What Qualifies as a Disability with Unum?

To be considered disabled by Unum, you must meet specific criteria primarily centered around being under the regular care of a physician and experiencing a significant impact on your ability to work due to sickness or injury. Unum's definition outlines two main scenarios for qualification.

Key Criteria for Unum Disability

Unum determines you are disabled when you are under the regular care of a physician, and one of the following conditions is met:

• Scenario 1: Unable to Perform Your Occupation (Not Working)

  • You are limited from performing the duties required of your regular occupation.
  • This limitation is due to a verifiable sickness or injury.
  • You are not currently working.

• Scenario 2: Working with Significant Income Loss

  • You are working.
  • You have experienced a 20% or more loss in your pre-disability earnings or functional capacity. (Note: The specific measure for loss is indicated as "20% or more loss in ...", implying a reduction in earning capacity or similar metric as defined in the full policy terms.)

It's crucial to understand that both scenarios require you to be under the continuous and regular care of a physician for your condition. This ensures that your disability is medically managed and documented.

Understanding the Requirements

The definition highlights several important components:

1. Regular Care of a Physician

This foundational requirement means that your condition must be actively managed and monitored by a qualified medical professional. It implies ongoing treatment, diagnosis, and medical advice related to your sickness or injury. Without consistent medical care, it may be difficult to establish and maintain a disability claim.

2. Impact on Your Occupation

For those not working:
If your sickness or injury prevents you from performing the essential duties of your regular job, even if you are capable of doing some other form of work, you may qualify. This focuses on your specific role and its requirements. For example, a severe back injury might prevent a construction worker from lifting heavy objects, making them unable to perform their "regular occupation," even if they could do desk work.

For those working with income loss:
Unum also recognizes situations where you are still working but your earning capacity or functional ability has been significantly reduced due to your sickness or injury. The policy specifies "a 20% or more loss in..." This typically refers to a substantial reduction in your earnings compared to your income before the disability, or a demonstrable decrease in your capacity to perform your job effectively, leading to reduced hours or responsibilities. This ensures that individuals whose conditions prevent them from maintaining their full pre-disability income level can also be considered for benefits.

Summary of Unum's Disability Qualification

To simplify, here's a table outlining the two primary paths to disability qualification with Unum:

Important Considerations for a Claim

• Documentation: Comprehensive medical records from your physician are essential to support your claim, detailing your diagnosis, treatment plan, and how your condition limits your ability to work.
• Policy Specifics: While this provides the core definition, the full terms and conditions within your specific Unum policy document will detail any waiting periods, benefit durations, exclusions, and other important aspects of your coverage.
• Claim Process: Once you believe you meet the criteria, initiate the claim process with Unum, providing all necessary medical and employment information.

Understanding these qualifications is the first step in assessing eligibility for disability benefits through Unum, ensuring you meet the medical and occupational criteria set forth by the insurer.