The purchase of a surgeon’s long term disability insurance policy is an important part of a financial plan. These policies generally involve the concepts of total disability coverage and residual disability coverage. Should disability happen, how these and other terms are construed by the insurance company can often undermine a valid claim.
Being totally disabled from practicing surgery does not imply absolute incapacity. Rather, total disability means you can no longer do the material duties of your own medical specialty in the usual way. While you may not be able to tolerate the physical and mental strain of performing several surgeries or procedures a day, you may be able to consult with patients in an office setting on a limited basis.
Many of our clients who are surgeons, physicians or dentists are in this situation. They can no longer perform their surgical specialties or routine procedures, yet they still practice general medicine.
It is imperative that you take action to maximize the surgeons long term disability benefits you are entitled to. If you have questions about your claim, we urge you to contact us as soon as possible for a free case evaluation.
How Total vs. Residual Disability affect Surgeons Long Term Disability Benefits
As disability lawyers, we understand when a surgeon can no longer operate or perform procedures, and can only maintain a limited office practice – in most cases that surgeon has taken an economic wallop, regardless of whether he or she has some residual level of ability to work on a regular basis.
Statistically, surgeons, dentists and other medical specialists are more likely to become partially disabled than totally disabled. Many LTD policies pay based on a percentage of income loss, while other policies are payable on the dollar amount of lost income. Others pay a residual or partial disability benefit.
Surgeons’ long term disability insurance plans are typically customized with specialty riders to meet particular needs, and often provide for a true own-occupation definition of disability and specialty-specific protection.
Some of the most common (and costly) mistakes that disabled surgeons and physicians make is to
- let the insurance company talk them into applying for residual disability benefits instead of total disability benefits, or
- accepting an award of residual benefits, when in fact the disabled surgeon is totally disabled under the terms of the policy.
On the other hand, many disabled surgeons prefer not to leave the medical profession entirely. After years dedicated to developing their surgical practice, they want to continue to serve in their chosen profession, even if on a modified level.
The key is to be aware of many hidden issues related your claim.
Residual disability claims are just one issue. And in almost all cases involving a surgeon’s long term disability claim, there are many steps you must take maximize your benefits.
Many Impairments Can Result in Total Disability for Surgeons
The scope of surgical specialties is broad: orthopedic, neurological, cardiovascular, vascular, reconstructive (plastic) surgery, periodontal, oral or general surgery.
The U.S. Department of Labor’s vocational database defines the surgeon’s vocational abilities as requiring high levels of manual and finger dexterity, arm-hand steadiness, control precision, excellent near vision, tremendous focus, stamina and stress tolerance, with a significant amount of standing/walking. The surgeon’s level of efficiency and performance must be at its peak during every surgical procedure.
Consequently a wide range of injuries and illnesses can disable surgeons from practicing their own specialty occupations. Many surgeons want to continue working if at all possible. If they desire to work in another occupation, such as another medical field, or any other occupation, such as teaching or consulting, the true Own Occupation policy should allow them to do so.
Attorneys Fighting for Surgeons Disability Denials
Disability insurance companies may try to award low residual or partial benefits as a way to avoid paying the surgeon’s entitled total disability benefits.
Other common tactics to underpay deserved benefits include reclassifying a specialty practice as generalist, applying a narrower definition of total disability than is in the policy, or limiting the duration of benefits when total disability benefits are justified. These can all drastically slash a surgeon’s long term disability benefit payments.
The law offices of Marc Whitehead & Associates dedicates its practice to representing physicians and health care professionals in all aspects of disability insurance claims and cases.
If you have any question regarding your disability insurance benefits, please do not hesitate to contact us for answers.