Physicians are facing increasing opposition from disability insurance carriers regarding claims for “own occupation” disability policies. This scrutiny and opposition is a predictable reaction to the expensive claims, which typically have long payouts including COLA and life-time riders, and the fact that the degree of disability or physical impairment necessary to substantially impede a physician from practicing is fairly limited in some circumstances.

These are multi-million dollar claims from the insurance carriers’ perspective and life-changing events from the physician’s perspective. You should not simply submit your claim and see what happens. 

Physicians are frequently reluctant to pursue these disability claims. Many physicians, just like lawyers and other professionals, define themselves and their identity by their profession. They struggle to return to practice because that is who they are. Unfortunately, some physicians struggle through just long enough to prove that they are not disabled. When they can no longer take the pain or accept the medical malpractice risk produced by their impairment, whether physical or behavioral, they may no longer qualify for the disability payments they and their family will now need to support them for the rest of their lives.

I have represented many physicians in these situations. When any event impairs your ability of practice occurs, you should do the following:

1.         Get a complete copy of your policy and all the riders from your insurance agent or advisor;

2.         Consult an experienced lawyer; and

3.         Get independent medical opinions regarding your disability prior to submitting your claim and submit that claim with all the opinions and medical records prepared in the same manner that your lawyer would prepare your brief and malpractice defense in the professional liability case.