Question regarding commensurate occupation

1st time post (I believe? Lol)…long time reader, this site is fantastic.
I had a question regarding the term commensurate occupation, I’m currently looking at being cut off next month. I’m suffering from neurological pain in areas that ain’t nice to talk about to put it nicely. I’m also facing central sensitization, and become hypersensitive.
I’m hoping that an upcoming treatment will have some effect, so far I’ve been to over 100 physiotherapy sessions. I spoke with my doctor and she advised the insurer that I couldn’t work more then potentially 20hrs a week in a letter. I face severe pain when sitting or doing repetitive tasks, the pain builds. Theres a long list of what I face, I’ve even lost consciousness once and almost a few other times from pain.
So…back to the question, how is the insurer able to ignore the maximum number of hours I can work being maybe 20, and say I’m able to work a commensurate occupation? (My previous work week was 37.5hrs)
Any light that can be shed is appreciated!


Has the insurance company said this?
I would get free consult:
Free Consultation Request — Resolute Legal

I found this thread interesting:

Specifically this comment:

Do have your benefit booklet to check the wording?

Because they can.
You may have to sue to get your LTD back.

Best of luck.

I did a search on this forum for “any occupation”.

Do they have a doctor report saying you can return to work? They tried this with me even though they had doctor reports saying I couldn’t not work until my issue was resolved. All I did was appeal and ask them to provide me with something from a doctor that states I can return to work. They couldn’t provide it and my benefits continued.

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Your doctor stated you could work. It doesn’t matter what the hours were, you can work therefore the insurer can discontinue your benefits.

If your doctor changes her official medical opinion and says you cannot work at your, or any other job then you should get reinstated.

I disagree, depending on the wording of the policy, the limit of working might be 'gainfully employed".

I would contact a lawyer if you’re cut off.

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I did a consult with a lawyer, at 20hrs a week I’m considered totally disabled under my plan. It falls short of the commensurate occupation salary. Was advised it appears I have a case.

Thanks for the replies, I’m going to keep my replies to a min in the event of litigation.

Yes there was a report allowing me to attempt light/ sedentary work. Employer refused to accommodate (specialized position, and safety concerns), the 20 hrs was me being ambitious and my Dr supporting my desire to attempt to work again.

It always comes down to the wording of the policy!

Good Luck!
Keep us posted when you have an outcome.