim or appeal submission proof of the extent of travel, such as credit card and other receipts and a copy of your passport if the travel is international. Your affidavit should describe the extent of the travel, focusing on how often, how long, how much advanced notice, the nature of the travel, and the nature of the tasks performed during the travel.
Travel can be a double-edged sword. If you have traveled since going on disability, the insurer will try to use it as evidence of your functional capacity. Such travel is particularly relevant if one of your job duties was travel. In such an instance, be prepared to distinguish between personal travel and business travel. You could argue that on personal travel you had the assistance of someone, sat if first class, and had plenty of time to rest when you reached your destination.
Often one of the most taxing requirements of an occupation is its 24/7 nature. While you may be able to do your job if were 9 to 5, you may not be able to do so because it often entails late nights and weekends.
In describing your occupation, make sure that the requirement of long hours is adequately described and addressed. Make sure your doctors address the issue.
Before reliance is made on your inability to perform the long hours of the occupation, you must check the policy to see if it contains a provision restricting consideration of hours to 40. This requirement often is described in the definition of “material and substantial duties,” which may provide language such as “[the insurer] will consider you able to perform that requirement if you are working or have the capacity to work 40 hours per week.”
Many claimants are disabled from an occupation because they cannot tolerate the amount of stress on the job or the job’s fast pace. If this is the case, make sure the stress component of the occupation is adequately supported. You may be able to do the physical aspects of the occupation (i.e., sitting for 8 hours), but cannot the occupation simply because of the stress.
In focusing on the occupation’s stress requirements make sure you only focus on the stress components of the occupation as opposed to the stress components of the job. Often you can assert that you cannot handle the stress of reporting to a demanding or crazy boss. If a job is stressful only because of a crazy boss, that is a job requirement not an occupation requirement.
Most occupations in today’s economy have physical requirements other than sitting, standing and walking.
Most office occupations require the use of a computer. Use of a computer requires the ability to keyboard and to visually scan a computer screen(s). Many disabilities restrict your ability to keyboard and/or visually scan a computer screen. For instance, we have had a number of clients who work at trading desks where they need to monitor many computer screens all at once. Some have visual and/or vestibular issues that prevent them from effectively monitoring the screens. Other clients have disabilities, such as multiple sclerosis, carpel tunnel syndrome and Parkinson’s disease that impact their ability to use the keyboard.
Some occupations require individuals to work in environments that are noisy, such as a trading floor or a trading desk. If you have a disability that impacts your ability to hear, you may be rendered disabled even though you have no restrictions in your ability to sit, stand or walk.
Therefore, in analyzing your occupation, pay close attention to special physical requirements that the occupation may have.
Besides an occupation’s physical demands, occupations have cognitive demands. Occupations may have a very fast pace, may require the integration and memory of vast amounts of information and data, and require the ability to communicate well with coworkers, customers and colleagues. A disability that affects an individual’s memory, concentration, processing speed, executive function, and ability to communicate can render him disabled even if he otherwise could perform the physical requirements of the occupation.
The cognitive demands of an occupation often are the most important for establishing disability. This is particularly the case when the cognitive demands are very high, such as in one of the professions or for a high level executive. It does not take much to be disabled from such occupations. All it takes is losing a step. Your client may still test with a high IQ, but he cannot be in an occupation, such as a trial attorney, if he only has average processing speed. Someone with average abilities cannot do such an occupation.
Cognitive abilities, as opposed to pain and fatigue (the prime reasons individuals are disabled from most illnesses), can be established objectively by neuropsychological testing. Because of the ability to objectify cognitive deficits, neuropsychological testing often is very helpful in establishing disability.
Risk of Relapse/Harm
There are two ways to be disabled. The first, which is extensively discussed in this book when you are physically unable to perform the duties of your occupation. For instance, the job requires you to stand for six hours, and you simply cannot stand for that length of time. The second is when you could physically perform the duties but should not because in doing so you would experience a significant risk of harm. One of the most frequent instances of a risk of relapse/harm disability is when the claimant has a very stressful job and a bad heart condition. The claimant could physically perform the duties of the job but should not because you would suffer a significant risk of a heart attack.
Risk of relapse/harm disabilities are very difficult to prove, so if possible it should not be used alone but in conjunction with a physical disability. For instance, in describing an individual’s disability primarily focus (if possible) on how the heart condition prevents you from performing the duties of the occupation. Focus on the fatigue, weakness, chest pain and shortness of breath. The risk of a possible heart attack should be included as an extra source of disability.
The biggest barrier to a risk of relapse/harm disability is the chance of harm. It must be high, specific and imminent. This often is very difficult to establish. For instance, with a heart condition, it may be difficult for the treating doctor to quantify the risk of returning to your high stress job. High stress is unhealthy for everyone. The risk must more than that.