Should Women Pay More for Disability Insurance?
Massachusetts is currently considering a bill that would prohibit disability insurers from charging higher rates to women than to men. Even if a woman is the same age, has the same job, and has the same health history as a man, she pays on average 25% more for the same protection, according to Massachusetts State Representative Ruth Balser.
This bill would prohibit discrimination in premium costs or benefits based on sex in individual disability, accident, or sickness insurance policies. It would also bar disability insurers from making any distinction in insurance policies based on conditions unique to one’s sex, such as pregnancy.
The disability insurance companies, on the other hand, say that the difference is necessary, due to the fact that women account for 70-80% of long-term claims nationwide. While they do purchase more disability insurance policies than men (60% as compared to 40%), insurers argue that this isn’t enough to make up the difference in revenue. Insurers are in the business of making money, and paying out more in disability benefits than the amount of premiums coming in isn’t good for business.
According to the Affordable Care Act, health insurers can’t charge a woman more solely because she is a woman. Yet, Montana is the only state with a law requiring disability insurance to be gender neutral, and Massachusetts has a bill in the works. It remains to be seen whether Massachusetts will pass this bill, and other states will follow suit. With some of the major disability insurance carriers (such as Unum and Guardian/Berkshire) keeping corporate offices in Massachusetts, we doubt the bill will be passed without a fight.
What’s your opinion? Should women pay more in disability premiums than men with the same characteristics? Are the disability insurance companies’ arguments in favor of the disparity justified?
Essential Tremors (ET): Part 2
In Part 1 of this post, we looked at the risk factors, symptoms, and treatment options associated with ET. In Part 2, we will discuss how having an essential tremor could potentially affect your total disability claim.
How do I file for total disability when I have ET?
For those with an “Own Occupation” policy, which means you are considered totally disabled if you can no longer work in your own profession, having ET would certainly qualify you for disability benefits if you are a medical professional.
Many physicians think that they can simply decrease the types of procedures they perform or amount of time spent at working as their ET becomes more disabling, but this is the wrong move to make. Changing your work responsibilities can alter your “occupation” under the terms of your disability policy. For example, if you forego performing medical procedures and merely manage your practice, the insurance company may claim that your occupation has changed from a physician to an office manager, and attempt to decrease or deny your disability benefits. Similarly, if you start to work part-time instead of full-time, and then file for disability, an insurance company will likely classify you as a part-time worker, and thus only give you part-time benefits.
Other physicians may decide to continue working in spite of their ET. This is also a mistake. Trying to work when you have ET places your patients at risk. If a patient did get injured and filed suit, his or her attorney would almost certainly assert that you should not have been working with patients and that you knew your ET could harm the patient.
The correct way to deal with insurance companies and your condition is to stop working as soon as it impinges on your ability to perform your occupation and file for disability insurance. Since, in many cases, the onset of ET is gradual, it is important to discuss you symptoms with your doctor so he or she can determine when your condition will progress to the point that it affects your work.
Conclusion
ET is a condition that can have an effect on actions as small as carrying a water glass or tying your shoes. It can also affect your occupation and the financial security that comes from having total disability insurance. We encourage you to speak with your doctor if you think you may be at risk for or have ET, and to contact a disability insurance attorney to help with the claims process if you are planning on filing for disability benefits.
Essential Tremors (ET): Part 1
We’ve done a profile on how Parkinson’s disease can affect physicians and dentists, but did you know that essential tremors are eight times more common than Parkinson’s disease? A hand tremor is one of the last things a physician or dentist wants. Not only can it affect daily life, but working with patients safely becomes increasingly difficult.
In this post, we will list some of the risk factors and common symptoms associated with essential tremors and take a look at what can be done to perhaps alleviate symptoms.
What is an essential tremor and what are the symptoms?
An essential tremor (ET) is a neurological disorder that causes rhythmic shaking of part of the body—most often the hands, head, or voice.
The primary symptoms of ET are involuntary shaking, voice fluctuations, nodding head, balance problems, and tremors that get worse during periods of emotional stress, fatigue, caffeine use, and/or purposeful movement. ET is a progressive disorder than can become worse over time.
What is the difference between Parkinson’s and ET?
Many people believe that Parkinson’s and ET are the same thing. However, there are some subtle differences between the two conditions, including:
- Timing: ET usually occurs when you are in motion, while Parkinson’s is most noticeable when you are at rest.
- Related Conditions: ET generally does not cause other health problems, but Parkinson’s has been connected to poor posture, a shuffling gait, and slow movement.
- Parts of Body Affected: ET is most common in the hands, head, and voice. Parkinson’s most often starts in your hands and may also affect the legs and chin.
What are the causes and how do you know if you are at risk?
ET appears to be a genetic disorder, because approximately 50% of people with ET have a particular genetic mutation. However, scientists are not sure what causes ET in people who do not have the genetic mutation. Researchers have found that changes in specific areas of the brain may contribute to development of the condition, but such studies are inconclusive.
Because the other causes of ET are unknown, the primary way to determine whether you have a high risk of developing essential tremors is to check your family history. Due to the fact that the mutation is an autosomal dominant disorder, if one of your parents has ET, you have a 50% chance of developing the disorder. Another risk factor is age—people over 40 are more likely to have an ET.
