Let's get physical. For most physicians, their job is not only mentally taxing but also physically demanding, requiring you to bend, squat, reach, hold uncomfortable positions for hours, and muscle your way through tedious procedures and exhausting shifts. For this reason, you likely purchased a good amount of long-term disability (“LTD”) coverage to protect your income if you ever became unable to perform your job due to a disability. You paid your premiums. You expect your LTD insurer to pay if you have to file a LTD claim. Sadly, many doctors' claims for LTD benefits fail. Understand why so you can avoid these five common mistakes many doctors make that end up costing them their LTD benefits.
1. MISDIAGNOSING YOUR DISABILITY
Typically, you will be considered disabled if you cannot perform the material duties of your “own occupation” as defined by your LTD insurance policy.
Many disabled doctors never file a LTD claim out of ignorance, embarrassment, or shame. Learn your policy's definition of disability to determine whether your limitations make you disabled.
2. FILING AFTER YOU'VE CHANGED YOUR “OWN OCCUPATION”
Just because you are still working does not mean you are not disabled. If your limitations have required you to reduce your hours or procedures, that may qualify you as disabled.
Also, if you file after you've changed to a reduced position, your new occupation may be considered your “own occupation” as defined by your policy.
3. GENERATING UNFAVORABLE MEDICAL RECORDS
The primary “proof” of your disability will be contained in your medical records, which can often contain misleading observations about your abilities, unhelpful absolutes, or omit critical symptoms you need to prove you are disabled.
Many disabled doctors don't know how to talk to their treating physicians to ensure their medical records support their disability.
4. FAILING TO GET VOCATIONAL EVIDENCE
After you file your claim, most LTD insurance companies will immediately hire a vocational expert to say what occupation(s) you can perform.
If you don't hire a vocational expert of your own, you will have nothing that a court can review to rebut the insurance company's evidence.
5. APPEALING A DENIAL WITH AN INSUFFICIENT RECORD (THAT CLOSES)
Most LTD claims, including legitimate ones, are denied. The only option left for the doctor is to appeal and this typically has to be done quickly (180 days).
Most doctors don't know the evidence they submit in the appeal is the only evidence a court can consider if the appeal is denied.
You are a doctor. You know medicine.
We are lawyers. We know the law, and we want to help.
Since its formation in 2006, Taylor, Warren, Weidner & Hancock has handled all types of insurance claims on behalf of the policyholder, including disability, life, fire, flood, wind, property and casualty, and auto, as well as personal injury claims. Our five attorneys at TWWH are led by senior partner, Stephanie Taylor, who has successfully assisted many doctors and other professionals in recovering LTD benefits initially denied. We never charge any fee or cost or require any obligation to explain your rights. If you have any questions or concerns about your LTD benefits or an LTD claim, contact us.