Dentist Long Term Disability Insurance Claim Tips for Benefit Approval

Dentists have a broad range of job duties, many of which require concentration, steady hands, and the ability to maintain uncomfortable positions for some length of time. When a dentist is no longer able to perform one of these key duties, they may qualify for long term disability benefits; however, seeking out the disability benefits you deserve (and have earned) can sometimes seem like fighting an uphill battle.

Understand the definition of “disability” in your policy. Is it really “own-occupation”?

Although all policies have their own language, the definition of disability in a long term disability policy is typically an “own-occupation” definition. This allows you to receive long term disability benefits if your injury or illness prevents you from performing your own occupation, or the occupation you are performing at the time you became disabled. If you were a dental surgeon, your own occupation is dental surgeon; if you are a periodontist, your own occupation is periodontist. Though this definition can shift over time, being able to establish your disability under an own-occupation definition is the first step in having your long term disability claim approved.

A detailed analysis of your production code reports is required to prove your “material duties.”

Because the procedures dentists perform are codified, it can be fairly easy for your disability insurance carrier to look back at your production code reports to see what constituted the “material duties” of your own occupation at the time you became disabled. But if you, like many dentists, shied away from performing certain procedures during the months or years leading up to your disability, the last couple of years of production code reports may not tell the whole story.

You may have been residually disabled for months or years if you suffered a 20% loss of income.

Depending on when you stopped performing certain dental procedures, your disability may have developed months or even years before you think. If you found yourself turning down work because you couldn’t handle the extra hours or turning down certain procedures because you weren’t physically capable of performing them to the best of your abilities, you may have been suffering from a residual disability. Your disability insurance carrier may ask, “what’s changed?” if you were still scheduling and performing procedures up until the point you filed for long term disability benefits.

Your medical records must document all your medical complaints and limitations.

The long term disability insurance carrier will want copies of all your medical records and will go through these documents with a fine-toothed comb. As a result, it’s important for your medical records to document all your complaints and limitations, particularly if your disability is pain-related. Pain is subjective and doesn’t show up on medical tests the same way other ailments do, so the more objective information your medical record contains, the more likely you are to have your long term disability claim approved.

Your policy may allow you to keep your dental practice running and collect total disability benefits.

Being disabled according to the terms of your policy does not mean you necessarily have to shut down the dental practice you’ve worked hard to build. This issue will turn on your disability insurance policy’s definition of “earnings.” If you bring in another dentist to work for your practice or take other steps to keep your practice running and your long term disability policy doesn’t define “earnings” broadly enough to include money your practice is earning, you may still qualify for total disability benefits even though your practice remains operational.

Business overhead disability policies have very specific language that usually requires you to keep the business “operational.”

Every business overhead policy is written differently, but many dentists’ long term disability insurance policies have “business overhead” coverage. This coverage requires you to keep your dental practice operational, but can provide dentists with additional long term disability benefits to cover certain overhead expenses you need to spend to keep your practice solvent (for example, rent, wages and benefits, or personal protective equipment). Receiving business overhead disability benefits can provide well-earned peace of mind for any dental practice owner who may be unsure about the next steps for your business.

At Dell & Schaefer, we’ve represented dentists all over the country and helped them fight for the long term disability benefits they deserve. We can help you too – and all we’ll need to get started is a copy of your benefit denial letter (if any) and a copy of your policy. If you’d like to talk to an attorney about your options, give a member of our team a call today to set up your free initial consultation.

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Disability Benefit Denial Options
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Disability Company Reviews
(642)
Showing 8 of 642 Reviews
Sedgwick

AT&T Was Great and Sedgwick Horrible

Reviewed by From a great job to a complete nightmare on March 20th 2024   Verified Policyholder | March 2024 date of disability
My Physician recommended that I take some time from a toxic environment after several deaths in my family coupled with AT&T trying to run tenured employees out of the door... read more >
New York Life

Keeps claiming they will not approve claim for pre existing conditions but my illness is not preexisting

Reviewed by M.T. on February 15th 2024   Verified Policyholder | May 2023 date of disability
I have been appealing a claim for LTD for 8 months! New York Life keeps claiming they will not approve claim for pre existing conditions but my illness is not preexisting ... read more >
Reliance Standard

Staff Lie

Reviewed by Tanya on February 12th 2024   Verified Policyholder | August 2021 date of disability
I had my disability cut off the day I was scheduled to find out whether I should have surgery. The claims examiner was aware that I had an appointment on that date and sai... read more >
Reply
Sent on February 12th 2024 by Attorney Gregory Dell

I am sorry to hear about your experience. It’s crazy that Reliance Standard would deny your disability benefits when you are suffering so badly that you need surgery.... read more >

Hartford

Former Hartford employee has had life insurance and accidental death policy's revoked for one late premium payment

Reviewed by Becky H. THOMAS on February 12th 2024   Verified Policyholder | February 2024 date of disability
Dislike how they are constantly interrupting the lives of their disabled EE's whom are entitled to benefit which they paid into out of there pay check every pay period onl... read more >
Reply
Sent on February 12th 2024 by Attorney Gregory Dell

Thank you for your review of Hartford and we appreciate you sharing.  It’s sad they don’t take care of their own employees.