Is there a cure for ET or a way to prevent it?
Unfortunately, is currently not a cure for ET. However, now that scientists have found a genetic link, further research could potentially discover ways to prevent ET.
How can I alleviate my symptoms?
Since emotional stress is one of the things that can aggravate ET, look for ways to relieve your stress. Other methods of alleviating ET include decreasing your coffee and caffeine intake and making sure that you get an adequate amount of sleep each night. Certain medications may also can help with ET, although it is important to speak with your doctor before starting any sort of treatment. Finally, surgery may be an option in some cases, although surgery certainly is not without its risks. Surgery for ET generally involves the implantation of a DBS, or a Deep Brain Stimulator. The DBS is a small device that delivers targeted electrical stimulation to the brain in an effort to reduce the frequency of tremors.
In addition to the foregoing methods of alleviating ET symptoms, there are other things that you can do to make living with ET easier, such as using a travel mug or straw for drinks, using heavier utensils for eating, wearing clothes that don’t have difficult buttons or laces, and saving your most difficult tasks for days when your tremor is least pronounced.
Disability Insurance Profiles: Principal Life
We are expanding our list of insurance company profiles that specifically market to dentists and doctors to include Principal Life.
See our other profiles of Great-West, MassMutual, MetLife, Northwestern Mutual, Guardian, Hartford, and Standard.
Principal Life (also known as “Principal Financial Group”) was founded in 1879. Initially, Principal Life operated primarily as an insurance company. Principal Life is now a member of the Fortune 500, and offers several additional services, such as retirement and asset management. Principal has most recently realized a growth in net income from $1.112 billion in June of 2014 to $1.290 billion in June of 2015.
Company: Principal Financial Group or The Principal.
Location: Des Moines, Iowa.
Associated Entities: Principal Financial Services, Inc.; Principal Life Insurance Company; Principal Real Estate Investors, LLC; Spectrum Asset Management, Inc.; Post Advisory Group, LLC; Columbus Circle Investors; Edge Management, Inc.; Morley Financial Services Inc.; Finisterre Capital, LLP.
Assets: $530.3 billion.
Notable Policy Features:
Principal Life sells polices that define “disability” as “own occupation”, which means that you are considered totally disabled if you are unable to perform the duties of your occupation. While this may seem like the right policy for a medical professional, you should be aware of a couple caveats. Coverage under a Principal Life policy is, in part, based upon a key definition that is usually referred to as your “occupation period.” Essentially, your “occupation period” is the time frame during which the “own occupation” definition of totally disabled applied. Once the “occupation period” has expired, Principal Life will only pay you benefits if you are unable to work in any occupation that you are reasonably suited to work in, based on your education, training, and experience.
The length of your “occupation period” can range from a base of 2 years after your disability to a period of 5 years, until age 65, until age 67, or until age 70, depending on your “occupation class.” Oftentimes, the policy provisions regarding “occupation periods” can be convoluted and difficult to decipher. If you unsure about the length of your “occupation period” under the terms of the policy, an experienced disability insurance attorney can help you understand the applicable policy language.
Claims Management Approach:
In comparison with other insurance companies, Principal Life generally conducts more in-person field interviews with claimants. Principal Life will not only conduct a field interview when you initially file your claim, but will also likely conduct several additional follow up interviews throughout the claims process.
Most insurance companies require you to fill out generic questionnaires that ask for information about the nature of your disability, among other things. Because Principal Life handles a lot of disability claims by physicians, it has created a particular “Medical Professional Occupation and Financial Questionnaire” that is more comprehensive than a generic questionnaire, and is specifically tailored towards collecting information from medical professionals. The questionnaire is quite extensive, and asks about a wide variety of information, from your ownership interest in your practice, to whether your practice participates in a health care network, to the credentials of the medical professional owners and associate professionals you work with, to whether you receive any reimbursements from prescriptions. If you are unsure about the content or scope of any questionnaire you receive, an experienced disability insurance attorney can help answer any questions you may have.
More than a Deep Breath: Stress in Doctors, and How to Handle It
We’ve talked about how medical professionals are more susceptible to mental health issues, so it shouldn’t be shocking that doctors and dentists are also more stressed out than the general populace. In fact, a study has shown threshold levels of stress that stay constant at about 28%, which is quite a bit higher than the general working population’s level of 18%. This shouldn’t be surprising, even if you disregard all the data associated with medical professionals and mental health; physicians are put in high risk situations every day.
While many physicians may assert that they have been dealing with stress their whole life and thus know how to handle it, it is important to be sure that you know how to recognize the signs of stress and how to properly decrease stress levels. Simply working through it or ignoring your stress may not get rid of it, and could even lead to other complications. For instance, stress increases the risk of conditions such as heart disease, Alzheimer’s, diabetes, depression, and obesity.
We created a list of some of the signs of stress, as well as a list of things that you can do to make your life a little less stressful both during work and outside of the office.
Signs of Stress
Some of these signs are very noticeable, and you could probably identify them in a second, but others are more subtle. If you suffer some of these symptoms on a daily basis, you may think that they are just part of your daily life, but it is important to note that many of these symptoms can be prevented.
