Long Term Disability | News & Information

Long Term Disability Claims for Dentists

Written by Jennifer Hess | Sep 05, 2014

With the high level cognitive and physical demands that dentistry requires, even a relatively minor medical condition can prevent a dentist from safely treating patients. Insurers often overlook the complex demands of dental practice, meaning long term disability claims involving dentists frequently require a detailed analysis of both the medical condition and the occupational duties affected.

Below we explain the unique disability claim challenges dentists face and how to protect your right to long term disability benefits. 

Why Long Term Disability Claims for Dentists Are Unique 

Long term disability claims for dentists are unique because the ability to practice dentistry depends on far more than general physical capacity. Dentistry requires exceptional precision, fine motor control, hand-eye coordination, visual focus, and sustained concentration. A dentist must be able to make small, controlled movements in a confined space while using sharp instruments and making real-time clinical decisions. Even a slight tremor, grip weakness, vision problem, cognitive impairment, or pain-related distraction can make it unsafe to perform dental procedures.

The physical demands of dentistry are also significant. Dentists often work in awkward positions, bend or lean over patients for extended periods, and rely on neck, back, shoulder, arm, hand, and finger endurance throughout the workday. For practice owners, disability may also affect the ability to manage staff, oversee finances, communicate with patients, and maintain the business side of the practice.

Unfortunately, disability insurers may focus too narrowly on whether a dentist can sit, stand, or walk, while overlooking whether the dentist can safely and reliably perform the actual duties of the profession. A proper long term disability claim should account for the full scope of dental practice, including precision-based procedures, patient safety concerns, sustained clinical focus, and the specific demands of the dentist’s specialty or practice. 

Occupational Duties Insurers Often Overlook

When evaluating a long term disability claim, insurance companies often focus on broad occupational requirements and fail to appreciate the specialized demands of practicing dentistry. While the ability to stand, walk, or sit throughout the day is important, these activities represent only a small portion of what dentists actually do. A thorough disability evaluation should consider the full range of physical, cognitive, and professional responsibilities required to safely care for patients.

Fine Manipulation and Hand Control

Dentists rely heavily on the ability to perform delicate, controlled movements with their hands and fingers. Many procedures require manipulating small instruments within a limited workspace while maintaining exceptional precision. Conditions affecting grip strength, dexterity, sensation, coordination, or steadiness can significantly interfere with a dentist’s ability to perform clinical procedures.

Repetitive Precision Movements

Dental procedures frequently involve repetitive, highly coordinated movements that must be performed accurately for extended periods. Even mild tremors, weakness, pain, or reduced range of motion can affect a dentist’s ability to maintain the level of precision required for patient care.

Sustained Neck Flexion and Awkward Postures

Dentists commonly spend much of the workday leaning, bending, reaching, and maintaining static postures while treating patients. These physical demands place significant stress on the neck, shoulders, back, and upper extremities. Conditions affecting these areas can make it difficult to sustain the positions necessary to complete procedures safely and effectively.

Clinical Decision-Making

Practicing dentistry requires more than technical skill. Dentists must continuously assess patient conditions, interpret diagnostic information, develop treatment plans, and make clinical judgments throughout the day. Cognitive impairments affecting concentration, memory, processing speed, or decision-making may interfere with a dentist’s ability to provide appropriate care.

Patient Safety Responsibilities

Patient safety is a critical component of every dental procedure. Dentists routinely work with sharp instruments and powered equipment in a confined area where even a small mistake can have serious consequences. A condition that affects physical control, reaction time, focus, or judgment may create unacceptable risks for patients, even if the dentist remains capable of performing some job functions.

Practice Management Duties

For dentists who own or operate their practices, professional responsibilities often extend beyond patient care. Managing employees, overseeing finances, maintaining regulatory compliance, and handling administrative functions can become difficult when a disabling condition affects physical or cognitive functioning.

Communication With Patients and Staff

Dentists must effectively communicate with patients, hygienists, assistants, specialists, vendors, and office staff throughout the day. Disabilities that affect speech, cognition, emotional regulation, or interpersonal functioning may impair a dentist’s ability to manage patient relationships and lead a successful practice.

Because these occupational demands are frequently overlooked, it is important for a long term disability claim to clearly explain not only a dentist’s diagnosis but also how the condition affects the specific duties required to practice dentistry safely and effectively.

Individual Disability Insurance vs. Group Disability Insurance for Dentists

Many dentists carry disability insurance through an employer, professional association, or dental practice, while others purchase individual disability insurance policies to provide more comprehensive protection.

