A Surgeon Seeking Disability Benefits Needs These Tips To Collect Benefits

Surgeons have incredibly physically – and cognitively – demanding jobs. Something as seemingly minor as a mild tremor or a moment of inattention can have dire consequences in the surgical field. What should surgeons know when filing for long term disability benefits?

The definition of “disability” in your policy is very specific and must be understood.

Many long term disability insurance policies are group policies that are governed by the Employee Retirement Income Security Act (ERISA). These ERISA policies aren’t very claimant-friendly and can make it tough to qualify for benefits.

But surgeons are fortunate to have been courted by long term disability insurance carriers, and many of the long term disability policies issued to surgeons have among the most generous definitions of “disability” available. Under many of these policies, the definition of the claimant’s “regular occupation” depends on the surgeon’s specialty; this can render a surgeon “totally disabled” even if they’re able to perform other surgical duties more than half the time.

A surgeon’s production code reports will be scrutinized to determine your “material duties.”

One of the easiest ways for a long term disability insurance carrier to assess the “material duties of the occupation” of a particular surgeon is to analyze the surgeon’s production codes. This can reveal which procedures the surgeon performs most often and may be used to challenge the surgeon’s characterization of their specialty. If a surgeon’s practice doesn’t take insurance (and therefore doesn’t use production codes to bill insurance), this can make proving the material duties of the occupation a bit more challenging. An experienced long term disability insurance attorney can help with this process, gathering the necessary records and reports to prove what procedures the surgeon does most frequently.

Your ability to continue working without doing surgery and collecting total disability may be an option.

There is plenty of gray area between shutting down one’s practice entirely and continuing to work full-time as a surgeon while dealing with a serious medical condition. Depending on your condition and the terms of your policy, you may be able to continue working (albeit not performing surgery) while collecting disability benefits. This can allow surgeons to maintain their pre-disability income without putting patients at risk.

Working with a chronic medical condition and then deciding to file for disability benefits is a challenge for most surgeons.

Many surgeons are Type-A personalities, and this can present a unique psychological barrier when it comes to admitting that you are too disabled to continue to perform surgeries. It is important for surgeons to focus on the medical issues they’re experiencing and how the impact of these conditions can ultimately affect patient care. Stepping back from a high-pressure surgical career can alleviate some of these problems and may even improve the surgeon’s ability to return to full-time work in the future.

Disability insurance companies are notorious for using their own “hired gun” doctors to deny disability claims.

Disability insurance carriers have a vested interest in denying claims for long term disability benefits, particularly high-dollar benefit claims like the one’s surgeons tend to file. As part of this process, the insurance carrier may hire its own medical experts to review your medical records and determine whether you are disabled under the terms of the policy. Knowing to expect these “hired guns” can help surgeons gather the necessary medical evidence to rebut the internal expert’s assertion.

Video surveillance and review of your social media are common tools used to challenge a surgeon’s complaints.

Another tool disability insurance carriers often use when denying a claim for benefits is the tool of surveillance. From monitoring your social media accounts to see how you are spending your time to engaging in actual video surveillance, your insurance carrier will stop at nothing to gather evidence it can use to deny your claim later. Surgeons must remain conscious of this surveillance and be honest when answering the insurance carrier’s questions – if you’ve told your insurer you can’t drive for more than 10 minutes and are then witnessed taking a 2-hour road trip out of town, your claim is likely to be denied.

Trying to navigate the ins and outs of a long term disability claim on your own can be frustrating and time-consuming. At Dell & Schaefer, we’ve helped hundreds of surgeons secure their long term disability benefits by submitting a comprehensive claim package. Get in touch with one of our experienced attorneys today to schedule your free consultation.

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Prevent a Disability Benefit Denial
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Negotiate a Lump-Sum Settlement

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Disability Company Reviews
(650)
Showing 8 of 650 Reviews
MetLife

MetLife for disability? Avoid the surgery unless it's life-threatening

Reviewed by Jeff on August 22nd 2024   Verified Policyholder | August 2024 date of disability
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

Reviewed by GaKRN on August 22nd 2024   Verified Policyholder | June 2024 date of disability
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 >
Unum

Unum Closed My Case Today

Reviewed by Scott C. on July 5th 2024   Verified Policyholder | March 2023 date of disability
Unum will keep you around, if they pay you 100 a month. But as soon as have to pay more than 2700 a month, they will drop you. We will be going to the attorneys office fir... read more >
Hartford

Ran me Around for Months

Reviewed by David on July 5th 2024   Verified Policyholder | January 2024 date of disability
Scammers. Immoral horrible people.
Reply
Sent on July 5th 2024 by Attorney Gregory Dell

David:

It’s horrible that Hartford did that to you.

