The Importance of Having a Transition Plan:
Part II

Physicians and dentists with slowly progressive conditions face unique challenges and hurdles when it comes to filing a claim with their disability insurance company.  In the previous post in this series, we looked at a few things doctors should take into account when deciding what to do with their practice in the event they need to file a disability claim. Another important part of a transition plan is determining an appropriate work schedule, given your condition, symptoms and policy requirements.

Should I Keep Working?

This is another question that we are asked a lot and, again, the answer is, it depends. There are risks associated with continuing to practice, but you can also prejudice your chances of collecting benefits if you make changes to your work schedule or take on another job without taking the requirements of your particular policy into account.

The primary factor is, of course, whether it is safe for you to be treating patients. If it’s not safe to practice, you shouldn’t be practicing. But with slowly progressive conditions, this can be a difficult thing to assess. There are usually good days and bad days. There may be remedies (like stretching, or ice/heat) that initially help, but over time lose effectiveness. Or in certain situations (such as progressive neuropathy or an essential tremor) the changes may happen so slowly that it is hard to perceive the day-to-day progression.

In addition, your policy may have certain definitions or requirements that set certain parameters for filing a successful claim that you can run afoul of if you are not careful. Some of the most common mistakes we see include:

  • Reducing work hours. While working shorter hours may make symptoms more bearable, doing this for too long could prompt your insurance company to change your classification from “full-time” to “part-time.” This becomes problematic because it is more difficult to prove you are totally disabled from working part-time. For example, if you stop taking on-call shifts and file a claim several months later, the company may argue that your previous on-call hours should no longer be considered part of your occupational definition for purposes of your disability claim.
  • Reducing procedures. Similarly, changing the types of tasks you perform can also prompt insurers to maintain that you have changed the material and substantial duties of your job. For example, if you’re a dentist and you stop performing root canals, your insurer may argue that your occupation is “a dentist who doesn’t perform root canals.” Again, this makes it more difficult for you to establish total disability because the more difficult procedures/duties are removed from the equation.
  • Taking a side job. Cutting hours or lightening work load can lead to a significant loss of income, so doctors often turn to side jobs that don’t exacerbate their symptoms, such as teaching part time at a local dental or medical school, financial advising, consulting, or perhaps selling real estate. However, what many don’t realize is that newer disability insurance policies often have plural definitions of occupation that define your occupation as everything you are doing immediately prior to the onset of disability. Again, an insurer can use the (lighter) duties of a second job to argue that you can still work as say, a real estate agent, and are therefore not eligible for total disability benefits, even if you can no longer practice as a doctor.

These are just a few examples of occupational changes that can have a dramatic impact on the future success of a disability claim. How much of an impact depends on the particular language of your policy, and this is not intended to be an exhaustive list of all of the issues that can arise during the transition out of practice. The above examples are merely intended as examples of why it is important to have a transition plan and know what your policy(ies) say before filing a claim. Conversely, if you put off these important questions for too long, you can make it much more difficult (and, in some cases) impossible to collect total disability benefits.

If you are considering filing a claim, or wondering how a transition plan would work for you, an experienced disability insurance attorney can help you understand the terms of your policy and apply it to your particular situation.


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