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.

Resources to Help You Win Disability Benefits

Disability Benefit Denial Options
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Sue Your Disability Insurance Company

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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
(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

Low payments

Reviewed by Dorothy on November 30th 2023   Verified Policyholder | November 2023 date of disability
I was injured at work. I did house keeping in a hospital. I tore just about everything imaginable in my knee. I was let go from my job, because I was no longer able to do ... read more >
Answered Questions by Our Lawyers
(1)
Showing 1 of 1 Answered Questions

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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Showing 12 of 896 Videos
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Showing 8 of 375 Dell Disability Cases

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 progressivel... 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 res... Read More >

General Surgeon wins Long Term Disability Insurance Trial Against Unum

Our client, a general surgeon with chronic back pain, will finally receive the long-term disability benefits that he has been denied since Oct... Read More >

A general surgeon and his legal team at Dell Disability Lawyers win disability insurance jury trial against Unum

In a federal court in Peoria, Illinois, a jury ruled against Unum Company (NYSE: UNM) and client will receive $246,000 in unpaid disability in... 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. Fortunate... Read More >

Neurosurgeon awarded partial disability benefits

Our attorneys were able to quickly procure total disability benefits for our client, a neurosurgeon, following his back surgery. Eventually, o... 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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(765)
Showing 8 of 765 Lawsuit Stories

Unum Motion to Deny Total Disability Benefits to OB/GYN Denied by Tennessee Judge

In Barbara J. Nylander, M.D. v. Unum Life Insurance Company and Paul Revere Life Insurance Company, Dr. Nylander, a board-certified physician ... Read More >

9th Circuit Holds That Release In Plaintiff's Wrongful Termination Lawsuit Bars Subsequent ERISA Benefits Claim

In Thomas A. Gonda, Jr., M.D. v Permanente Medical Group, Inc., et. al., plaintiff Thomas Gonda, a thoracic surgeon for The Permanente Me... Read More >

Dental surgeon sues Paul Revere Life Insurance Company for wrongful denial of long-term disability benefits

A California disability lawyer filed a federal lawsuit in Federal Court against The Paul Revere Life Insurance Company (Paul Revere). The Plai... 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 >

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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 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 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 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 lawyers 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 lawyers 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 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 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 lawyers 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 lawyers have been able to either get our clients paid monthly disability benefits or obtain a one-time lump-sum settlement. Our 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 welcome you to contact any of our attorneys 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 700 videos and regularly provide tips to help protect your disability benefits.

Who do you help?

Our lawyers 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 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, GoToMeeting sessions, or Skype. 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 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.