Prudential

Denied but Not Denied but I am Denied

Reviewed by KDDK on July 5th 2024   Verified Policyholder | August 2022 date of disability
I went out in Aug. 2022 for neck pain. After seeing a neurologist I had to get an ACDF C5-7, it was also determined I had carpal tunnel in my right hand and bulging disk i... read more >
New York Life

Claiming They Are Not Receiving Paperwork

Reviewed by Macey on June 26th 2024   Verified Policyholder | February 2024 date of disability
After suffering from medical issues from my delivery in February, I had to have a colostomy bag placed. Now New York Life is trying to claim my condition was pre-existing ... read more >
Hartford

Truly Horrible and Immoral Company with No Customer Service

Reviewed by William M. on June 26th 2024   Verified Policyholder | June 2020 date of disability
My experiences with Hartford have been nothing short of cruel. They started off by claiming that having Glioblastoma, which has an expected life span of about fifteen mont... read more >
Hartford

Sent my Direct Deposit to a Strangers Bank Acct

Reviewed by Brad on May 2nd 2024   Verified Policyholder | February 2024 date of disability
I went on short term disability and The Hartford put my direct deposit into someone else’s bank account. Somehow they messed up a number or two and they are refusing to ... read more >
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Q: Who are the top companies you would recommend for a surgical specialist?

Answered on August 1st 2022 by Attorney Stephen Jessup
A: Mac, all insurance companies have their idiosyncrasies when it comes to the claim review process that can caus... Read More >
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Disability Benefit Denial Reason #3 - Video & Social Media Surveillance

One thing many disability insurance claimants don't know about (or expect) from the claims review process involves video and social media surveillance. Disability insurance carriers often hire people to follow claimants around with a telephoto lens - or even send social media friend requests from fake accounts - to glean whatever information they can about the c... Read More >

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Disability Denial Reason #2 - Change of Disability Definition & Vocational Review

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The Standard, Ameritas and Sun Life Agree to Pay Residual Disability Benefits to General Surgeon

Our firm represents a general surgeon who can no longer perform surgeries on a full-time basis due to multiple spinal surgeries as well as a previous shoulder injury. The surgeries he has undergone are as follows:Left L5-S1 micro-discectomy June 2012Right C6-C7 ACDF May 2013Left C5-C6 ACDF June 20173 level lumbar laminectomy/decompression M... Read More >

Principal reinstates benefits of Orthopedic Surgeon unable to work full-time after Attorney Rachel Alters submits Appeal

Dr. S is 47-year-old left hand dominant Orthopedic Surgeon who was forced to stop working full-time effective May 2, 2016, due to progressively worsening left arm pain which significantly impacted his ability to perform the material and substantial duties of his occupation on a sustained basis. He has a well-documented history of degenerative disc disease, spondylosis with C5-6 neuroforaminal stenosis, and C6 ... Read More >

Principal Approves Long Term Disability Benefits for Surgeon

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 concern... Read More >

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Our client, a general surgeon with chronic back pain, will finally receive the long-term disability benefits that he has been denied since October 2004. The United States District Court for the Central District of Illinois entered a final judgment of $402,268.00 against UNUM (formerly known as Paul Revere Life Insurance Company). In addition to the $402,000 our client's disability policy will pay him more... Read More >

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In a federal court in Peoria, Illinois, a jury ruled against Unum Company (NYSE: UNM) and client will receive $246,000 in unpaid disability insurance benefits the insurer withheld from a general surgeon it had claimed was capable of conducting major surgeries, despite the surgeon's difficulty standing for more than one hour at a time.The eight-person jury, which included an employee from State Farm Insuran... Read More >

Unum approves long-term disability benefits for a general surgeon diagnosed with cervical degenerative disc disease

Our client, a general surgeon for 25 years, was forced to stop performing surgery due to chronic degenerative cervical disc disease. Fortunately, our client had purchased a long-term disability policy from Paul Revere Insurance Company (acquired by Unum), during the early years of his career. The Unum long-term disability policy provides a monthly disability benefit in excess of $12,000 in the event our c... Read More >

Neurosurgeon awarded partial disability benefits

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Seven Surgeries and The Standard Still Denies Disability Insurance Benefits

Our client was employed with the State of Oregon as a Technical Support Representative. She sought disability through her employer provider LTD Policy with Standard due to low back, hip, and lower extremity pain. She had two hip, two knee and three back surgeries.After paying her for 1.5 years Standard hired a board-certified neurologist to perform a review ... Read More >
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9th Circuit Holds That Release In Plaintiff's Wrongful Termination Lawsuit Bars Subsequent ERISA Benefits Claim

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

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

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Federal Court Overturns Aetna Denial Of Disability Benefits

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Court Finds Irregularities in Procter & Gamble Disability Insurance Benefit Denial

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5 Ways We Help Get Your Benefits Paid

Get Your Disability Application Approved

Our goal is to get your application for disability income benefits approved. Applying for disability insurance benefits can be a difficult process and the information you provide is critical. Most disability insurance companies look at your application in hopes of finding a reason to deny your claim. Your disability company will ask you to complete numerous forms, interview you, request lots of information, speak with your doctors and possibly request to have you examined by their "hired gun" doctor.

Through our experience of having helped thousands of disability insurance claimants, our disability insurance lawyers will guide you through the entire application process and give you the best chance to get your disability claim approved the first time.