Lincoln Financial

Never received benefits my entire leave - or help with them

Reviewed by Anna on December 19th 2023   Verified Policyholder | November 2023 date of disability
I used my short term disability insurance for maternity leave and started the process beforehand knowing when I would be out (scheduled induction.) It took a little over a... read more >
Sun Life

Unscrupulous Tactics

Reviewed by Misseekayy on December 19th 2023   Verified Policyholder | May 2023 date of disability
Sunlife uses unscrupulous tactics in order to prevent payment of claims. They wait until it is close to the 30 day mark and then they ask for another form of information o... read more >
Sedgwick

Lame

Reviewed by Dennis T. on December 11th 2023   Verified Policyholder | March 2022 date of disability
My experience with Sedgwick and personell is as follows: Unhelpful, unprofessional and an overall unpleasant experience.
Unum

Unum thought I was fine to work. I wasn't

Reviewed by Elizabeth L. on May 21st 2020   Verified Policyholder
48 yoa dentist POTs Dx aug 22. Attempted to return to work initially but got sick. Was going to go back 2 days/wk in September but could not. Then did go back part time as... read more >
Reply
Sent on May 21st 2020 by Attorney Stephen Jessup

Elizabeth, please contact our office to discuss the denial of your claim and your rights to pursue legal action against Unum.

Answered Questions by Our Lawyers
(4)
Showing 4 of 4 Answered Questions

Q: Mass Mutual Disability Insurance - Own Occupation Rider, for Dentist vs Other insurance Carrier

Answered on April 21st 2023 by Attorney Gregory Dell
A: Jim, Guardian / Berkshire prior to 2021 was one of the best disability companies. They had some management cha... Read More >

Q: Should I contact you before submitting my application for a private disability benefit?

Answered on July 10th 2020 by Attorney Steven Dell
A: It is in your best interest to contact us as early as possible if you think you are going to need to file a lo... Read More >

Q: Can I claim a permanent disability to avoid a surgery that requires several months of down time without promising results?

Answered on September 14th 2019 by Attorney Jay Symonds
A: Lia, each claim depends on the specific facts and circumstances of the case in conjunction with the specific t... Read More >

Q: Can I re-establish my yearly option to upgrade Guardian disability insurance?

Answered on August 30th 2016 by Attorney Rachel Alters
A: Sam, we would need to see the policy and the information they sent you with respect to the denial of the incre... Read More >
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MetLife Approves Disability Benefits to Dentist With De Quervain's

Prior to contacting our office, our client filed a claim for long term disability benefits under his individual disability insurance policy wi... Read More >

Confidential Disability Settlement for a Dentist After Insurance Companies Bad Faith is Exposed

Our client enjoyed a long and successful career in the dental profession. That he enjoyed this profession was emphasized by his many achieveme... Read More >

Dell Disability Lawyers prove dentist is totally disabled and not residually disabled

More than sixteen years ago, shortly after starting his dental practice, Dr. Johnson (name has been changed for privacy purposes) bought a dis... Read More >

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

Our client, a general dentist, purchased a long-term disability policy from Berkshire Life Insurance Company of America. The policy defined "d... Read More >

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Dell Disability Lawyers was able to successfully procure a settlement for a dentist whose disability benefits from UNUM Provident were termina... Read More >

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Our client, a 48 year old dentist, began to experience difficulty performing the substantial and material duties of his occupation as a result... Read More >

Unum Provident and Monarch Life Insurance Company pay total disability to dentist

Ever since our client was in junior high school, he had dreamed of being a dentist and opening his own dental practice. Through years of hard ... Read More >

Seven Surgeries and The Standard Still Denies Long Term Disability Benefits

Our client was employed with the State of Oregon as a Technical Support Representative. She s... Read More >
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MetLife Slammed by California Judge for Long Term Disability Denial

In Tash v. Metropolitan Life Insurance Company (MetLife), Raymond Tash, a dentist, became disabled due to multiple injuries and was initially ... Read More >

Reliance Standard Disability Denial Upheld Due to Claimant's Lack of Strong Medical Record Support

In the case of Amy Wright v. Reliance Standard Life Insurance Company (Reliance), Plaintiff was the vice-president of... Read More >

Unum Wrongfully Terminated Disabled Lawyer’s Disability Claim of Depression and Anxiety Despite Improvement in His Condition

This Unum lawsuit and appeal in federal court is a great victory for all Unum disability claimants. This ca... Read More >

Federal Court Overturns Aetna Denial Of Disability Benefits

In the recent case of Ferrin v. Aetna Life Ins. Co. a federal judge from the Northern District of Illinois determined that Aetna improperly te... Read More >

Court Finds Irregularities in Procter & Gamble Long Term Disability Benefit Denial

In ERISA cases filed in a district court asking for judicial review of a plan administrator's denial of benefits, the court is generally limit... Read More >

Federal Judge Makes Companion Life Insurance Pay Long Term Disability Benefits

Companion Life tried to play games and deny long term disability benefits, but thankfully a New Mexico Federal Judge made them pay disability ... Read More >

NFL Disability Review Board Ignores Evidence of Disability and Appeal Court Reverses Lower Court Decision

In Darren Mickell v. Bert Bell/Pete Rozelle NFL Players Retirement Plan (Plan), Mickell spent nine years in the NFL as a defensive e... Read More >

Judge Agrees that MetLife's Denial of Long Term Disability Benefits was Reasonable

In Anne Ehlert v. Metropolitan Life Insurance Company (MetLife), Ehlert was a consulting pension actuary for pension plans at Towers Watson.... Read More >

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