Continue reading “More than a Deep Breath: Stress in Doctors, and How to Handle It”
Unum Denies Its Own Employee Disability Benefits
In previous posts, we have discussed how Unum is notorious for wrongfully denying disability claims. Recently, Unum refused to pay its own employee disability benefits.[1]
Apparently, the Unum employee suffered from carpal tunnel—due to all the typing that her job required—and also suffered a back injury in her home office. Naturally, the Unum employee saw a hand specialist for the carpal tunnel, and a back specialist for the back injury. After the Unum employee had surgery on her hand to treat the carpal tunnel, the Unum employee’s primary care physician placed her on work restrictions. However, the primary care physician did not send the work restrictions to Unum because she thought that the other doctors had already documented the restrictions.
Unfortunately for the Unum employee, the other doctors had not forwarded the restrictions to Unum. Instead of reaching out to the Unum employee’s doctors to see if the disability claim was legitimate, Unum simply denied the long term disability claim due to a lack of documentation. At that point, the primary care physician came forward and expressly told Unum that she supported the restrictions, but Unum still refused to pay any benefits.
[1] See http://www.lawyersandsettlements.com/articles/first_unum/interview-unum-lawsuit-insurance-29-20883.html#.VfhBwxFVikp.
Better Treatment for Back Pain?
Chronic back pain is one of the issues that countless doctors and dentists face every day. Many of our clients have suffered from pain that doesn’t allow for effective practice, and thus have had to deal with the disability insurance claims process. According to the American Society of Anesthesiologists, there is a new treatment that could help alleviate some forms of back pain in certain patients. We’re going to be taking a look at the study they published regarding spinal cord stimulation (SCS), as well as answer some questions about SCS for those who don’t know about it.
The Study
This study compared the effectiveness of high frequency to traditional SCS therapy for back and leg pain. Researchers treated 90 patients with high frequency therapy while 81 received the traditional SCS. After three months, 85% of back pain patients, and 83% of leg pain patients reported a 50% or greater reduction in pain, while only 44% of back pain patients and 56% of leg pain patients in the traditional SCS group experienced a 50% reduction in pain.
Also, more patients (55% to 32%) in the high frequency group stated that they were “very satisfied” with their pain relief. Patients of the high frequency treatment didn’t experience any paresthesia, which is commonly associated with SCS.
SCS Questions
- What is SCS?
SCS is therapy that delivers low-level electrical signals to the spinal cord or to specific nerves in order to block pain signals from reaching the brain.
- How does SCS work?
A device is implanted in the back near the spinal cord through a needle and generator is placed through a small incision in the upper buttock. The patient is able to adjust the intensity of the signals or turn the current on or off.
- How does the SCS stay charged?
It depends on the device: some SCS systems have a pulse generator, which is like a battery, some have a rechargeable pulse generator system that can be charged through the skin, and others do not require recharging but last a shorter time before they need to be replaced.
- How much higher is the high frequency SCS?
The high frequency SCS pulses at 10,000 Hz, while traditional SCS has a frequency between 40 and 60 Hz.
- What is paresthesia?
Paresthesia is a sensation such as tingling or buzzing that is commonly associated with SCS. It is thought to potentially mask a patient’s perception of pain, and is often distracting or uncomfortable, thus limiting the effectiveness or desirability of SCS treatment.
- What are the risks of SCS?
SCS doesn’t address the source of the pain; it merely interrupts the pain signals sent to the brain from your body. If you have pain that stems from a correctable anatomical problem, it is probably best to look for treatment that will address this problem first. SCS also involves an implant and surgery, which naturally comes with risks and potential complications.
These include:
- Allergic reactions to the implanted material
- Bleeding
- Infection
- Weakness, numbing, clumsiness, paralysis
- Fluid lead from the spinal cord
- Migration of the electrode
- What is this treatment called?
The treatment is being called HF10™.
Conclusion
This study is just the first step in a new treatment that could bring relief to people suffering from chronic pain. We encourage you to speak with your doctor before starting any sort of treatment.
“Working Through Pain:
How Chronic Conditions Affect Dentists”
Dentists are particularly at risk for disability due to the strenuous nature of their job. Dentists are also some of the most likely to keep working through the pain–even if they shouldn’t be. Our new article in Dentaltown Magazine explores how working through chronic pain can affect dentists in their personal and professional lives. Read the full article at Dentaltown today.
“Working Through Pain: How Chronic Conditions Affect Dentists”
Are Longer Hours Hindering Your Ability to Work?
Long hours at work are typical of doctors: there is no break in people getting sick or having physical issues. But what does working long hours do physically and mentally to doctors, and how can this affect your practice? The term “overwork” refers to the increasing risk that a worker will experience symptoms of fatigue and work stress, which can undermine productivity rates. We’re going to be taking a look at some of the statistics involved with professionals working long hours and then discuss how this can not only hinder productivity in your practice, but can also affect your body and, in some cases, how soon you need to file a disability insurance claim.