Submit A Strong Appeal Package

If your disability insurance benefits have been wrongfully denied, then our disability insurance lawyers know exactly what it takes to get your disability claim approved. You only get once chance to submit an Appeal, therefore every piece of evidence that will support your disability claim must be included. The goal is to win your disability benefits at the Appeal level, but while preparing your Appeal you must consider how a federal judge will review your disability claim if your benefit denial is upheld.

Preparing a strong disability appeal package is an art that requires you to understand how the courts interpret your disability policy language, ERISA regulations / laws, and how to strategically present evidence in support of your definition of "disability". We encourage you to contact any of our attorneys for a free immediate review of your disability denial.

Sue Your Disability Company

98% of the disability insurance lawsuits filed by our law firm have resulted in either the payment of benefits or a lump-sum settlement agreement. Our disability insurance attorneys have filed ERISA governed and private policy long term disability insurance lawsuits against every major disability insurance company in state and federal courts nationwide and we love fighting for the "little guy" against the multi-billion dollar insurance company giants.

We have recovered hundreds of millions of dollars for our clients and we would like the opportunity to provide you with a free review of your disability benefit denial. There are many complex factors in a disability benefit lawsuit and the legal battle to win long term disability benefits can be fierce.

Prevent A Disability Benefit Denial

Approval of long-term disability is a continuous process as every disability insurance company will evaluate your eligibility for benefits on a monthly basis. You can never let your guard down and assume that your disability company will continue to pay your benefits for as long as you think you need them.

Our disability insurance law firm offers a reasonable flat fee monthly claim handling service in which we handle every aspect of your long-term disability claim and do whatever it takes to make sure you are paid every month.

Negotiate a Lump-Sum Settlement

Let's discuss if a lump-sum settlement or buyout of your disability insurance claim is both available and makes financial sense for you. Our disability insurance lawyers have negotiated more than five-hundred million dollars in disability insurance buyouts and we know how to get you a maximum settlement. A disability insurance company is not required to offer a buyout and not every disability company offers them.

Questions About Hiring Us

Who are Dell Disability Lawyers?

We are disability insurance attorneys that know how to get your short or long term disability benefits paid. As a nationwide law firm we have helped thousands of disability insurance claimants throughout the United States to collect hundreds of millions of dollars of disability insurance benefits from every major disability insurance company.

In more than 98% of our cases, our attorneys have been able to either get our clients paid monthly disability benefits or obtain a one-time lump-sum settlement. Our disability insurance lawyers have seen it all when it comes to disability insurance claims and we know exactly what it takes for your disability claim to be approved.

We offer disability insurance attorney representation nationwide and we welcome you to contact any of our lawyers for a free immediate review of your disability claim. We also invite you to visit and subscribe to our YouTube channel where we have more than 850 videos and regularly provide tips to help protect your disability benefits.

Who do you help?

Our disability insurance attorneys help individuals that have either purchased a long term disability insurance policy from an insurance company or obtained short or long term disability insurance coverage as a benefit from their employer. We have helped individuals in almost every type of occupation with monthly disability benefit payments ranging from $1,500 to $50,000.

Our clients include all types of employees ranging from retail associates, sales representatives, government employees, police officers, teachers, janitors, nurses, pilots, truck drivers, financial advisors, doctors, dentists, veterinarians, lawyers, consultants, IT professionals, engineers, professional athletes, business owners, and high level executives.

A strong understanding and presentation of the duties of your occupation is essential for securing disability insurance benefits.

Do you work in my state?

Yes. We are a national disability insurance law firm that is available to represent you regardless of where you live in the United States. We have partner lawyers in every state and we have filed lawsuits in most federal courts nationwide. Our disability insurance lawyers represent disability claimants at all stages of a claim for disability insurance benefits. There is nothing that our lawyers have not seen in the disability insurance world.

What are your fees?

Since we represent disability insurance claimants at different stages of a disability insurance claim we offer a variety of different fee options. We understand that claimants living on disability insurance benefits have a limited source of income; therefore we always try to work with the claimant to make our attorney fees as affordable as possible.

The three available fee options are a contingency fee agreement (no attorney fee or cost unless we make a recovery), hourly fee or fixed flat rate.

In every case we provide each client with a written fee agreement detailing the terms and conditions. We always offer a free initial phone consultation and we appreciate the opportunity to work with you in obtaining payment of your disability insurance benefits.

Do I have to come to your office to work with your law firm?

No. For purposes of efficiency and to reduce expenses for our clients we have found that 99% of our clients prefer to communicate via phone, email, fax, or video conferencing sessions. If you prefer an initial in-person meeting please let us know. A disability company will never require you to come to their office and similarly we are set up so that we handle your entire claim without the need for you to come to our office.

How can I contact you?

When you call us during normal business hours you will immediately speak with a disability insurance attorney. We can be reached at 800-698-9159 or by email. Lawyers and staff must return all client calls same day. Client emails are usually replied to within the same business day and seem to be the preferred and most efficient method of communication for most clients.

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