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Berkshire Life Insurance Company approves long-term disability benefits for a dentist suffering from lumbar disc disease

Attorney Cesar GavidiaAuthor: Attorney Cesar Gavidia

Our client, a general dentist, purchased a long-term disability policy from Berkshire Life Insurance Company of America. The policy defined “disability” as the inability to perform the substantial and material duties of his regular occupation. Our client maintained a solo dental practice since 1995. After several years of practice, Dr. Q began experiencing back pain which made it difficult for him to bend over patients for long periods of time and perform most of his dental procedures.

The pain continued to worsen as time went on. Dr. Q’s treating neurologist diagnosed Dr. Q with lumbar degenerative disk disease and associated radiculopathy. Eventually, the pain forced Dr. Q to put his practice up for sale and discontinue the practice of dentistry.

Knowing that the application process for long-term disability benefits could be complicated, Dr. Q contacted Dell and Schaefer to assist him in submitting his claim for long-term disability benefits. Attorneys Gregory Dell and Cesar Gavidia gathered all of the medical, financial, and occupational information necessary to submit Dr. Q’s claim for long-term disability benefits. Berkshire delayed payment of Dr. Q’s disability claim as Dr. Q. had began working in a new occupation as a dental professor. After field interviews with Berkshire and our client, Attorneys Dell & Schaefer were able to prove that the material duties necessary to be a professor are not similar to the material duties required to work as a solo general dentist. Once Berkshire accepted that Dr. Q could no longer practice dentistry on patients, they agreed to pay long-term disability to our clients. Berkshire agreed to pay benefits just prior to Attorneys Dell & Schaefer filing a lawsuit for their failure to pay. Attorneys Dell & Schaefer continue to maintain Dr. Q’s long-term disability claim with Berkshire on a monthly basis.

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