The Athletics Of A Physician’s Duties May Cause Disability

An interesting article published in ACS Surgery News compares surgeons to athletes and discusses how surgery is a performance sport that often requires strength and grace.

See https://www.mdedge.com/acssurgerynews/article/157238/pain/has-change-surgeon-pain-disability-rise

The article notes that physicians are prone to cervical spine disease, rotator cuff pathology, and degenerative lumbar spine disease, as well as chronic neck, back, and shoulder pain, concluding that disability is on the rise.

In our law practice, we have worked with numerous physicians, surgeons, dentists, and chiropractors who, after years of practice, experience debilitating, chronic pain that impacts their ability to safely and properly perform their job duties. Under most disability insurance policies, the inability to effectively perform the material duties of the insured’s occupation renders the insured disabled. However, many insureds mistakenly believe that they need to be close to an invalid or barely able to function in order to qualify for benefits. This is simply not true. Disability Insurance policies are marketed and sold as income insurance if there comes a time when the insured cannot properly and effectively perform the material duties of his or her regular occupation with reasonable continuity. Thus, a surgeon with debilitating neck or back pain that struggles to get through the day and questions the ability to effectively treat patients may be disabled under the terms of their disability policy.

Determining when one is disabled can be difficult because the insured has been working, often for years, in pain. Most physicians and professionals have worked hard to reach their current level of success and are reluctant to admit disability and walk away from a career which they truly enjoy and are well respected. Eventually however, the doctor gets to the point where they realize they cannot keep working and makes plans to transfer their patients, sell the practice, or bring in an associate. At that point they decide to file for disability thinking that there will be no issue because they paid for disability coverage and they have a documented medical condition.

Unfortunately, insurance companies do not make the disability claims process simple and often approach claims as if the insured is looking for early retirement. The date of disability is challenged as is the decision to sell or transfer the practice. Many companies begin asking for financial and employment data which is not necessarily relevant and may be used to deny benefits. It is extremely important that the insurance company clearly understands the physical and strength aspects of the insured’s duties and how their medical condition(s) prevent them from performing those duties. Making sure a disability claim is prepared prior to filing can save months and months of delays and a possible denial. If you have any questions about filing a disability insurance claim, please contact us for a free consultation.