Yale Journal of Health Policy, Law, and Ethics

Defining "Regular Occupation" in Long-Term Disability Insurance Policies

Margo Jasukaitis & Daniel O'Hara

ABSTRACT. Millions of American workers purchase "regular occupation" disability insurance to protect against disability-related job loss. Unlike general disability insurance policies, which require workers be disabled from doing any job to receive benefit payments, "regular occupation" insurance pays benefits when workers become disabled from doing their specific job. Whether a disabled worker receives benefits under such a plan often turns on how insurers and courts define the worker's "regular occupation."

Some Circuits look to the duties, conditions, and experience required to do a worker's job. But others define a worker's "regular occupation" in generic terms—even if that description does not accurately capture the person's work. When a worker's occupation is defined generically, the worker is unlikely to qualify as disabled under their insurance plan and thus does not qualify for benefits. The divergent interpretations of "regular occupation" insurance plans across circuits run headlong into the goals of fair and uniform benefit administration set out in the Employee Retirement Income Security Act (ERISA).

This Note argues "regular occupation" must be defined with reference to a worker's actual job requirements. We explore the shortcomings of defining "regular occupation" without reference to a worker's actual job and propose several solutions to standardize the definition of "regular occupation."

AUTHOR. Margo Jasukaitis, J.D., Georgetown University Law Center, 2020; B.A., Loyola Marymount University, 2012. Daniel O'Hara, J.D., Georgetown University Law Center, 2020; B.A., the University of Delaware, 2016. The authors would like to thank Daniel Geyser, Brian Wolfman, Bradley Girard, and their peers in the Georgetown Law Appellate Courts Immersion Clinic, each of whom embodies what it means to be a good colleague and friend. Margo Jasukaitis would like to thank Daniel O'Hara for his patience, humor, and determination throughout this project, as well as her parents, Jacquie and David, and her partner, Joe, whose support makes everything possible. Daniel O'Hara would like to thank Margo Jasukaitis for making the process of writing this Note such a pleasant and memorable one, and his parents, Laura and James, for their unwavering support.

RECOMMENDED CITATION. Margo Jasukaitis & Daniel O'Hara, Defining "Regular Occupation" in Long-Term Disability Insurance Policies, 19 Yale J. Health Pol'y L. & Ethics (2020).