As a dentist, you probably have purchased at least one disability insurance policy, and you probably sought out “own occupation” coverage. However, in our experience, many dentists do not understand what their policy actually says or realize that there are several variations of “own occupation” policies. Additionally, many of the newer disability policies being sold to dentists have particular requirements and “rules” that must be followed in order to qualify for benefits.
Our latest article with Dentaltown Magazine discusses some of these pitfalls and explains why it is important to know what your policy says before filing a claim. Read the full article at Dentaltown today.
Doctor Money Matters Podcast
Q & A with Ed Comitz, Esq.
What Every Physician Should Know About Disability Claims
Ed Comitz recently sat down with Dr. Tarang Patel, host of the popular Doctor Money Matters Podcast, to talk through some of the most common questions physicians have about filing disability claims, such as:
- What should a physician look for in a disability policy?
- How hard it is for a physician to collect disability benefits?
- Do I need a lawyer to file a disability claim?
- What is the disability claims process like?
- If I have an “own occupation” policy, can I work in a different occupation and still collect disability benefits?
- What are the most common pitfalls that lead to physician’s claims being denied?
Episodes can also be accessed on www.drmoneymatters.com, and via iTunes, Google Play, Stitcher and other podcast platforms along with Facebook and YouTube.
Dentists have a high likelihood of filing a disability claim at some point in their career, which is not surprising given the unique demands of the profession. Comitz | Beethe attorney Derek Funk’s article in Dentist’s Money Digest discusses what dentists should look for when reviewing new or existing policies and what to expect when filing a disability claim. Read the full article at Dentist’s Money Digest today.
Physicians experiencing burnout can put both themselves and their patients at risk if they continue to practice. However, it is important to recognize that there are several degrees between ordinary stress and fatigue and a disabling condition, and where you fall on that scale is something that your insurance company can (and likely will) misconstrue, if you are not precise when reporting your claim. Comitz | Beethe attorney Derek Funk’s article in MD Magazine discusses some of the challenges faced by physicians who file disability claims due to mental health conditions and limitations. Read the full article at MD Magazine today.
Ed Comitz’s Continuing Education course “Disability Insurance Roulette: Why is it So Hard to Collect on My Policy” is now available through Dentaltown. This CE is an electronically delivered, self-instructional program and is designated for 2 hours of CE credit. In this course, Ed discusses why it is so difficult for dentists to collect disability benefits and how to avoid the most common mistakes made by dentists when filing disability claims. Ed also covers the key provisions to look for in disability insurance policies and provides an overview of the disability claims process. Finally, the course discusses how disability insurance claims are investigated and administered, and identifies common strategies used by insurance companies to deny claims.
Information on how to register can be found here.
For more information regarding what to look for in a policy, see this podcast interview where Ed Comitz discusses the importance of disability insurance with Dentaltown’s Howard Farran.
Comitz | Beethe Associate Karla Thompson recently spoke with Geoff Williams, a journalist for U.S. News & World Report Money, about common mistakes consumers make when they file insurance claims.
In the article, Ms. Thompson discusses one of the chief errors that can lead to a claim being denied: talking to claims analysts on the phone. Mr. Williams writes:
If you’re a conversationalist and enjoy talking, be careful. Karla Baker Thompson is a Scottsdale, Arizona-based insurance attorney who specializes in representing professionals with disability insurance claims.
“Most people don’t realize how claims handlers are trained to ask loaded questions whenever they talk to policyholders, and to memorialize everything the claimant says in a written memo after the call,” Thompson says. “The questions might seem routine or mundane to the policyholder, but the answers they elicit can have serious consequences, including denial of the claim.”
Thompson offers the example of a claims handler asking what you’ve been doing that day.
“If you say you went out to pick up a prescription, you’re not just making small talk. You’ve just led that claims adjuster to believe – whether accurately or not – that you’re capable of leaving the house, getting in your car, driving, filling out paperwork, and possibly lifting and carrying bags,” Thompson says.
Maybe, Thompson adds, someone drove you to get that prescription, or maybe you did go out yourself but you came back and felt miserable afterward.
“If you’re just speaking off the cuff, you may not be giving the proper context to your answers,” she says. “Worse, you could say something inaccurate by mistake.”
Other examples in the article include assuming your insurance company is right and not getting the proper documentation to support your claim.
Check out the article in its entirety to learn more: Don’t Make These Mistakes When Filing an Insurance Claim.
Smartphones are getting smarter, and the desire for convenience and streamlined administration is at an all-time high. We have taken a look at how Skype doctors could potentially influence your medical treatment, but what if your smartphone could predict depression without the help of a medical professional? A new app claims to be able to identify people who are at a higher risk for depression.
