Long-Term Disability: Response to Majeski v MetLife Webinar
The following question was submitted via email by a Canadian participant in the Majeski v MetLife webinar (question is shortened here):
"The case I am working on is for a lawyer representing a 60 year old client who is trying to get long term disability benefits (for the past 8 years). He was a regional sales manager for a transportation company, essentially selling freight for specific industry.
There were only 3 working in the local office for this province, so he was also responsible for casual work (Dispatching and Yardman) for vacation relief, sick days. He lost eyesight in one eye and the other eye is also at risk due to diabetic retinopathy.
Precautionary medical restrictions to prevent hemorrhaging in his good eye include no heavy lifting, forward bending or exertional activities. Medical specialists suggest to limit reading to no more than 30 minutes continuously or up to only 4 hours per work day.
According to his insurance policy, the definition of a short-term disability is 3 months of inability to perform his generic occupation, not just his specific job. Long term is defined as 2 years of inability to perform this same specific job.
Does that mean that a job search would include any sale manager position? Does it mean that a job search would include all types of sales positions or just freight sales positions? The transferability to other sales manager occupations would be limited by his knowledge/education, so I would think he would have to stay in trucking - transportation field. and thereafter any occupation for which he is suitably qualified by experience, training, etc.
So does that mean if he could not do his customary job then he could do something like dispatch if provided with adapted equipment and computer software (Jaws) to limit the demands of reading even though this is below the skill level that he had advanced to with training on the job (work and courses)?
Any comments, or suggestions would be much appreciated. I am spinning my wheels on this one."
I wanted to share with you the responses I gave:
The first step is to consider whether you are the most appropriate person to be addressing the answers to these questions. My suggestion is that the gentlemen's attorney should retain an expert in disability law for the province in which your client resides.
Second, it sounds like you have a copy of the actual disability policy for this gentlemen's case. It is important to read the policy definition of the occupation. My guess is that his occupation was titled "Regional Sales Manager - Motor Carrier". His expertise seems to be in the area of freight regulations and pricing. I would take that as his occupation. My guess is that the physical demands related to the miscellaneous tasks he performed are most likely outside the definition of his occupation. (As a side note, it appears that the physical demands related to those side tasks are more strenuous than those related directly to his occupation.)
Third, the disability carrier would be smart to explore accommodations to the gentlemen's work situation. They may be able to return him to productive, gainful employment by providing an assortment of assistive devices and/or a modification to his work tasks.
Fourth, if this person was referred to you for an Functional Capacity Evaluation, the scope of that engagement would be reflected in the referral questions. Assuming that the referral was from the client's attorney, did the question infer some burden on you to determine the occupation versus the job? If this is not clear I would contact the lead attorney and get everyone on the same page.
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