Excessive workloads have become a common feature in many occupations, with consequences that extend beyond productivity. In some cases, individuals seeking higher earnings voluntarily assume extended work hours, while others are driven by employer expectations or job demands. From an underwriting perspective, prolonged work hours, sustained stress, and insufficient recovery time introduce medical and financial risk factors that warrant careful consideration in Disability insurance underwriting.

Chronic overwork is frequently associated with conditions such as cardiovascular disease and stroke as well as affecting mental health. According to the World Health Organization and the International Labour Organization, “working 55 or more hours per week is associated with an estimated 35% higher risk of a stroke and a 17% higher risk of dying from ischemic heart disease, compared to working 35‑40 hours a week.”¹

In addition to medical concerns, excessive workloads can also impact financial underwriting. When income is closely tied to extended hours, underwriters must evaluate whether current earnings are realistically maintainable long-term. For salaried employees, there is less concern from a financial standpoint as their income is not directly tied to the number of hours worked; however, for hourly and self-employed individuals, their income has a direct correlation to the number of hours they work, therefore attention must be paid to hours being worked to determine if their income is sustainable long term.

Let’s review a case study:

36‑year-old male, LPN, requesting $8,000 Individual Disability Income insurance. He has worked in home health care for two years and states his income is $160,000.

• An online search shows the average salary of an LPN in the state he resides is $56,500 at the 50th percentile and $65,000 at the 90th percentile.
• The application states he works over 30 hours per week but does not provide a specific number.
• Paystubs show current hours worked as 91.55 for a one-week period and show YTD hours worked as 2,074 for 6.5 months, which is approx. 80 hours per week. The paystub also shows a YTD income of $83,947, annualized to $155,000, being paid hourly with overtime.

In reviewing this case, these are some questions that come to mind: Does it seem reasonable for a LPN in home health care to make $155,000 a year? If he quit his job, could he go elsewhere and make the same amount of money? Can he sustain an 80‑hour work week long-term? If applying for the Residual Benefit rider, how would his employment situation impact the rider? Medically, how might an 80‑hour work week impact his health, and are there currently any signs of health issues?

When reviewing cases involving chronic overwork, it is important to assess whether the overall logistics of the case are reasonable and sustainable. In situations where income is driven by excessive hours, consideration may be given to limiting coverage based on a more typical work week, such as 60 hours, rather than 80 to 90 or evaluating whether the Residual Benefit rider should be offered. In addition to considering the potential sustainability of an applicant’s work schedule, careful attention should be paid to their medical history for indicators of burnout or other conditions that may be associated with the demands of prolonged work schedules.

While chronic overwork may not present an immediate concern, it can have significant long-term health implications and may not represent a financially sustainable income pattern.

Endnote

1. “Long working hours increasing deaths from heart disease and stroke: WHO, ILO,” World Health Organization, May 17, 2021, https://www.who.int/news/item/17-05-2021-long-working-hours-increasing-deaths-from-heart-disease-and-stroke-who-ilo.

Last accessed: May 12, 2026