Understanding the differences between these forms of coverage is important because the type of policy you have can significantly affect your eligibility for benefits and the amount you may receive.

Individual Disability Insurance Policies

Many dentists purchase individual disability insurance policies early in their careers to protect their earning capacity. Major insurers that commonly provide long term disability coverage to dentists include Guardian, Principal, MassMutual, Ameritas, and The Standard. These policies are often specifically designed for highly skilled professionals and may offer stronger protections than employer-provided coverage.

Individual policies frequently include favorable provisions such as true own occupation definitions of disability, specialty-specific coverage, residual disability benefits, and optional riders that can enhance benefits over time. Because these policies are individually negotiated and often involve substantial monthly benefits, the exact policy language can have a significant impact on a claim.

Employer-Provided Group Disability Policies

Group long term disability policies are typically provided through an employer or dental practice as part of a benefits package. While group coverage can provide important financial protection, it is often less customizable than an individual policy and may contain more restrictive definitions of disability.

Many group policies replace only a portion of a dentist’s income and may not fully account for the specialized nature of dental practice. In addition, group policies frequently contain provisions that allow the definition of disability to become more restrictive after a period of time, making it important to understand the policy’s specific terms.

Key Differences Between Individual and Group Coverage

Several policy provisions can have a substantial impact on a dentist’s disability claim:

    • Own Occupation Definitions: Individual policies often contain stronger own occupation language that focuses on your ability to perform the duties of your specific occupation or specialty. Group policies may contain narrower definitions or eventually transition to an any occupation standard.
    • Residual Disability Benefits: Many individual policies provide residual or partial disability benefits when a dentist experiences a loss of income but remains capable of performing some work. These benefits can be particularly valuable for dentists who reduce their schedules or transition away from clinical duties.
    • Specialty-Specific Coverage: Some individual policies recognize the unique duties of dental specialists such as orthodontists, oral surgeons, periodontists, or endodontists. This may allow benefits when a condition prevents you from performing your specialty even if you remain capable of other forms of work.
    • Benefit Amounts: Individual disability policies are often designed to protect a larger percentage of a dentist’s income than group coverage. Dentists who own practices may also have separate disability overhead expense policies that help cover business expenses during a period of disability.

Because disability policies vary significantly from one insurer to another, dentists should carefully review their coverage and understand how their policy defines disability before filing a claim.

 

Understanding “Own Occupation” Disability for Dentists

One of the most important provisions in a dentist’s disability insurance policy is the definition of disability itself. Many dentists purchase disability coverage specifically because they want protection if a medical condition prevents them from practicing dentistry, even if they remain capable of working in another capacity. Whether a policy provides that protection often depends on its own occupation language.

What Is Own Occupation Disability?

In general, an “own occupation” definition of disability focuses on whether you can perform the material duties of your regular occupation. For dentists, this means the insurer should evaluate whether your condition prevents you from performing the clinical and professional duties required in your dental practice, rather than simply asking whether you can perform some other type of work.

Because dentistry requires a unique combination of technical skill, precision, judgment, and physical endurance, many conditions that would not prevent someone from working in another profession can still be disabling for a dentist.

Why Strong Own Occupation Language Matters

Not all own occupation provisions provide the same level of protection. Some policies allow dentists to continue receiving benefits even if they transition to another occupation, while others contain limitations that can reduce or eliminate benefits if the insured earns income elsewhere.

Strong own occupation language is particularly valuable for dentists because it recognizes that years of specialized training and experience cannot easily be transferred to another profession. A dentist who can no longer safely perform procedures may still be capable of teaching, consulting, or working in a non-clinical role, yet still qualify for benefits under a properly drafted own occupation policy.

Specialty-Specific Definitions

Many dental specialists purchase policies that recognize the unique duties of their specialty. These provisions can be especially important because the physical and cognitive demands of various dental specialties may differ significantly.

For example, an oral surgeon who develops a hand tremor may no longer be able to safely perform surgical procedures, even if they could still perform certain non-surgical duties. Similarly, an orthodontist with a vision impairment or neurological condition may be unable to perform the precise clinical work required by the specialty despite remaining capable of performing other types of employment.

When a policy includes specialty-specific language, the focus should be on whether the claimant can perform the duties of that particular specialty rather than dentistry in a general sense.