Longer Hours
There numbers regarding the average work week for Americans, especially professionals such as doctors, show that most people expect to work extended hours. This is associated with the trend of “presenteeism” among doctors and dentists, which we have spent some time dissecting. In fact, many professionals now view the traditional 40-hour work week as a “part-time” job, and state that working those hours show laziness or a lack of desire to get ahead.
- In 2006, American families worked an average of 11 hours more per week than they did in 1979.
- 85.8% of males and 66.5% of women are working 40 or more hours per week. ((See American Average Work Hours at 20Something Finance))
- 37.9% of professional men worked over 50 hours a week between 2006 and 2008, which is an increase from 34%.
- The number of professional women working over 50 hours increased even more drastically, from 6.1% to 14.4% in the same time period. ((See Top-Level Professionals View 40-Hour Work Week as Part-Time at The Huffington Post))
- 52% of top income earners in America report working “extreme jobs,” which are those that require more than 60 hours a week. ((See Success Comes at a Steeper Price at ABC News))
Effects of Overwork ((See The Effects of Working Time on Productivity and Firm Performance))
Studies have shown that working longer hours leads to a decrease in productivity per hour. Any doctor that has worked more than 10 hours a day, as they often do, can attest that the 9th hour is much more difficult to get through than the first. The evidence shows that longer working hours have a negative effect on worker health due to fatigue and work stress, all of which further decrease labor productivity.
Workers with long hours are at a greater risk of health issues. For instance, those who perform repetitive tasks have an even greater chance of cumulative trauma disorder, such as carpal tunnel syndrome. This shouldn’t be shocking to medical professionals, as many of the disabilities that they suffer come from repetitive use injuries. An interesting way to think of the way your hours affect your work is to think of your body using a minimum amount of energy for posture and immunity, which has a great effect on back and neck pain. If you draw too much on this energy for work, your posture and immunity will suffer.
As another example, working extended hours can have a negative effect on mental health. We have also discussed how medical professionals are more susceptible to mental illness. Studies have shown that working long hours leads to increased stress, which can contribute to the already stressful situations doctors face every day.
What Does This Mean for You?
One positive finding regarding hours worked and productivity is that those who have the flexibility to schedule their own hours are not only happier but more productive. Even more striking is the fact that even if workers had to put in overtime, if they chose this overtime themselves instead of being asked to do it by a supervisor, they were much more productive and less fatigued.
This is certainly good news for those medical professionals that own their own business and are able to schedule their time as they see fit. However, doctors such as residents or those working within another professional’s practice may feel pressured to take on more hours, and are also constrained by other doctors’ schedules. For these reasons, it’s important for the medical and dental community as a whole to take a better approach regarding long hours. While we certainly don’t presume to know what is most appropriate in terms of streamlining care and administration, it certainly seems logical that doctors be encouraged to work fewer hours or have more freedom in scheduling the hours that they are going to work.
Let us know what you think about working long hours and whether you have schedule flexibility in the comments!
Could Your Tech Be Hurting You? : Skype Doctors
The third and final post of our series on insurance claims technology focuses on the recent development of digital healthcare. Our previous topics included Facebook and insurance company apps, and we analyzed how they can have a greater effect on your claim than you would think. You are now able to obtain a diagnosis and medication prescriptions via Skype. Just like the Hartford app, this is looking to streamline administrative processes and save people time. However, it is controversial in that many doctors believe that there are cases in which a physical examination is necessary, and webcam quality may not be enough to correctly diagnose a patient.
Diagnoses via Skype
It is touted as being quick and efficient; users need only to type in their symptoms and payment information and they will be connected with a doctor who can then call in a prescription as they see fit. While this is very convenient for people who are too busy or in too much pain to travel to and wait in a doctor’s office, it could also lead to a wrong diagnosis, which would almost assuredly use more time and money.
While there haven’t been any studies on how effective this form of treatment is, we advise disability insurance claimants to exercise caution when using these Skype calls. Because this technology is so new, there is little information on how disability insurance would approach Skype consultations in conjunction with a disability insurance claim. An insurance company could potentially say that this information is unreliable, and use the alleged lack of reliable medical evidence to deny your claim. If you are facing a disability insurance claim, speak with an attorney experienced in the area before you use a Skype consultation as evidence of your condition.
Conclusion
While it is certainly helpful that many things are now available at our fingertips through the development of new technologies, it is important to keep in mind that giving more information than necessary to insurance companies may hurt your claim. Most people who file disability claims have nothing to hide, but it is the insurer’s job to make money, and paying every claim isn’t a good way to do this.
Did we miss any new technology? Let us know in the comments!
Could Your Tech Be Hurting You? : Apps
Welcome to part two of our three part series dealing with digital media and the ways that it can affect the disability insurance claims process. We have already taken a look at Facebook and how your profile can affect your claim. This week, we are discussing insurance company mobile apps. We’re taking a look at this potentially harmful form of technology, and how insurance companies could use it to deny you benefits.
Claims Apps
Since everything from food to transportation has an app, insurance companies are also looking to take advantage of this growing technology. This can be helpful to disability insurers seeking to reduce costs and eliminate human error in claims administration, as apps can streamline processes that would normally require at least a phone conversation. The Hartford, for instance, created a mobile app that allows you to manage your claims wherever you have a smartphone, which in most people’s cases, is everywhere. Unum Group has also joined the technology rush by developing an app of its own.
