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.
A recent article by health insurance writer Allison Bell explains, from an insurance industry perspective, why the new administrative demands on health care professionals might lead to an increase in doctors facing disability:
[I]t seems reasonable to ask whether, for example, the new pressure to convert to electronic health records will lead to some physicians at small or understaffed practices to develop carpal tunnel syndrome and blurry vision from trying to enter, or at least, check, many of the records themselves. Will sleep deprivation related to an increase in workload cause or aggravate objective conditions, such as lack of exercise, obesity and high blood pressure, that will, in turn, lead to an increase in the number of doctors with disability insurance who suffer heart attacks. strokes and disabling car accidents?
Healthcare professionals: Do you think the push for electronic health records and the Patient Protection and Affordable Care Act will lead to an increase in disabled doctors?
When it comes to disability insurance, your treating physician’s support can be critical to getting your legitimate disability claim approved. If your doctor can’t provide adequate documentation of your condition or is reluctant to get involved, there is a much higher chance that your claim will be denied. However, fully discussing your condition with a professional, compassionate treating physician will help ensure supportive medical records. When you are involved in a disability insurance claim, it is important to understand how to approach your treating doctor so that he or she can help you.
When to discuss your potential claim with a physician is an important timing issue. Instead of trying to enlist your doctor’s help at the very first visit, you should wait to talk to your treating physician until after he or she knows you and your condition well enough to opine accurately as to your ability to work. It is vital that you develop a relationship of trust and confidence with your doctor before inviting him or her to assist you in your claim. Physicians are often reluctant to support claims for disability insurance benefits if they question the motivations behind the claims. A physician who has treated, without success, the policyholder making a legitimate disability claim will be more willing to cooperate with the extensive process.
Birth defect or congenital disability? Fit, convulsion, or seizure? Quadriplegic, paraplegic, or person with a spinal cord injury? Midget, dwarf, little person, or person of short stature?
The Research and Training Center on Independent Living at the University of Kansas publishes and updates a pamphlet called Guidelines for Reporting and Writing About Disabilities that is a helpful reference manual for understanding and using preferred and accurate terminology when writing on the subject of disabilities.
While there is not complete agreement on which terms are preferred, the booklet has been adopted into the Associated Press Stylebook, reflects the input of over 100 national disability organizations, and has been endorsed by the AIDS Action Council, National Down Syndrome Congress, Bazelon Center for Mental Health Law, Brain Injury Association of America, Post-Polio Health International, the National Council for Independent Living and many others.
In addition to specific terminology, the manual provides some general guidelines, including:
- Do not focus on disability unless it is crucial to a story. Avoid tear-jerking human interest stories . . . Focus instead on issues that affect the quality of life for those same individuals . . .People with disabilities actively participate in their communities and can participate even more when portrayed just like anyone else in the community.
- Put people first, not their disability. Say woman with arthritis, a child who has a learning disability, or person with a disability. This puts the focus on the individual, not the particular functioning limitation. Labeling the person as the disability (for example, a quad) dehumanizes the individual and equates the condition with the person.
- Do not portray successful people with disabilities as heroic overachievers or long suffering saints. Even though the public may find these portrayals inspirational, these stereotypes raise false expectations that all people—with and without disabilities—should be such “super humans.”
- Avoid sensationalizing and negative labeling. Saying afflicted with, crippled with, victim of, or suffers from devalues individuals with disabilities by portraying them as helpless objects of pity and charity. It is more neutral to say an individual with AIDS than a person who suffers from AIDS. Similarly, do not use emotional descriptors such as unfortunate or pitiful.
- Emphasize abilities, not limitations. For example, uses leg braces or walks with crutches is more accurate thanconfined to a wheelchair or wheelchair bound.
- Bypass condescending euphemisms. Disability groups strongly object to the use of euphemisms to describe disabilities. Terms such as handicapable, differently abled, special, and challenged reinforce the idea that people cannot deal honestly with their disabilities.
- Maintain the integrity of each individual. Do not use words or phrases regarded as offensive.
- Do not imply disease when discussing disabilities that result from a prior disease episode. People who had polio and experienced after effects have post-polio syndrome. They are not currently experiencing the disease. Do not imply disease with people whose disability has resulted from anatomical or physiological damage…Reference to disease associated with disability is acceptable only with chronic diseases, such as arthritis, Parkinson’s disease, or multiple sclerosis.
In the wake of a number of complaints from passengers with disabilities, the Transportation Security Administration is planning to launch a toll free disability hotline in January so that passengers with disabilities can call in advance if they anticipate needing extra assistance during security screening. In recent months, there have been numerous complaints, many from elderly women, alleging that TSA agents subjected them to strip searches because they were unfamiliar with the specialized medical devices the women were wearing.