Transition to Any Occupation Definition

Many group long term disability policies contain a provision that changes the definition of disability after a certain period of time, often 24 months. During the initial period, benefits may be payable if you cannot perform your own occupation. After the transition, benefits may continue only if you are unable to perform any occupation for which you are reasonably suited by education, training, or experience.

This change can create significant challenges for disabled dentists. Even if your condition permanently prevents clinical practice, an insurer may argue that you’re capable of teaching, consulting, performing administrative work, or engaging in another occupation. Understanding whether and when your policy transitions to an any occupation standard is therefore critical to evaluating your long-term eligibility for benefits.

Because own occupation provisions vary considerably from one policy to another, dentists should carefully review their policy language and understand exactly how disability is defined before filing a claim or responding to a denial.

 

Challenges Dentists Face During Long Term Disability Claims

Dentists often have high-value disability insurance policies due to their earning potential and the specialized nature of their work. As a result, insurers may closely scrutinize claims and actively search for reasons to deny benefits, reduce payments, or terminate an approved claim.

Common challenges dentists may encounter during the disability claims process include:

    • Surveillance: Insurance companies may hire private investigators to observe and record your activities. Insurers sometimes attempt to use isolated moments captured on video or in photographs to argue that you are capable of working. They may also conduct background checks and monitor your social media accounts for information they believe conflicts with your reported symptoms or restrictions.
    • Independent Medical Examinations (“IMEs”): Your insurer may require an examination by a physician of its choosing. These evaluations are often used to challenge the opinions of your treating doctors or minimize the impact of your condition on your ability to practice dentistry.
    • Denials Based on Paper Reviews: Rather than conducting an in-person examination, insurers may rely on physicians who simply review medical records and issue opinions regarding your work capacity. These reviewers may not fully appreciate the precision, dexterity, concentration, and patient safety considerations required in dental practice.
    • Vocational Assessments Favoring the Insurer: Insurance companies often retain vocational experts to evaluate whether a dentist can continue working or transition into another occupation. These assessments may rely on generic occupational descriptions and fail to account for the highly specialized skills, fine motor demands, and clinical responsibilities involved in practicing dentistry.

Because disability insurers often evaluate claims through a financial lens, dentists should be prepared for ongoing scrutiny and ensure that their medical evidence accurately reflects how their condition affects their ability to safely and effectively practice

 

How To Prove Long Term Disability for Dentists

Successfully obtaining long term disability benefits often requires more than a diagnosis alone. Insurance companies typically want objective evidence demonstrating how a medical condition affects a dentist’s ability to perform the specific duties of the profession. The strongest claims often include both medical evidence and vocational evidence.

Medical Evidence

Medical evidence helps establish the existence, severity, and functional impact of your condition. Depending on your diagnosis, useful forms of medical evidence may include:

    • Treating Physician Support: Detailed medical records and narrative reports from your treating providers can explain your diagnosis, symptoms, treatment history, and resulting functional limitations. Strong physician support is often critical to a successful claim.
    • Functional Capacity Evaluations (“FCEs”): These evaluations measure physical abilities such as strength, endurance, range of motion, and functional tolerances. For dentists, an FCE may help document limitations involving standing, reaching, neck positioning, upper extremity use, and other physical requirements of clinical practice.
    • Neuropsychological Evaluation Testing: If your condition affects concentration, memory, attention, processing speed, or executive functioning, neuropsychological testing can provide objective evidence of cognitive impairment. These assessments are often valuable in claims involving neurological conditions, mental health disorders, brain injuries, or autoimmune diseases.
    • Cardiopulmonary Exercise Testing (“CPET”): CPET can objectively measure endurance, exertional capacity, and fatigue. This testing is often used in claims involving conditions that impair stamina or make it difficult to sustain a full workday.
    • Vestibular Testing: For conditions involving dizziness, imbalance, vertigo, or coordination problems, vestibular testing can help document limitations that may interfere with performing precise dental procedures safely.

Vocational Evidence

Medical evidence alone does not always explain why a dentist cannot work. Vocational evidence helps connect your documented limitations to the actual duties of your occupation.

    • Vocational Assessment: A vocational expert can analyze the physical, cognitive, and professional demands of your dental practice and explain how your condition affects your ability to perform those duties. This can be particularly important when insurers rely on broad occupational classifications that do not accurately reflect the realities of dental practice.
    • Personal Affidavit: A detailed personal statement can explain how your symptoms affect your ability to perform the specific duties of dentistry. This may include describing difficulties with fine motor control, concentration, stamina, neck or back pain, visual limitations, or other impairments that interfere with patient care and practice management responsibilities.
    • Witness Statements: Statements from colleagues who regularly observe you can provide valuable insight into how your condition affects your daily functioning. These individuals may be able to describe changes in your physical abilities, cognitive functioning, endurance, mood, or capacity to perform professional activities before and after the onset of your disability.