The Hartford’s app claims that you can start a short-term disability claim, update your personal data, and check the status of a claim, including your payment information. It also provides you with definitions and benefits details meant to help you navigate through the claims process. The Unum app comes with features that allow you to upload images of documents and authorization forms that are needed to evaluate claims and you can also get in direct contact with a service representative. While it seems that these apps could be extremely handy, we would caution you to use care in filling out any of the information, just as you would completing paperwork on a claim.
An insurance company could potentially use information that is carelessly filled out, or mistakenly filled out incorrectly to deny a claim. Further, mobile apps, while convenient, can lead to an over share of information. For example, it’s not hard to imagine an insurer creating a mobile app that includes location tracking—a common feature of many apps—to aid in surveillance. We would advise you to carefully consider whether to use an insurance company app, be very vigilant about what information you put in the app, or to at least consult with a disability insurance lawyer before using it.
Could Your Tech Be Hurting You?: Facebook
It seems that in recent years, everything is becoming digital. You can do any number of things from your smartphone or computer that had to be accomplished with face time, or personal interactions, in the past. Everything from buying groceries to dating can be done online, and the disability insurance claims process is no exception. This week, we’re starting a series that takes a look at three ways that the modern age has changed how you and your disability insurance company can approach your claims.
First, we’re going to start with a form of social media that almost everyone has: Facebook. It may be a great way to share photos and keep in touch with old friends, but Facebook could be hurting your insurance claim in a way that perhaps you weren’t aware of.
We have written at length on ways that insurance companies can use surveillance to often unfairly deny people their benefits. From stakeouts to tailing to GPS tracking, insurance companies have been known to do some pretty unsavory things in the name of saving money. With the rise of different forms of social media, this gives insurance companies another tool to monitor you and your activities in the hope that you do something that would allow them to deny your claim.
We have also discussed how posting pictures or statuses on Facebook can lead to insurance companies denying claims because it appears that you are leading an active lifestyle, but you probably didn’t know that even a deactivated account can be brought up in litigation. In the case of a Mr. Brannon Crowe, he was ordered to bring up 4,000 pages of his entire Facebook page–one that was deactivated four days after the order.
While Mr. Crowe may not have been trying to hide anything, and most people aren’t, the message is still important. Not only is it crucial to keep your social media accounts free from any information that an insurance company can misconstrue to claim you aren’t disabled, but if you are really concerned about surveillance, deactivating won’t do the trick. Since deleting your Facebook results in a loss of all the networks and relationships that you have built over the years, we certainly aren’t saying that you should delete it and swear off of social media. We simply advise that you are careful about what you post, and if you have any questions about what this could be, feel free to comment or email us!
Unum is Making Some Changes, But Are They Good For Your Plan?
In previous posts, we have discussed how courts and juries have reprimanded Unum and its various subsidiaries for wrongfully denying disability claims. Now, Unum is once again making the headlines—this time for making significant changes to its leadership at the highest levels of the company.
What’s changing?
Essentially, Unum is undertaking a widespread overhaul of its upper management. Marco Forato is now the senior vice president for global growth strategy, Steve Mitchell is the new chief financial officer, and Steve Zabel is the new president of the U.S. closed block operations. Additionally, Vicki Gordan has been promoted to senior vice president and chief internal auditor, and Matt Royal is now the chief risk officer for Unum.
While any change of leadership can have substantial ramifications, those insured by Unum should take particular note that Unum has appointed a new “president of the U.S. closed block operations.” “Closed block” refers to Unum’s discontinued product lines, which, according to Unum’s 2014 Annual Report, include long-term care and older individual disability policies. If you are a physician or dentist with a Unum policy, your policy is probably part of Unum’s “closed block” operations.
Unum’s new president of “closed block” operations will likely face a challenging task because any losses suffered from paying out Unum’s old disability policies cannot be offset by new business. Additionally, such “closed block” operations are a relatively new phenomenon in the insurance industry, so there is a very small reserve of historical data for Unum to draw upon.
What does this mean?
Generally speaking, a company does not make such extensive changes without expecting results. Consequently, it is likely that several, if not all, of Unum’s newly appointed leaders will be under substantial pressure to perform. Because fresh leaders often want to leave their own mark on their industry, insureds should pay close attention to any new changes in policy announced by Unum during this transitional period.
More specifically, insureds with older individual disability policies with Unum should be aware that Unum will likely be looking for new, creative ways to deny their claims. If you have such a policy and you feel that Unum has arbitrarily changed your policy’s terms and/or wrongfully denied your disability claim, you should consult with an experienced disability insurance attorney to ensure that Unum’s leadership is not improperly exceeding the scope of their newly acquired authority.
