Pharmacist Disability Insurance Benefit Claims & Tips For Getting Benefits Paid
Here at Dell Disability Lawyers, we’ve handled thousands of disability claims filed by pharmacists over the years, and have learned a few things during the process. Pharmacists’ disability claims have some unique challenges and nuances, from how the definition of “disability” is defined in the policy to what type of medical documentation the long term disability insurance company will accept as proof of disability. Many disability insurance carriers simply don’t understand the ins and outs of a pharmacist’s job, which can make getting your benefits seem like an uphill battle. Read on for some disability benefit claims and tips pharmacists can use to get their benefits promptly paid.
The definition of “disability” in your policy is important to understand.
The long term disability insurance policy’s definition of disability is one of the most critical pieces used to determine whether a specific pharmacist will qualify for disability insurance benefits. Many policies broadly provide that “disabled” means you can no longer “do your duties as a pharmacist” – which begs the question, what are a pharmacist’s duties? This definition isn’t limited to exactly how the pharmacist is currently doing their duties in their current location, but instead relies on a nationwide standard, or the “national economy” definition.
Relying on the national economy definition of disability can be risky, as the long term disability company is unlikely to fully understand the scope of your occupational duties. Pharmacists have demanding jobs that often require long hours, steady concentration, and long days spent on one’s feet, and most pharmacists’ long term disability insurance policies are group policies that don’t make allowances for a specific person’s work environment. Pharmacists also must be at the top of their game mentally at all times, between the potentially dangerous medications they work with and the fact that many physicians tend to defer to pharmacists when it comes to patient questions about drug interactions.
The change of definition from own occupation to any occupation results in many denials.
Initially, a long term disability insurance policy may provide benefits to a pharmacist who is unable to perform their “own occupation” using the nationwide standard. But over time, this definition may shift to an “any occupation” standard, providing continued benefits only if the pharmacist is too disabled to perform “any” occupation that fits their education and skill set. Because pharmacists often have tailored their medical documentation and other claim support to an “own occupation” definition of disability, the switch to an “any occupation” definition often results in claim denials.
Why is the transition from short term to long term disability sometimes challenged?
Most short term disability policies are administered by the disabled person’s employer. On the other hand, long term disability policies (except for Walgreens, which is self-insured) are paid by the disability insurer – and once this money begins coming out of the insurance carrier’s pockets, it has far more of an incentive to deny your claims. Even if most of these denials are successfully appealed, each claimant who stops fighting back means more money the insurance carrier gets to keep.
Strong medical documentation of your disability is required for a pharmacist to get approved.
Many pharmacist claimants have pain conditions that prevent them from working on their feet for a full 40 hours a week. For pharmacists in particular, this chronic pain can lead to cognitive difficulties; someone who is distracted by serious pain may not double-check the dosage or drug interactions, potentially leading to serious consequences. Unfortunately, many long term disability insurance carriers don’t seem to give appropriate weight to pain-created cognitive troubles.
Because there is not yet an objective way to measure how much pain a person is experiencing, the more objective medical evidence you can gather, the better. In other words, being able to provide an MRI that shows you have several bulging or ruptured discs in your spine will support your disability claim more than a physician’s statement that you’ve reported experiencing lower back pain. You may also opt for cognitive testing or memory tests that can show whether your memory or ability to multitask has been compromised.
What tools do disability companies use to determine the credibility of your complaints?
One of the greatest tools in your arsenal can be a series of neuropsychological tests designed to show the reliability of your complaints. Because pharmacists are intelligent and tend to start out at a higher-than-average level on these timed tests, showing how one’s skills have deteriorated – even if they’re still technically “above average” – can go a long way toward boosting your credibility.
But long term disability insurance carriers have their own arsenal of tools, not all of which are always known to the disability claimant. Most disability carriers use video surveillance and monitor claimants’ social media accounts, comparing the information they glean with what the claimant has already told them. If a claimant overstates the impact of their disability and is then observed driving for a long distance, working out, going to social events, or engaging in any other activities they claimed not to be able to do, their claim likely will be denied.
The long term disability insurance attorneys at Dell Disability Lawyers have seen every type of disability policy and worked with just about every disability insurance carrier out there. We have the experience and the expertise to work with your insurance company to see what it will take to get your benefits paid. For more information, please reach out to any of our disability insurance attorneys to schedule a free initial consultation to discuss your long term disability claim.
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Sedgwick
Don't trust them, they like to play games
They suck the life out of people that need help. They falsely advertise for helping people that they care. Sorry to tell you it's all about money, they do not care for any... read more >
New York Life
Lyme Disease Disability Claim Denial
I have had repeat claims for genuine medical leave and they have repeatedly been denied by NY Life. I have even been diagnosed with Lyme and going through treatments and t... read more >
New York Life
Disappointed with NY Life Disability Excuses
I am beyond disappointed with NY Life Disability Insurance’s handling of my father’s claim. My father, a 66-year-old man who has suffered two strokes and continues to ... read more >
New York Life
New York Life is a joke!
This company sucks when it comes to disability claims. They are slow at processing stuff, then they always say they didn't recieve the doctors information. You spend your ... read more >
MetLife
They FULL OF ****
MetLife is what everyone on this review are saying. They don't contact you to let you know what's going on with your claim or to let know you need additional info. I had a... read more >
Sedgwick
Worst Company Ever
If something happens to you at work you better hope you die, my son is going through HELL because this company is handling his work comp. NO RETURN PHONE CALLS, TEXTS, EMA... read more >
MetLife
MetLife for disability? Avoid the surgery unless it's life-threatening
The worst company I ever dealt with, never received a call from my claim manager.
Reliance Standard
Short Term Disability Claim/Inconsistent to NO Communication
When I did call & reach a live person they were kind & helpful. The person assigned to my claim left one phone message & I have not spoken to her since. Information she re... read more >
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