 

Why High-Income Dentists Face Increased Claim Scrutiny

Dentists are often among the highest earners covered by disability insurance, which can result in substantial monthly benefit payments when a claim is approved. In our experience, the increased financial exposure means insurers frequently devote additional resources to evaluating and monitoring these claims. As a result, dentists may experience a level of scrutiny that exceeds what many other claimants encounter.

The complexity of many dentists’ insurance portfolios can also attract additional attention. It is not uncommon for dentists to have multiple sources of disability coverage, including individual disability insurance policies, employer-provided group coverage, residual disability benefits, and disability overhead expense policies. Some dentists may also have policies purchased at different stages of their careers from different insurers. Coordinating benefits across multiple policies can create complicated issues regarding disability definitions, earnings calculations, offsets, and benefit eligibility.

Practice ownership presents another layer of complexity. Many dentists continue to have ownership interests in their practices even after they stop performing clinical work. Insurance companies may closely examine the claimant’s ongoing involvement in the business, including management responsibilities, financial oversight, employee supervision, and other administrative activities. Insurers sometimes attempt to argue that these activities demonstrate an ability to work, even when the claimant remains unable to perform the clinical duties of dentistry.

Some dentists also have buy-sell agreements funded by disability insurance or business overhead expense policies designed to cover operating costs during a period of disability. These arrangements can raise additional questions regarding income, ownership interests, business operations, and the interaction of multiple insurance benefits. Insurers often review these issues carefully when evaluating a claim.

Because of the high financial stakes involved, insurance companies may engage in more aggressive claim management tactics. Dentists are frequently subjected to repeated requests for documentation, extensive financial reviews, social media monitoring, surveillance, independent medical examinations, and periodic reassessments of their disability status. Understanding this heightened level of scrutiny is important for dentists pursuing disability benefits and underscores the need for thorough documentation of both their medical condition and the occupational demands of their practice.

 

How Riemer Hess Helps Dentists With Disability Claims

Disability claims involving dentists often require more than simply submitting medical records to an insurance company. Because dentists perform highly specialized work and frequently have complex disability insurance coverage, claims must be presented in a way that clearly demonstrates how a medical condition affects the ability to safely and effectively practice. At Riemer Hess, we assist dentists, orthodontists, oral surgeons, and other dental professionals at every stage of the disability claim process, including:

    • Initial Claim Assistance: The foundation of a successful claim is often established before the claim is ever submitted. We help dentists understand their policy provisions, identify potential issues, develop supporting evidence, and present the occupational demands of their practice in a way that accurately reflects the realities of their profession.
    • Ongoing Claim Monitoring: Even after benefits are approved, disability claims often remain under active review by the insurance company. We help clients respond to requests for updated medical records, financial information, questionnaires, and other documentation while navigating ongoing claim reviews.
    • Appeals: When a claim is denied or benefits are terminated, we review the insurer’s rationale, identify weaknesses in the decision, obtain additional supporting evidence, and develop a comprehensive strategy designed to address the insurer’s concerns and strengthen the claim.
    • Litigation: If an insurance company continues to deny valid benefits, our attorneys represent disability claimants in lawsuits involving both group and individual disability insurance policies. We work to hold insurers accountable when they fail to properly evaluate the evidence or apply policy provisions fairly.
    • Coordination With Medical and Vocational Experts: Depending on the circumstances, we may work with treating physicians, vocational experts, neuropsychologists, functional capacity evaluators, and other specialists to help document the limitations that prevent a dentist from performing the duties of the profession. By combining medical evidence with a detailed understanding of the occupational demands of dentistry, we work to ensure that insurers receive a complete picture of how a disability affects a claimant’s ability to practice. 

Dentists face unique disability challenges because their profession depends on precision, dexterity, concentration, and physical endurance. When a medical condition interferes with those abilities, securing disability benefits requires demonstrating how your symptoms affect the specific demands of dental practice. Understanding your policy, documenting your limitations, and developing strong medical and vocational evidence can significantly improve your chances of obtaining and maintaining the long term disability benefits you deserve.