ER Doctor Disability Claims Long Term Disability Insurance Law Firm

For more than two decades, we have had the privilege of helping those who help so many.  The disability insurance law firm of Newfield Law Group proudly represents Emergency Room physicians, helping them to navigate the minefield of their private and often group LTD (ERISA) long term disability insurance claims. Our idea of what an Emergency Room physician does is often guided by our television experiences, which truly fail to capture the realities. Even before COVID-19, Emergency Room

Physicians had high incidences of disability, due to the intense pressures of the work, and other significant work factors. COVID-19 made the situation more dire and caused many Emergency Room doctors to file disability insurance claims. Newfield Law Group knows that these claims will continue, as hospitals have created challenges environments for their Emergency Room doctors.  They have lost vital support with nurses leaving, and have increased patient loads, with limited resources at times.  

What Type of Coverage Do Emergency Medicine Physicians Have?

Most physicians were sold private disability policies, often “own-occupation” disability insurance, when they were residents, offering them future increasing in coverage, as their income got bigger.  These were often quality policies with highly rated companies, who promised to pay if or when the insured was unable to perform the material and substantial duties of their occupation.With an own-occupation disability insurance policy, the Emergency Room physician who cannot perform their duties in the ER due to sickness or injury may have a claim, and may still be able work in a different setting and receive disability benefits. It might be a claim for total disability under a private policy and might be a residual claim for the loss of income, between the Emergency Room physician and a physician in a private practice or clinic with a lower salary, and less attendant responsibilities.  These doctors might also have a group LTD (ERISA) policy through the hospital which employs them and might also provide benefits. However, that coverage is often inferior, with numerous limitations imposed – for mental health claim limitations, subjective condition limitations, or occupational limitations, and sometimes are not tax-free benefits, as is the case typically with private policies.  Often, at the end of two years, the claim analysis will change, and an ER physician who was considered disabled may no longer be considered disabled by the insurance company, since they may be able to practice internal medicine and no longer qualify for benefits.  They may be able to pursue residual disability insurance benefits, potentially working in a reduced capacity on a more limited basis.

What Can The Emergency Room Physician Expect In Disability Benefits?

We understand how frustrating it is when an ER Physician, who dedicated years of training and work to get to this level, is now unable to continue to work.  When that occurs, the last thing you want to do is to battle your disability insurance company for your justly due benefits.   We take this burden on for our clients so they can focus on their health and to ensure the process evolves efficiently and smoothly.  We pursue total disability for our clients where appropriate and guide them for residual disability claims when still working while disabled.Just as every occupation is different, every disability insurance claim is different. But the one thing all disability insurance claims have in common is an approach and focus upon what the insured claimant cannot do as a result of their condition – and what supports their claim for benefits.   Disability insurance is more than just income insurance. It is identity insurance for the Emergency Room physician, to insure their specific occupation.  

CASE HISTORY – New York ER Doctor 

We were retained by a prominent New York ER doctor who was suffering from significant orthopedic problems which impacted upon his functionality and degraded his ability to perform his work with the required precision.  Our work was to help navigate the claim process for his private individual disability insurance contract and his group LTD policy through his employment with the hospital.We worked with him and his doctors to develop both the medical support necessary to articulate how and why he was impaired and to provide the insurers with a keen understanding and appreciation for what it took for this doctor to perform his work successfully.By developing the claim comprehensively and anticipating the issues to be raised by the insurers, we were able to smoothly move the client from his end of employment to the collection of his benefits.  In doing so, we were able to relieve our client of the substantial stress involved for him in this process, and his concerns and worries about his financial future.  We were able to address all of his concerns, and to work closely with the insurers to satisfy their requests for proof of loss to support his impairment.This success is typical of what occurs when we are engaged early in the process so that we are able to share our vast experience with the claim process to anticipate any issues before they may become problems.  Like we tell clients, we should prevent the spill, and not clean the mess, after.

Disability Insurance Claims and the Emergency Room Physician

If you are contemplating a long-term disability insurance claim, please consult with us to address what your issues or concerns are, so we can help you navigate this often challenging process during a difficult time in your life.As we know from two decades helping disabled doctors, it sometimes takes time for the disability claim adjuster to manage a claim and to secure an approval.  Working with counsel can often facilitate an approval, and more quickly, anticipate the numerous requests for information and documentation to support a claim.  Most doctors secured initial coverage in residency when they were young, and never expecting to file a claim.  These doctors who purchased disability insurance policies often have nowhere to turn when it is time to file a claim.   The disability insurance policy which was procured years ago cannot be found. A call is made to the insurance company that has collected premiums for many years. What happens now?  How can you protect yourself when filing a disability insurance claim? Be prepared for an avalanche of paperwork, medical record requests and requests for additional information. Each insurance company has its own methods for filing a claim.   Each claim, and each policy, will have different requirements, but Newfield Law Group seeks to proactively create a universal submission that can span all claims and coverages for the Emergency Medicine physician.  It is important to know that every submission of information or documentation provided by the ER physician gets scrutinized and will be part of your claim record. The ER doctor is advised to work with an experienced disability insurance attorney to protect their claim and have them guide the process and take actions on their behalf with the disability insurance company. Too much is at stake, with the high policy benefit amounts.

How Can You Protect Yourself At Claim Time?

Before you intend to file a claim, you should understand and appreciate what your coverage provides, what limitations, if any, may exist, and how best to navigate the process.  We invite you to call our office at (877) 406-7883 for a free, no-obligation consultation.   We are a national firm, based in New York.  During our conversation, we will be able to give you information about your claim, the insurance company and what your options are to combat what the disability insurance company is trying to do.  We will share insight into the process and how we might add value to your claim.