An oral and maxillofacial surgeon is considered the most skilled position in the dental profession. Not only does an oral and maxillofacial surgeon have to be trained in dental surgery, but they also handle anesthesia, which means they are trained for that as well. According to CNBC, an oral surgeon is the third highest paying profession in America. Despite their highly specialized profession, many oral surgeons find it very difficult to get their long-term disability claim approved.
In this article, we will explore the following:
- Why an oral surgeon may struggle to get approved for Long Term Disability benefits;
- Tips to strengthen your claim; and
- How you can get help understanding your policy and defending your claim.
Why It’s So Difficult to File For Disability as an Oral and Maxillofacial Surgeon
Oral and maxillofacial surgeons have a highly specialized skill set that requires peak performance to avoid making a potentially life-threatening mistake. So when an oral surgeon is disabled, why does the insurance carrier make it so hard to get a claim approved?
One simple reason – money. Your insurer is not worried about your health and wellbeing. They are worried about how much it will cost to pay your claim for the duration of your illness. In addition to your regular salary, you may have a rider that helps recover from other losses. If you own your oral surgery practice, this rider will help you offset the loss of patients you had before you were injured.
For example: let’s say that you are involved in a car wreck and spent two years recovering from your injuries, your patients had to find a new provider. When you do go back to work, your income will likely be much lower than it was before your accident. A recovery rider will help you get by while you rebuild your practice.
Four Tips to Help You Create a Solid Claim
Tip #1 Gather Strong Medical Evidence
Do not count on your insurance company to gather medical evidence in support of your claim. Collect medical evidence from all of your treating providers and submit it to the insurer. Be sure that the doctors are noting your limitations on your chart. If you seek treatment for any mental health issues, be sure to include those medical records as well.
Tip #2 Anticipate Surveillance
It is completely legal for your insurance carrier to conduct surveillance, and you can be sure that a high value claim for a surgeon will be under surveillance. Your insurer will hire an investigator will stake out your home and follow you to your appointments. Insurers typically schedule surveillance when they know you will have to leave your home for medical treatment. This way, there is a good chance the investigator will be able to record your activates outside the home.
Tip #3 Stay Off Social Media
There is a high probability that any social media accounts will be monitored. As an oral surgeon, your work schedule probably does not allow for social media. However, when you are at home with nothing to do but rest, you may be tempted to start an account. We suggest staying off social media entirely during the claim period. The insurance investigator will try to use social media accounts to deny your claim.
Tip #4 Do Not Try to Go Back to Work Too Fast
When an oral surgeon rushes back to work before they are ready, they risk making a mistake that could cause more injury to themselves or land them in court if they injure a patient. Even if your claim is denied, you have the right to appeal the decision. If you need help, you can hire an attorney that specializes in long term disability insurance claims.
Oral surgeons will find it difficult to get a long-term disability claim approved. Due to the cost of the payout, the insurance company will actively look for reasons to deny the claim. Follow the tips above to improve the chances that your claim will be approved.
If you are considering purchasing a disability insurance policy or have recently purchased a policy, we will help you understand what you are entitled to and whether there are deficiencies in your coverage that could lead to a denied claim. It is easy for individual policyholders who are not trained to read insurance policies to misread or misunderstand the disability policy. As part of our evaluation, we will explain what everything means to you in your situation.
If you have already applied and your insurer has denied your claim, we encourage you to speak with an attorney. The Ortiz Law Firm is based in Florida, but we represent claimants across the country. You can schedule a free case evaluation with no obligation by calling (888) 321-8131. We can help you evaluate your claim to determine how to move forward with the appeal or litigation process.