Carpal Tunnel Syndrome and You: The Issue, and 10 Things You Can Do to Prevent It
Carpal Tunnel Syndrome consists of pain, weakness, numbness, or tingling in the fingers or hand caused by pressure on the median nerve in your wrist. The median nerve controls the feeling and movement in the thumb and all of the fingers except the pinky. For a dentist, this syndrome can be quite debilitating, as this profession requires the full use of both hands in order to examine and perform surgery on patients. Today, we’re going to take a closer look at the symptoms and causes of Carpal Tunnel Syndrome, as well as 10 steps you can take to prevent it from happening.
Symptoms and Causes
While there are multiple symptoms of Carpal Tunnel Syndrome, there are a few that are rather noteworthy:
- Sleep interruption from numb hands and tingling fingers: you may think that the numbness and tingling is simply due to sleeping on your hand in an awkward position, but there may be more to it than that.
- Loss of fine motor skills/weakness in hands.
- Pain radiating up the arm: it may just radiate up the forearm, or it could potentially also make your shoulder and neck ache.
- Hand pain or wrist pain: this is perhaps the most straightforward symptom of the syndrome.
There seems to be no one cause of Carpal Tunnel Syndrome, but there are several risk factors, including:
- Anatomic factors: wrist fractures or dislocations can lead to extra pressure on the median nerve.
- Sex: the syndrome is more common in women.
- Inflammatory conditions: illnesses such as rheumatoid arthritis.
- Workplace: working with vibrating tools, holding static positions for a long time, repetitive motions with the wrist. These workplace factors put dentists at a higher risk for contracting Carpal Tunnel Syndrome than the general population.
Continue reading “Carpal Tunnel Syndrome and You: The Issue, and 10 Things You Can Do to Prevent It”
Do You Need Disability Insurance for More than Just Yourself?
We spend a lot of time talking about disability insurance claims and mostly focus on the big one: personal disability insurance. However, there are three other types of insurance that you may not have been aware of, and could be potentially helpful to you and your practice. Today, we’ll be taking a look at key-person disability insurance, buyout disability insurance, disability insurance for overhead, and, of course, personal disability insurance.
Personal Disability Insurance
Essentially, disability insurance is insurance that you buy for yourself in the event that you become disabled while working. If you work in a profession where disability is a possibility, it is important to have personal disability insurance for the sake of your future. For instance, dentists are at higher risk for disability due to repetitive movements and static positions, so it is crucial for them to have a disability policy.
Further, we recommend that you purchase an individual disability insurance policy for yourself, and not through an employer-sponsored program. This makes sure that the policy is not covered by ERISA in the event that you do have to file a disability claim.
Key-Person Disability Insurance
Key-person disability insurance is a type of coverage for those that own their own business or practice. This form of insurance covers an employee that is “key” to your business: someone who would be impossible to replace due to their skill, customer base, knowledge or burden of responsibility. If this person was to become disabled, and you had key-person disability insurance, the business would receive disability income checks. These checks could be used to cover the financial loss of the missing employee, or it could pay for a temporary worker while the insured person recovers from the disability.
There are several things to consider when determining if you should buy key-person disability insurance. These include the contingencies for the company if a key employee is disabled, the time to find and train a suitable replacement, the amount of revenue directly attributable to the key person, whether or not the key person’s disability will result in the loss of clients, and whether your company is willing to self-insure.
Unlike personal disability insurance policies, key-person policies are limited in their features and options. Often, they are custom designed for the company so that they meet specific needs, and are also often very short term, lasting between 12–24 months. This is because it is usually assumed that you could find and train a replacement in that time span.
Continue reading “Do You Need Disability Insurance for More than Just Yourself?”
Arthritis and Its Many Forms: How It Affects Dental Professionals
The number one cause of disability in America is arthritis, which afflicts over 50 million people. With a U.S. population of 320 million this means that 1 person in every 6 has arthritis. These large numbers could be due to the fact that there are over 100 different types of arthritis ranging from lupus to gout. In this post, we will look to focus on the three most prevalent types of arthritis: osteoarthritis, rheumatoid arthritis and psoriatic arthritis. We will also discuss how they can affect your practice as a dentist, and how to approach a disability insurance claim for arthritis.
The Basics: Symptoms, Causes & Treatment
Osteoarthritis (OA) is the arthritis that arises simply from the overuse of joints, and for this reason it is known as “wear and tear” arthritis. Symptoms include pain, swelling and stiffness in the joints after either overuse or long periods of inactivity. It is most commonly developed as people naturally age and their bodies reflect that age, but can also be found in professions with repetitive movements, such as dentistry.
Since OA is due to aging or the effects of repetitive motion, OA is often progressive. It is the most common form of arthritis, and treatment can range from added exercise and weight loss (where the main cause of the OA is obesity), to taking various pain relievers, and even surgery.
Rheumatoid arthritis (RA), on the other hand, is an autoimmune disease, and is three times more common in women than it is in men. The body’s immune system mistakenly attacks joints, which leads to inflammation that causes further damage. While the symptoms are similar to OA in that there is joint pain and swelling, rheumatoid arthritis also can bring about fevers, fatigue, and weight loss. The joint pain you may be experiencing is often symmetrical, meaning both sides of the body are affected, in RA.
