When an osteopathic family physician was battling serious health challenges—otosclerosis, lung cancer, and tinnitus — he became unable to continue practicing medicine. Fortunately, with the tireless advocacy of his counsel at Newfield Law Group with MetLife, his Individual Disability Income (IDI) claim was approved and benefits secured.
A Daunting Challenge
In December of 2023, shortly after his diagnosis and subsequent treatments, including a hospital stay and a resection of a carcinoid tumor, the doctor was focused solely on his recovery and the potential that he could return to working.
Only after a period of time, not recovering, did he accept and appreciate that he could no longer treat patients directly. The safety of his patient became an issue, both due to the hearing loss and tinnitus impact, and his cognitive issues and energy.
His typical day of patient consultations and hands-on procedures was restricted by the post-surgical recovery process and ongoing health issues related to both the cancer and his tinnitus. Some of his important examinations were directly impacted, which would degrade the level of care provided to his patients.
Initial Filing and Follow-Up
Jason Newfield worked closely with the doctor’s own medical team, obtaining necessary documentation and ensuring all reports and records were aligned with MetLife’s requests. We developed an audio file of the specific tinnitus sound that our client was hearing to help demonstrate its impact.
Based on years of representing clients in disability claims with Met Life, Newfield provided more than is required by the typical claims form. The goal is not to dump a truckload of documents on the claims adjuster; rather, it is a strategic approach providing specific occupational and medical information to preempt MetLife, or any other disability insurance company, from denying a claim based on medical records.
In December 2024, this critical paperwork was submitted to ensure MetLife had all the necessary details to evaluate the doctor’s claim. The back-and-forth correspondence called for extensive medical documentation and clarification of his occupational duties, especially once he shifted to remote administrative tasks at his practice.
We met with Met Life to address issues and concerns, and provided additional information and insight on the issues of both medical and occupational, to allow the claim adjuster to understand and accept the limitations that existed.
MetLife’s Approval
On March 14, 2025, MetLife finalized its review, confirming that the doctor met the policy definitions of Total Disability for his regular occupation as a family physician. He was approved for benefits from December 2023 under his disability insurance policies. Additionally, his future premiums were waived, providing much-needed financial relief.
Why Our Involvement Mattered
- Timely Coordination: With the attorney’s help, all supporting medical records from multiple specialists were promptly delivered to MetLife.
- Development of Collateral Evidence. We developed strategies to provide collateral evidence, which was compelling for the claim, and to demonstrate why occupational issues would be impacted.
- Clear Occupational Evidence: Demonstrating that direct patient care constituted the “material and substantial duties” of his occupation was crucial. Although he managed to perform certain administrative tasks for the practice remotely (as the owner), those duties did not undermine his eligibility for Total Disability benefits, given the definitions in his policies. We were able to articulate how his impairment met his policy definition to secure total disability.
- Protection for Direct Claim Interaction. When the insurance company sought to speak to our client for clarity, we worked together to manage this process smoothly and effectively through our preparation and advocacy.
- Persistence: By maintaining frequent communication with the insurance company, every hurdle in MetLife’s claim review process was addressed proactively.
Looking Ahead
While MetLife continues to evaluate the doctor’s ongoing disability, this initial approval represents a significant victory. It provides a solid foundation to seek continued benefits if medical and occupational limitations persist and future benefits for our client.
A Testament to Experienced Advocacy
For anyone facing the stress of medical uncertainty and the complexities of disability insurance, this case study is a powerful reminder: thorough experience of what to expect, preparation, diligent follow-up, and strong legal advocacy can make all the difference. This outcome has allowed the doctor to focus on his health and recovery, rather than battling paperwork and disability insurance denials.