Sen. Charles Schumer, D-N.Y. and New York State Senator Michael Gianaris made a request in a letter to U.S. Department of Homeland Security and TSA officials for passenger advocates to be trained and familiarized with various medical conditions and medical devices so that they can provide “alternative methods for addressing the needs and concerns of elderly, disabled and other vulnerable passengers.”
Senator Schumer further said:
While the safety and security of our flights must be a top priority, we need to make sure that flying does not become a fear-inducing, degrading and potentially humiliating experience. Right now, passengers who feel that their rights are about to be violated have nowhere to turn, but by training passenger advocates at each of our airports, the TSA can finally give passengers a voice.
TSA has not commented on the proposal but issued a statement reminding the public that customer service representatives are available at most airports. The TSA currently offers Tips for the Screening Process on its website as well as other more detailed information, and we will be reviewing some of the other regulations for passengers with disabilities in subsequent blog posts.
UPDATE: The TSA Cares hotline designed to assist travelers with disabilities and medical conditions has now been launched. It is recommended that those traveling with special medical needs contact the hotline at least 72 hours in advance of their arrival at the airport with questions about screening policies, procedures and to coordinate getting through the security checkpoints. The TSA Cares toll-free hotline number is 1-855-787-2227, and its hours of operation are Monday through Friday 9:00 a.m. to 9:00 EST, excluding federal holidays.
Many of the questions surrounding a disability insurance claim depend on the language in your policy. Thus, the first step to a successful disability claim is getting a copy of that policy. Though it is always important to keep a copy of your disability insurance policy and any related documents, sometimes policyholders forget to do so, they lose the document, or the papers become accidentally damaged.
The simplest way to get a copy of your policy is to call or send a letter to your insurance company directly. You can search for your disability insurer’s phone number and address on the Arizona Department of Insurance website. The insurer may require you to pay a minor fee, but they will send you a copy.
Once you receive your copy, check to make sure it is actually yours and that no pages are missing or damaged. If you have questions about the provisions in the disability insurance policy or filing a claim for benefits, you can bring your copy to a disability insurance attorney who can help interpret it and guide you through the disability claims process.
When a disability insurance company is fighting a claim, it will often agree to pay benefits – but with a “reservation of rights.” What is a reservation of rights and how can it impact a legitimate disability claim?
When an insurer pays a disability claim under a reservation of rights, it is essentially providing a provisional payment. Though the insurance company may be sending you a check, it is not admitting that it actually has any liability under the policy. Instead, it is “reserving the right” to stop paying your disability claim if it can find evidence to deny it later. Once the company denies your disability claim, they can also demand you to repay them whatever proceeds they have distributed to you.
This practice is good for the insurance company, as it buys it extra time to investigate – and often later deny – a claim without putting it at risk of violating the laws against undue delay in payment. However, because the insurance company can still investigate the claim and then demand full repayment at any moment, the reservation of rights provides no peace of mind for the policyholder. Fortunately, a disability insurance attorney can protect you from this uncertainty by properly presenting your claim and thoroughly monitoring the insurance company’s actions to reach a beneficial result.
As we have discussed in the past, surveillance is a tool commonly used by disability insurance companies to analyze – and often deny – legitimate disability claims. When surveillance is taken out of context or misconstrued, it can lead to unfair disability denials.
All too often, disability insurance companies expect people with disabilities to stay at home, in bed. What they fail to realize is that most doctors actually encourage disabled claimants to try some activities of daily living, light physical therapy, or social interaction. Just because a disabled person can eat chips at a restaurant with family doesn’t mean he can perform all of the duties of his former occupation. Nevertheless, disability insurers often try to get any physical activity on camera and use it as proof that the claimant is not disabled.
Many people filing for private disability wonder when private investigators are watching them. After years of dealing with disability insurance detectives, we have recognized the five most popular times for surveillance of policyholders:
- During holidays. This is when policyholders are likely to be out of the house enjoying time with family and friends.
- On the claimant’s birthday. Just as on holidays, a disabled claimant is likely to push themselves to get out and enjoy the day.
- Over weekends. During weekends, insureds or more likely to attempt minor errands or go outside with family.
- Any time they have a chance of catching a claimant engaged in physical activity, based on information provided by the claimant on activity logs and in interviews. For example, if the claimant wrote on an activity log that he takes his dogs out in the morning, the private investigator will be there with a camera to document the insured walking in the yard.
- Near the end of fiscal quarters, when the insurance company is under pressure to save money by denying or terminating claims.