Unfortunately, the causes of RA aren’t fully understood. Symptoms can start and stop, occasionally going into remission, but RA is usually progressive. Risk factors for RA include family history of the disease, smoking, periodontal disease, and microbes in the bowels. There is no cure for RA, and it is treated somewhat similarly to OA in that pain medication, increased exercise, and surgery can be used to try to alleviate symptoms.
Continue reading “Arthritis and Its Many Forms: How It Affects Dental Professionals”
Wearable Fitness Trackers and Disability Insurance Litigation: How Your Fitbit Could Help or Hurt Your Claim
Recently, courts have been exploring the use of data from wearable fitness trackers in litigation. Devices like the FitBit, Jawbone UP, and Nike Fuelband have the capability to track all kinds of fitness-related data, such as steps taken, heart rate, temperature, calories burned, and sleep patterns. In cases where someone’s physical abilities are at issue, as is often the case with disability insurance claims, this data can be valuable. But who is this data most valuable to–the claimant or the insurance company? And is that value outweighed by a claimant’s right to privacy? These are questions yet to be fully addressed.
Benefits and Drawbacks. For claimants, data from a wearable fitness tracker could be a great way to show how a disability has caused a cessation or downward trend in activity. Providing the data to an insurance company may give a better picture, over a longer period of time, than any single doctor’s visit or Independent Medical Examination.
On the other hand, providing wearable fitness tracker data to an insurance company could hurt a claim in several ways. First, if your disability isn’t the type that would prevent you from walking (such as a hand injury, vision problems, orthopedic injuries where movement is part of physical therapy, etc.), step counts could be irrelevant. Nevertheless, data showing a high step count can give an insurance claims adjuster or a jury the erroneous impression that you are very physically active and thus not “disabled.”
Second, for claimants that haven’t accurately described their limitations to the insurance company, the tracker’s data can be presented as objective evidence that the claimants weren’t telling the truth. For instance, if a claimant wrote on a claim form that he “never” walks for more than 10 minutes at a time, then he has a very unusual day where he had to walk for 30 minutes, the insurance company could use the fitness tracker data to argue that the claimant is a liar. (In such a scenario, the claimant should have told the insurer that he “rarely” walks more than 10 minutes, or that he tries to avoid doing so, as opposed to saying he “never” does).
Third, inaccurate data could lead the insurer to make inaccurate conclusions. Wearable fitness trackers aren’t perfect. Step trackers tend to log movements other than walking as steps, such as when the wearer raises her arms up and down. Heart rate monitors will track increases in heart rate that are the result of mental or emotional stress in the exact same way they track increases caused by physical exertion. There is also the possibility of human error that affects the accuracy of the data. For example, if you forget to turn your device into “sleep” mode, it can’t track how restless your sleep is.
When Data Can Be Required. An insured may or may not want to provide fitness tracking data to an insurance company voluntarily, but if the insurance company requests it, does the claimant have to comply? The answer is less than clear.
In the claim context (when no litigation has ensued), the insurance company can only impose requirements covered in the policy. Of course, policies don’t explicitly state that a claimant has to provide fitness tracker data–at least not yet. However, an insurance company could argue that policy clauses requiring you to “cooperate” with the claims investigation or provide “proof of loss satisfactory to us” include a requirement to produce this type of data. In those instances, it’s best to have an attorney evaluate the request to see if it is, in fact, required under the policy.
If a lawsuit has been filed, the insurance company may have more leeway when it comes to requesting wearable fitness tracker data. While it is doubtful that an insurer could force a claimant to wear a tracker if he or she isn’t already, it’s easy to imagine a case where an insurer requests existing data from a device that a claimant already uses.
In federal courts, where most disability insurance cases are litigated, the insurance company can ask for any information that is relevant, or reasonably calculated to lead to the discovery of information that is relevant, to the claims or defenses in the case. The only exceptions are for things like privileged information (such as communications with your attorney) or requests that cause undue annoyance, embarrassment, oppression, or burden.
For data stored online, insurers could subpoena the data directly from the device manufacturer. Fortunately, some fitness tracker manufacturers have already publicly stated that they will resist such subpoenas to the extent possible. Insurance company lawyers are more likely to request that data from the claimant directly, in which case it becomes very important for the claimant’s attorney to evaluate whether that request is allowed under court rules.
What Is A Discretionary Clause?
Discretionary clauses grant your insurance company substantial discretionary authority to interpret your disability insurance policy and determine your eligibility for disability benefits. If your disability policy contains a discretionary clause and your insurance company denies your claim, courts will generally be reluctant to overturn the denial.
Here is an example of a discretionary clause taken from a Unum policy:
DISCRETIONARY ACTS
The Plan, acting through the Plan Administrator, delegates to Unum and its affiliate Unum Group discretionary authority to make benefit determinations under the Plan. Unum and Unum Group may act directly or through their employees and agents or further delegate their authority through contracts, letters or other documentation or procedures to other affiliates, persons or entities. Benefit determinations include determining eligibility for benefits and the amount of any benefits, resolving factual disputes, and interpreting and enforcing the provisions of the Plan. All benefit determinations must be reasonable and based on the terms of the Plan and the facts and circumstances of each claim.
