Principal Approves Long Term Disability Benefits for Surgeon
Author: Attorney Stephen Jessup
Our client was a highly successful Podiatric Surgeon who was suffering from severe neck pain due to two crushed cervical facet joints with resultant nerve impingement. Despite his best efforts to continue to work in his capacity as a surgeon the pain and associated numbness and weakness was making it increasingly difficult to effectively examine and treat his patients. The pain became so severe and his concerns for the safety of his patients and his own health left him with no choice but to walk away from his life’s work and a highly successful medical practice. Shortly thereafter he filed his claims for long term disability benefits under his individual policies with Unum and Principal.
What is taking so long?
After filing his claim for benefits our client contacted Attorneys Dell & Schaefer and spoke with Attorney Stephen Jessup. During an initial consultation he discussed with Attorney Jessup the nature of his medical conditions, his occupational duties and surgical schedule as a Podiatric Surgeon, and advised Attorney Jessup that Unum had quickly approved his claim for benefits. Our client expressed his concerns over the seemingly long amount of time it was taking Principal to render a decision. Attorney Jessup requested copies of all correspondence to and from the insurance carriers and a copy of our client’s disability policies. Upon receipt and analysis of the information Attorney Jessup scheduled a follow up consultation with our client to discuss his rights and options.
Alleviating the stress
As our client had been a very successful surgeon and medical practice owner, he was concerned about the financial ramifications of stepping away from the practice of medicine and even more concerned about whether his insurance companies would honor their obligations under the policies, as his only source of income would be from his disability benefits. Not wanting to risk making any mistakes in dealing with the insurance carriers, he hired Dell & Schaefer to manage the monthly handling of his claim.
Acting quickly, Attorney Jessup sent out letters of representation to both Unum and Principal. As Unum had already awarded benefits, Attorney Jessup focused the majority of his attention to Principal. The elimination period under the Principal policy had already passed and Principal was still evaluating our client’s medical records and his medical production reports to determine his occupational duties. Concerned that Principal might be erroneously categorizing our client’s occupation as that of a Podiatrist, and not a Podiatric Surgeon, Attorney Jessup emphasized the importance of the differences with specific attention to the physical demands of the latter.
Only two weeks after being retained, Attorney Jessup was able to secure our client’s benefit with Principal. Additionally, he has also been able to get Unum to agree to reduce the reporting requirement for additional forms to once every three months as opposed to monthly.
Don’t risk your financial security
For many medical and business professionals the proposition of walking away from their life’s work and the financial security that often comes from same is a daunting and scary thought. Not only are you faced with coming to terms with a new understanding of who you are now that your identity as a doctor/professional has radically changed, but also with the concerns of financial security. For many their long term disability insurance policies will often serve as their main source of income. As such, it is wise to leave little to chance and consult with a qualified attorney who is experienced in dealing with disability insurance companies and who understand insurance company tactics. As much as one would like to think that an insurance company will honor their obligations, it is not at all uncommon to find yourself faced with an onslaught of information requests and scrutiny from your insurance carrier.
If you are thinking about filing a claim for disability benefits; have already filed a claim and are awaiting a decision; or you are already on claim and want to have an attorney maintain the monthly handling of your claim please feel free to contact our office for a free consultation to discuss how we may be able to assist you in securing disability benefits under the policies you have been dutifully paying premiums on for years.