Bartolic Law helped many Physicians get their long-term disability insurance paid, under both group policies offered through their employers, and under individual policies supplementing the group coverage. In one case, a client worked as an Anesthesiologist. After recovering from a cardiac event, the client never regained the stamina for full-time clinical practice. After the insurer terminated benefits due to recovering from the cardiac event, we were able to persuade the insurer that the residual reduced capacity and stamina not only physically rendered the client unable to work full-time, but also caused the client to make more mistakes, which would place patients at risk if the client kept working. In another case, our client was a clinical and academic Gastroenterologist and suffered from Cervical Radiculopathy. Despite surgical intervention, the client still had lasting limitations in mobility of the client’s upper extremities and neck, which made the client unable to perform various procedures that make up a large portion of clinical practice. We documented the medical limitations, and also used CPT billing codes to demonstrate the portion of the client’s work made up of the procedures the client could not perform, resulting in the claims being paid.
Did you work hard for many years to become a physician, only to develop a disability that prevents you from doing your job? It is critical for physicians to recognize when a medical condition impacts their ability to work, as continuing on when you shouldn’t can hurt your patients. But if you cannot work, what happens to the financial support you built for yourself and your family? Fortunately, many physicians have insurance policies in place that provide benefits should a disability arise and keep them from working. On the other hand – unfortunately – getting those benefits from your policy can be less than easy for most claimants.
Filing a claim for disability benefits is only the first step in what can be a long and frustrating process for many people. Then, the insurance company will likely request substantial documentation, possibly delay your claim, and might deny your claim for one of many common reasons. This can leave people stressed and at a loss of what to do – when you are already dealing with the loss of your career. This is why you should leave the claim process to a Chicago disability lawyer who can fight for the benefits you deserve.
Ferrin v. Aetna Life Ins. Co., 336 F. Supp. 3d 910 (N.D. Ill. Sept. 28, 2018) (holding insurance policy’s grant of discretionary authority is void under Texas law due to certificate being issued after effective date of regulation, and policy renewing after effective date, and holding Plaintiff was disabled from Any Reasonable Occupation where treating doctors certify she can sit at the occasional level, and insurer’s consultants opine Plaintiff can sit frequently, as weighing all evidence together would make capacity likely at low end of frequent range at best).
Sadowski v. Tuckpointers Local 52 Health & Welfare Trust, 281 F. Supp. 3d 710 (N.D. Ill. Dec. 20, 2017) (holding plan was arbitrary and capricious in denying medical benefits for removal of spinal cord stimulator following a fall down the stairs and infection where plan argued the expenses were caused by the same injury as the car accident necessitating implantation of the stimulator years earlier)
Tassone v. United of Omaha Life Ins. Co., 264 F. Supp. 3d 867 (N.D. Ill. Aug. 30, 2017) (awarding client long term disability benefits denied by United of Omaha despite insurer’s doctor opining there was no objective evidence of functional impairment)
Suson v. PNC Fin. Servs. Grp., Inc., No. 15-CV-10817, 2017 WL 3234809 (N.D. Ill. July 31, 2017) (holding Liberty Mutual’s denial of client’s long term disability benefits was arbitrary and capricious where Liberty Mutual disregarded client’s carpal tunnel syndrome and relied on a vocational opinion to which client never had an opportunity to address before litigation)
Physicians’ occupations have much in common, but also vary greatly based on the nature of the specialty and the distribution between clinical work and academic or teaching work. The specific procedures the Physician performs regularly are highly important in a disability claim. Physicians must also consider the risk to themselves and to others in working with permanent limitations. The law recognizes that when one is physically able to work, if doing so presents an unreasonable risk, the claimant can be legally disabled. This risk can be to yourself, or even to patients in many cases. Bartolic Law helps physicians and many other medical professionals obtain the benefits they need should a disability impact their careers. Never hesitate to contact us to learn more about how we can help.