State of the Art
Post-104 / LTD ("Any Occupation") Services
The hallmark of this service consists of a multi-day situational work assessment to provide an evidence based disability evaluation of client's capacity to sustain attention/concentration, work activity pace, persistence, productivity and stamina at a competitive level in consideration of presenting cognitive, emotional, social-interactional and/or physical impairments in the context of work demands across these same domains. Standardized work samples and simulated work activities form the basis of the evaluations. This process and the vital role of the situational assessment is depicted in the graphic below as especially emphasized in the depicted red and green boxes. The following two disability criteria may be distinctly evaluated using this methodology:
(a) the 'own occupation' (pre-2 year) disability status is evaluated by considering the client's capacity to perform pre-condition essential job tasks at a competitive employment level. The evaluation may be used as an initial assessment or as a rebuttal to an insurer examination.
(b) the 'any occupation' (Post 104 week/2 year) disability status is evaluated by considering the client's capacity to perform occupations previously selected as being suited by reason of 'education, training or experience' at a competitive employment level. The evaluation may be used as an initial assessment or as a rebuttal to an insurer examination.
If used as a rebuttal to an insurer examination (IE), the assessment considers whether the IE selected appropriate occupations for the individual, and whether the IE considered the case law requirements of 'commensurate remuneration' and 'commensurate socioeconomic status' in rejecting the client's Post 104 week eligibility. It also provides a multi-day situational work assessment to ascertain the individual's actual competitive employability on a full time basis as required of the Post 104 case law, but typically ignored in Post-104 Week Disability IE assessments.
Post-104 Week/2 Year LTD Multi-Disciplinary Rebuttal Process
The lack of comprehensive, evidence based IE Post 104 or assessment leads to erroneous denial of Post 104 Week IRB entitlement through undermining the following best practice factors:
- Failure to measure the client’s actual post-condition occupationally relevant capacities (i.e. occupational aptitudes, academic achievement levels, attained levels of education)
- Inadequate measurement of the client’s physical functioning (i.e. minimal FAE testing)
- Failure to consider/measure the client’s interpersonal functioning and mental/behavioural suitability relative to the demands of the identified occupations
- Failure to consider/measure the client’s current post-accident intellectual/cognitive & language abilities relative to the demands of the identified occupations
- Failure to consider the client’s capacity to psychologically cope with, and adapt to, work-like demands
- Failure to utilize a methodology through which to establish the client’s ability to sustain attention/concentration, work pace and productivity at a competitive capacity on a full time basis
Premature or inappropriate termination of IRB/LTD benefits, often have devastating impacts on the claimant’s:
While these impacts theoretically may increase the value of a tort claim, such issues may also motivate the client towards premature settlement by creating an insurer imposed financial crisis.
A cost effective solution:
- Financial status
- Familial and psychological stability
- Rehabilitation progress
- Retraining opportunities
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