The Purple Robot
The “Purple Robot” is an app in development at Northwestern University. While it isn’t available to the public yet, the app was able to identify 87% of participants who were determined to be at risk of depression. How? By tracking GPS data that showed how much users moved between their regular locations. The more users moved, the less likely they were to be considered at-risk.
The Purple Robot also could detect 74% of higher-risk participants by figuring out who used their phone the most for texting, playing games, and checking social media. Talking on the phone more frequently, on the other hand, was not indicative of a greater chance of depression. Unfortunately, there wasn’t enough data, probably due to the small number of participants in the study, for researchers to determine the effectiveness of the app using both GPS and phone usage trends.
Pros and Cons?
Currently, this app only can tell you if you have an above-average chance of having depression and cannot diagnose it. While it certainly could help people to recognize if they need to see their doctor to discuss their potential depression, it could also potentially incorrectly identify you for being at risk. The test in the study used a low cutoff score, so it may have identified people for being at risk when they actually weren’t.
The Purple Robot is still in testing, and its developers at Northwestern University are planning on including more data, such as how long people talk on the phone and who they talk to, into the analysis. They are also encrypting the data, which provides some peace of mind for those who are concerned about data leaks.
Even if the app is changed to become more accurate, the GPS capabilities may be a turn-off for some people. Especially due to the hype surrounding multiple recent data hacks, having your GPS location at risk is definitely something to consider before using this app.
Since this app has not been revealed to the public, we don’t know quite what effect it would have on the disability insurance claims process. We do, however, recommend that you are cautious about the apps that you use that involve your health, especially if you think you may eventually have to file for disability.
We would also advise that you speak with your doctor if you think that you may be depressed. While these apps may assist you in realizing that you need to seek help, they aren’t yet able to substitute for diagnosis from a medical professional.
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.
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.
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!
We’ve discussed the issues involved with “presenteeism” and how it can affect disability insurance claims, but it’s making waves in other news regarding healthcare workers and their patients. Healthcare workers are going to work sick, and while it is admirable to be dedicated to your job, it creates a huge risk to those with already compromised immune systems. Since healthcare workers are entrusted with the duty of caring for high risk patients, it’s important that we take care of our healthcare workers as well. However, that seems to not be the case, as in the medical field it is seen as weak to take days off, and sometimes taking more than two sick days is rewarded with an extra week of work for residents.
Here are some statistics that highlight this phenomenon:
95.3% of 504 physicians believed that working while sick put patients at risk. ((http://archpedi.jamanetwork.com/article.aspx?articleid=2344551))
83.1% of the 504, however, worked sick at least 1 time in the past year.
98.7% didn’t want to let colleagues down, and 64% feared being shunned by colleagues.
80% of a random sampling of 1,033 Norwegian physicians reported working even though they had symptoms that in a patient would be considered “sickness”. ((http://www.ncbi.nlm.nih.gov/pubmed/11355720/))
However, it’s imperative that we don’t blame healthcare workers, but instead society and its approach to doctors’ and dentists’ sickness as a whole. It doesn’t seem to make sense that we place such a heavy emphasis on coming to work no matter what when lives are at stake. While it would seem to be common knowledge that placing an already compromised immune system in jeopardy would be a bad idea, the medical community’s desire to work through diseases is contradictory to this, and perhaps it’s time to change the culture.
Physicians, what do you think about “presenteeism”, and how do you think we can change the culture surrounding it? Tell us in the comments.
Comitz | Beethe disability insurance attorneys Edward O. Comitz and Patrick T. Stanley recently had their article “The Injured Physician: Is Your Work Ethic Hurting You and Your Patients?” published in the Winter 2013 edition of AzMedicine, the quarterly publication of the Arizona Medical Association.
In the article, Mr. Comitz and Mr. Stanley review some of the unintended consequences, both professional and personal, of a physician continuing to work through adversity, and the potential impact on his or her disability insurance coverage. For example, a physician who has modified his practice or work schedule in an effort to accommodate a disability may effectively change his occupational definition as it is defined in his “own occupation” disability insurance policy, making it difficult, if not impossible, to collect benefits when they are most needed.
The article also analyzes some of the pitfalls of “residual disability” or “partial disability” riders, such as the manner in which the insurer will determine the amount of benefits paid and differences in how long the insurance company is required to pay benefits.
The Arizona Medical Association periodically updates its website with recent editions of AzMedicine, or you may contact our office to obtain a copy of the full article and/or to speak with a disability insurance attorney.
Scottsdale attorney Edward O. Comitz was recently consulted by the popular financial website The Street regarding his thoughts on whether it’s a good financial decision to purchase an individual disability insurance policy. Based on the high premiums and his experience as an attorney who specializes in assisting sick or injured claimants with obtaining the individual disability insurance benefits to which they are entitled, Mr. Comitz advised that, with the exception of medical professionals such as dentists and surgeons – for whom even a minor injury can be career-ending – disability insurance is not a good investment unless you are also prepared to incur the costs of hiring an attorney if your claim is denied or terminated.