It is easy to see why discretionary clauses are “highly prized” by disability insurance companies.[1] Such clauses not only grant your insurance company the authority to interpret the provisions of your disability policy, but also the authority to resolve factual disputes. The practical consequences of this are obvious: any close calls regarding ambiguous policy language or the seriousness of your disability will be resolved in the insurance company’s favor.
Discretionary clauses also make overturning a denial of disability benefits much more difficult. If your disability insurance policy has a discretionary clause, the court can generally only overturn your denial if you prove that the denial was an “abuse of discretion” because it was “illogical, implausible, or without support in . . . the record.”[2] In contrast, if your disability policy does not contain a discretionary clause, the court generally conducts a “de novo,” or independent, review of your claim.[3] In some cases involving discretionary clauses, courts that would normally be willing to overturn a denial under de novo review have been compelled to uphold the denial under the more exacting abuse of discretion standard.[4]
Not surprisingly, because the “abuse of discretion” is a high legal standard, the inclusion of discretionary clauses in disability policies dramatically reduces policyholders’ chances of successfully challenging a denial of benefits. A 2004 study found that only 28% of lawsuits to overturn denials of benefits were successful if the policy included a discretionary clause.[5] In contrast, policyholders won 68% of similar cases involving policies that did not have discretionary clauses.[6]
Insurance companies’ abuse of discretionary clauses has led several states to outlaw them.[7] You should avoid disability policies which include discretionary clauses. If you already have a disability policy which includes one, talk to your insurance agent about finding a new policy.
[1] See Rush Prudential HMO, Inc. v. Moran, 536 U.S. 355, 384 (2002).
[2] Saloma v. Honda Long Term Disability Plan, 642 F.3d 666, 667 (9th Cir. 2011).
[3] Id. at 673.
[4] See, e.g., Curtis v. Kansas City Life Ins. Co., 2011 WL 901992 (W.D. Ky. 2011).
[5] Brent Brehm and Corinne Chandler, California’s Ban on Discretionary Clauses in Disability and Life Insurance Policies, Advocate: Journal of Consumer Attorneys Associations for Southern California, June 2013.
[6] Id.
[7]The states that have outlawed discretionary clauses are: California, Colorado, Hawaii, Illinois, Indiana, Kentucky, Maryland, Maine, Michigan, Montana, New Hampshire, New Jersey, New York, Oregon, South Dakota, Texas, Utah, Vermont, and Wyoming. See American Health Insurance Plan’s (AHIP) “Limitations on the Use of Discretionary Clauses: Summary of State Laws,” available at www.ahip.org.
Disability Insurer Profiles: Great-West
Great-West Life & Annuity Insurance Company (“Great-West”) is the final disability insurance provider we will look at in our series profiling insurance companies that specifically market to physicians and dentists.
See our profiles of MassMutual, MetLife, Northwestern Mutual, Guardian, Hartford, and Standard.
Great-West, which also goes by the registered mark of “Great-West Financial,” was incorporated in 1907, and traces its roots to a Canadian parent company that was incorporated in 1891. Due to the nature of the economy and other factors, many insurance companies have suffered substantial losses in the past few years, and Great-West is no exception. Great-West’s net income recently dropped from 238.1 million in 2012 to 128.7 million in 2013. Consequently, Great-West may be looking to substantially increase its profits by, for example, denying high paying disability claims.
Company: Great-West Life & Annuity Insurance Company.
Location: Greenwood Village, Colorado.
Associated Entities: Great-West Lifeco Inc.; Great-West Lifeco U.S. Inc.; Great-West Life Assurance Company; Great-West Life & Annuity Insurance Company of New York; Great-West Capital Management, LLC; Great-West Funds, Inc.; GWFS Equities, Inc.
Assets: $55.3 billion in 2013.
Notable Policy Features: Great-West is the insurance company that provides group disability insurance for the American Dental Association (ADA), so if you have a Great-West policy, your claim will probably be governed by the terms of the ADA’s group disability policy.
Great-West frequently sends out notices of updates and changes to the underlying contract between the ADA and Great-West, so there is a chance that you may end up with insurance coverage that you did not bargain for at the point of sale. Oftentimes these notices are full of legalese and insurance jargon, and may be difficult to understand. Nevertheless, it is important for you to promptly review any notices you receive, because they may impact your disability coverage in significant ways. If you receive such a notice and are unsure about what it means, an experienced disability insurance attorney can explain how the changes outlined in the notice will impact your policy.
Additionally, if you have a Great-West policy, you should be aware that your policy may contain a very strict provision requiring you to obtain proper medical care for your condition. For this reason, if you are thinking about filing a disability claim with Great-West, you should make sure that your medical treatment is both well-documented and “appropriate” under the policy’s terms.
Claims Management Approach: How Great-West administers your disability claim will depend on the terms of the policy at the time you file your claim. Because the terms of the ADA’s group disability policy are renegotiated on a regular basis, the terms of your disability policy will likely change over time. Since your initial copy of the policy may no longer be accurate by the time you file your disability claim with Great-West, be sure to ask for a copy of the current version of your policy so that you know your rights under your disability insurance policy.
These profiles are based on our opinions and experience. Additional source(s): Great-West Financial’s 2013 Annual Report; www.greatwest.com.
