Disability Claims

Attorneys who handle disability claims in the Dallas – Fort Worth area need to have an understanding as to how “disability” is defined.
The most commonly used definition used in Texas law is the Worker’s Compensation definition. In the 1944, Texas Supreme Court opinion styled, Texas Employers’ Insurance Association v. Mallard, the Court held that the standard definition of “total incapacity” is that “a person is disqualified from performing the usual tasks of a workman, in such a way as to enable him to procure and retain employment …” This definition has been broadened over the years. Total disability as that term is defined under the Workers’ Compensation Act and as that term was defined for the jury in the workers’ compensation case does not preclude the possibility of rehabilitation. The definition of “total incapacity” given to the jury in the workers’ compensation case stated that it “does not imply absolute inability to perform any kind of labor, but means that one is disabled from performing the usual task of the worker, not merely the usual task of any particular trade or occupation, to such an extent that he cannot get and keep employment requiring the performance of the usual task of a worker.” This has been stated in at least two cases. One was the 1963, Texas Supreme Court case, Texas Employers Insurance Association v. Hawkins. The other is a 1992, Texarkana Court of Appeals case styled, Southwestern Electric Power v. Martin.
The definition of “Total Disability” is a little different. Total disability is a relative matter and depends chiefly on the circumstances of each case and on the nature of the occupation and the capabilities of the person injured. It does not mean absolute physical disability of the insured to transact any kind of business pertaining to his occupation, but exists if he is unable to do any substantial portion of the work connected therewith. This is told to us in the 1961, Texas Supreme Court case styled, Prudential Insurance Company of America v. Tate.
In Texas, the laws regarding Workers Compensation insurance are such that very few attorneys will handle a case involving any kind of disability related to Workers Compensation insurance. However, anyone who has a disability insurance that is not Workers Compensation Insurance should seek the advise of an experienced Insurance Law Attorney if they find themselves in a situation where their claim for benefits are being denied. These policies are many. They are sometimes offered through work but often times are part of standard health insurance policies or standard life insurance policies. Most policies covering any type of credit situation also provide disability coverage such as auto loans and home loans and credit cards.
A person will most often see a policy with a name such as “Life and Disability” or “Credit Life & Disability.”