Following bilateral hip surgery, a physiologist that had an “own occupation” disability policy hired our firm to help him better understand the terms of his policies and see if he was eligible for benefits. While he was no longer able to perform the substantial and material duties of his specialty, this doctor did not want to sell or forego his practice. Instead, he planned to hire another doctor and simply monitor the progress and treatment plans of his patients. Additionally, he wanted to seek medical director positions with nursing homes and other healthcare facilities in order to stay active in the medical field. After gaining an understanding of this client’s duties, his medical specialty and his restrictions and limitations, we agreed to represent him during his application for disability benefits and throughout the evaluation process.
All documents and information in support of our client’s eligibility for disability benefits were provided to the insurer. We further advised the insurer that while this doctor could no longer perform the substantial and material duties of his own occupation, he would continue to work in a completely different and much more sedentary capacity. After much back and forth with the insurer, including in depth conversations about the subject disability contract and the law, they agreed that he was disabled under the terms of his disability policy. As such, this doctor continues to receive monthly disability benefits while working as a medical director for a number of facilities and keeping track of his patients. Because the insurer continues to seek information and proof of disability, this doctor still retains our firm to represent him in his ongoing claim for benefits.