# Get an own-occupation answer the file can act on

> An LTD examination has to test job demands and duration. A diagnosis recap does not close the claim.

Source: https://imecore.com/use-cases/long-term-disability

## The report recites the chart and never answers own occupation

The insurer asked whether this person can do this job, and for how long. What comes back is a diagnosis and a prognosis. The own-occupation period is already ending, and human resources still cannot set restrictions.

- The job description is missing or two years stale.
- Attending physician statements contradict the specialist notes.
- The own-occupation period ends while records are still outstanding.
- Psychiatric and physical questions get mixed in one report.
- Restrictions have no review date anyone can use.

## What IMECore does about it

### Ask about the job, not only the diagnosis

The referral captures the occupation, the demands, and whether the question is own occupation or any occupation.

### Attending notes and the job file together

Physician statements, specialist notes, pharmacy, and the job description attach to the case. IMECore flags the gaps.

### Own occupation stays a separate question

The template keeps own occupation, any occupation, and duration as distinct answers. A reviewer checks each one.

### Psychiatric and physical files do not blur

Assign the specialty the questions need. The case will not send a physiatry file to answer a psychiatric duration question.

### Restrictions with a review date

Each restriction carries a scope and a review date. The employer view shows capability, not the clinical narrative.

### A committed date on a slow specialist

Psychiatric and neurological diaries run long. The case shows the report date from the day it opens.

## How it runs

1. **Open the LTD referral.** Capture the policy question, the occupation, and the date the own-occupation period ends.
2. **Collect the job and the chart.** Request attending statements, specialist notes, pharmacy, and a current job description.
3. **Book the specialty the questions need.** Match psychiatry, physiatry, or occupational medicine to the actual question, then set the report date.
4. **Review duration and restrictions.** Confirm own occupation, any occupation, and each restriction have answers before release.

## Numbers worth knowing

| Figure | What it measures | Source |
|---|---|---|
| $4,000–$8,000+ | Typical BC psychiatric or neurological IME cost | lawyerinfo.ca, BC WCAT guide |
| 2–6 months | Typical wait to book a BC specialist IME | lawyerinfo.ca, BC WCAT guide |
| ~6.5 hours | Average examiner time per IME across review, exam, and report | SEAK 2024 IME fee survey |

## Questions people ask

### Is an LTD examination the same as a SABS insurer examination?

No. LTD sits on the disability policy, not on the SABS. The questions are occupation, duration, and restrictions. Ontario FSRA SABS rules do not govern the file.

### What records does the examiner need?

Attending physician statements, specialist notes, pharmacy, imaging, and a current description of job demands. Without the job file, the own-occupation question has nothing to test.

### Can the employer see the diagnosis?

The employer view shows capability and restriction. Clinical detail stays with the insurer and the examiner unless the employee consents to more.

### What if we only need a paper review?

Open a file review on the same questions. It is faster when a specialist examination will not land in time. It cannot speak to current presentation.

### How do we handle a change from own occupation to any occupation?

Put both questions on the referral. The report template treats them as separate answers with separate dates.