Like other recently disabled doctors and dentists, chances are you have considered suspending or deferring the specialty duties of your own occupation just so you can remain active in your practice. Be aware, the insurance company may use this against you.
The video above explains how insurance companies use every tactic they can to argue that claims for long term disability benefits are either undeserved or should be reduced. This occurs often with high-payout claims such as those for medical and dental professionals.
High-salary earners who own and operate a professional practice rarely succumb to disability without a fight. That is where the danger lies. As an impairment sets in, or after an injury strikes, the resulting disability becomes something the insured tries to compensate for and manage on their own.
Greatly impacted by this phenomenon are doctors, dentists and others whose livelihoods depend on their medical skills to treat and help patients. Their careers are based on the ability to perform medical procedures involving manual dexterity, arm-hand steadiness, and mental and physical strength and stamina. The loss of any one of these physical components can bring a lucrative practice to an early end.
By deferring or suspending the specialty duties of their own occupation as a surgeon or dentist, many are able to remain active in their practice, at least temporarily. But doing so can lead to the denial of a disability insurance claim, or getting a drastically reduced benefit amount.
How Can Suspending the Specialty Duties of Your Own Occupation to Offset a Disability Result in Claim Denial?
Example:
Marie, an oral surgeon for 20 years, spends her days performing dental surgeries and extractions, implants, bone grafts and restorative treatments. Her work requires hours of standing over patients in awkward postures while using manual dexterity and precision tools.
When Marie first started her practice, she purchased a long term disability policy with a rider covering her own occupation as a dentist.
For several years, Marie has suffered from degenerative disc disease. Now Marie realizes she is no longer able to perform the grueling surgeries and other specialty aspects of her profession. But she is used to calling the shots, and is determined to remain active in her practice.
Marie turns over the surgical aspects of her practice to her associate – at least until she can get her back sorted out – and spends her work time scheduling appointments, counselling patients, advising staff, ordering supplies and other administrative duties. By temporarily abstaining from performing the skilled, specialty duties of her own occupation as a dentist, she is able to remain involved with her practice.
But the reality is, her back is not going to improve. She will learn in the months to come, after undergoing treatments and surgery, the damage and chronic pain will limit her everyday functionality.
Marie files a disability claim. Her insurance company denies her claim, stating that at the time her claim was filed, her job duties involved scheduling, counselling, ordering supplies and other administrative tasks (not skilled dentistry or surgery).
The insurance company bases their decision on the fact that Marie would be able to perform similar duties in a low-impact, administrative job.
It is very common for many highly trained professionals disabled by chronic medical problems to want to remain active in their practice. To do so, they unwittingly shift their practice to offset their disability.
Insurance companies intently watch for this and other inadvertent missteps by high-payout claimants, as well as ways to “interpret” policy wording.
For a free legal consultation, call 800-562-9830
No matter what your policy says, your insurer may challenge your right to disability benefits.
Always be mindful of what your occupational duties are during the time of disability, should you consider suspending the specialty duties of your own occupation to compensate for a disability. It is also important to know if your disability policy will allow you to work in another capacity and still collect benefits.
Even for policies with an own occupation provision, many doctors’ and dentists’ disability insurance claims are denied. Insurance companies find ways to allege that you can still perform the duties of your own occupation.
Or, although you still work in your dental or medical practice, they will reclassify your occupation to say you were also an administrator or other lower classification – to either deny or significantly reduce benefits.
Free Disability Case Evaluation
You didn’t succumb to disability without a fight; neither should you give in to the insurers.
If you are a doctor or dentist struggling with a medical condition that is obstructing your ability to perform surgery or other essential duty in your medical specialty, contact Marc Whitehead & Associates for a free case evaluation and to discuss how we can help you win your disability insurance claim.
Call or text 800-562-9830 or complete a Free Case Evaluation form
