Factual Disability

“Factual disability” is a legal term of art that simply refers to the inability to work due to an illness or injury.  This is the type of disability that most people think of in connection with a disability claim.

Click here to learn more about the difference between “factual disability” and “legal disability.”

Field Interview

A face-to-face interview conducted by a representative hired by your insurer, typically at your own home or office.  During the interview, the representative will ask you questions about your disability, your prior job, your daily activities, etc., in the hopes of discovering information that your insurer can use to deny your claim.

Click here for a list of some of the reasons why your insurance company may be asking for a field interview.

Functional Capacity Evaluation (FCE)

An FCE is a formal examination that is generally performed by an occupational therapist (OT) or a physical therapist (PT), as opposed to a physician. Insurers use FCEs to gather information about a claimant’s capacity to perform certain physical tasks, such as lifting, pushing, pulling, carrying, reaching, stooping, kneeling, crouching, crawling, etc.  The person conducting the FCE will also typically record the claimant’s pain levels when engaging in each respective activity.  

Following the FCE, the insurer will compare the results of the FCE to the job duties required by the claimant’s reported occupation.  If the insurer believes that the claimant still has the capacity to perform his or her required job duties, it will deny or terminate the claimant’s benefits.

Click here for more information about FCEs.

Future Purchase Option Rider

A future purchase option rider (also known as a future increase option rider) permits the insured to increase his or her total monthly benefits on specific option dates, which usually occur on an annual basis.  In order to obtain the increase, you typically will have to pay an increased premium and provide proof that your earned income is sufficient to justify the increase in benefits.  However, this type of rider generally provides that the insured is entitled to the increase regardless of his or her health. This is significant because it means that the increases will not be subject to any additional exclusions, whereas you may have medical conditions that would normally be excluded from coverage if you were to apply for a brand new policy.

Click here for more information about how these riders work to protect your growing income.