Pima County Medical Society Publishes Ed Comitz and Karla Thompson’s Article Re Surveillance in Disability Insurance Claims
The January 2013 edition of Sombrero, the publication of the Pima County Medical Society, features an article by Comitz | Beethe’s disability insurance attorneys, Edward O. Comitz and Karla Baker Thompson. The article, “Surveillance Misuse in Claims Investigations,” reviews some of the ways in which evolving technology has led to overly intrusive surveillance of claimants by insurance companies.
Among the surveillance techniques being utilized are stakeout operations, tailing (sometimes using a “decoy” investigator), pretexting (obtaining your personal information under false pretenses), and GPS and cell phone tracking. For example, some private investigators use a stingray, which is a cell phone tracking device that operates as a miniature cellular tower from inside of the PI’s vehicle. The device enables an investigator to connect to a claimant’s cell phone, even when it’s not in use, and, after taking measurements of the phone’s signal strength, triangulate its location. Since most people tend to carry their cell phones at all times, the device then allows the investigator to track the insured’s movements remotely.
The law surrounding some of these intrusive surveillance techniques, which have been made possible by modern technology, is not yet settled, and it is important that anyone on claim with their disability insurance carrier remain vigilant to the possibility of surveillance at all times, regardless of whether a human being is conducting the surveillance. Long gone are the days when surveillance was only conducted by someone with a camera sitting in a car outside an insured’s home.
Private investigators hired by disability insurance companies pretext to acquire your personal information from others. They do this by pretending to be someone else (often you), contacting people you know, and then probing them for your sensitive information. Pretexting is not only deceptive and unprincipled, but it may also be illegal. Private investigators engage in this conduct to produce evidence that will enable insurance companies to deny your disability insurance claim.
The Gramm-Leach-Bliley Act specifically addresses pretexting as it pertains to obtaining personal information from financial institutions. Many private investigators believe the scope of the Act is limited to pretexting with financial institutions only, therefore, they assume other pretexts—those not involving contacts with your financial institution—are legal. This is a misconception, however, according to Joel Winston, the Associate Director of the FTC, Division of Financial Practices. In an interview with PI Magazine, Winston clarifies the scope of the Act:
First, we should dispel the misimpression, if there is one, that the pretexting provisions of [the Gramm-Leach-Bliley Act] only apply if the pretexter is getting “financial information.” Actually, what the statute says is if you are getting any personal, non-public information from a financial institution or the consumer, that is covered by the statute.
(emphasis added). Winston also answers other questions about pretexting as they relate to private investigators. Although the Q-A session is mainly designed to illuminate private investigators of legal fences surrounding the practice of pretexting, it is also an excellent source of information for those who fear they might become victims of unlawful pretexts, or for people who want to learn more about the illegality of pretexting.
To view the article click here.
What is your most valuable financial asset? According to Chicago Tribune columnist, Gregory Karp, for most people “the answer isn’t in their golden eggs, but in the goose that laid them.” That is, their most valuable financial asset is not their car, house or retirement account, but their ability to make money.
When you suffer from long-term or short-term disability, you will likely be unable to continue working and, therefore, will lose your most valuable financial asset – your ability to earn money. For many Americans without disability insurance, this financial blow can be devastating.
For this reason, in his article entitled Disability Insurance Primer, Karp stresses the importance of long-term disability insurance and provides a basic overview of what disability insurance is, what it is not, and how to find an appropriate plan. The article is a good source for those seeking disability insurance or looking to change their current disability benefits plan.
Ed Comitz, disability insurance attorney in the greater Phoenix area, Tucson, and Flagstaff, also provides answers to frequently asked disability insurance questions. For example, in his blog post, Disability Insurance Policies: Which type do you own?, Mr. Comitz describes fundamental differences between individual, group and employer-sponsored disability insurance policies. In another post, How to Get a Copy of Your Disability Insurance Policy, Mr. Comitz explains the process of obtaining a copy of your policy from the insurance company. Finally, in How Specific is Your “Own Occupation”?, Mr. Comitz provides understanding about key terms within your policy and how insurers may try to classify these terms in a way to deny your disability insurance claim.
Ed Comitz, disability insurance attorney at Comitz | Beethe, recently had his article “Are Non-Competition Agreements Enforceable or Not?” published in the Winter 2010 edition of AzMedicine, the publication of the Arizona Medical Association for healthcare professionals.
In Today’s Uncertain Financial Environment, How Difficult Will It Be for You to Collect on Your Disability Policy?
Attorney Ed Comitz’s article “In Today’s Uncertain Financial Environment, How Difficult Will It Be for You to Collect on Your Disability Policy?” was recently published in the July/August 2010 edition of The Journal of Medical Practice Management.