Maximum Capacity Language
Some long-term disability (LTD) policies allow the claims examiner to determine the number of hours you could work if working to your “maximum capacity.” The income you could receive is then used to reduce the LTD benefit you are paid – whether you are earning that income or not.
Maximum capacity or “optimal ability” language gives the carrier the right to assume that the claimant can work more than they are currently and reduce the healthcare professional’s benefit accordingly.
Our LTD policy does not include this highly subjective limitation.