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Doctors and Surgeons: How to Prove a Long Term Disability Claim

Disability Wiki.

Long term disability claiming for physicians and surgeons present certain challenges for two reasons: (1) the insurers the work can be extremely demanding on several fronts -- physically, cognitively, and emotionally.  

The Problem: Long Term Disability Insurers Rely on Outdated and Sparse Job Descriptions for Doctors and Surgeons

Team of Medical Doctors and Disability Insurance AttorneysThe long term disability insurance companies tend to rely on job descriptions in the Dictionary of Occupational Titles (4th ed.) (“DOT”), which is published by the U.S. Department of Labor.  The problem is that these descriptions are sparse -- rarely encompassing all responsibilities, duties, and capacities required. Also, the DOT is highly outdated. 

In the DOT, occupations of physicians and surgeons are typically identified as "light" occupations. Light occupations require a significant amount of standing/walking and some lifting/carrying of items weighing up to 20 pounds.   

Long term disability insurers focus heavily on these exertional requirements of work as a physician or surgeon, particularly the standing/walking requirement. While standing/walking are certainly significant requirements, focusing only on those requirements does not fully assess other significant requirements that may preclude work. 

How the DOT Describes Job Duties of a Physician

The DOT describes the occupation of physician under many codes depending on the specialty. An index is available here. For example, the description of family physician (CODE: 070.101-026) details the following requirements, which are typical of all physicians, regardless of specialty: examines patients; using medical instruments and equipment; elicits and records information about patient's medical history; orders or executes various tests, analyses, and diagnostic images to provide information on patient's condition; analyzes reports and findings of tests and examinations, and diagnoses condition of patient; administers or prescribes treatments and medications.

How the DOT Describes Job Duties of a Surgeon

The DOT's description of surgeon (CODE: 070.101-094) lists these occupational requirements: performs surgery to correct deformities, repair injuries, prevent diseases, and improve function in patients; examines patient to verify necessity of operation, estimate possible risk to patient, and determine best operational procedure; reviews reports of patient's general physical condition, reactions to medications, and medical history; examines instruments, equipment, and surgical setup to ensure that antiseptic and aseptic methods have been followed; performs operations, using variety of surgical instruments and employing established surgical techniques appropriate for specific procedures.

O*NET: Another Resource to Identify Job Duties

Additional descriptions of the occupational requirements of physicians and surgeons are available from the Occupational Information Network (“O*NET”), an online database developed under the sponsorship of the DOL. Like the DOT, O*NET provides separate descriptions for each medical specialty.  However, it provides a more detailed description of each occupation and it is more up-to-date.  You can see an index here.

The Solution: You Must Educate the Insurer and Provide More Detail

To correct blind reliance on the DOT or O*NET, the disability insurance attorneys at Riemer Hess proactively educate the insurers regarding the critical occupational demands that are often overlooked.

The Work Requires Very Specific Physical Abilities, Depending on the Area of Practice

Doctors and surgeons must have very specific physical abilities to perform their work, depending on their specialty.  These requirements go far beyond sitting, standing, walking, lifting, and carrying.  For example, a heart surgeon needs good near vision, excellent hand eye coordination, steady hands, and manual and finger dexterity. They must be able to comprehend dimensional and spatial relationships. They also need to be capable of bending over a patient, often for extended periods, during surgeries.

The Work Is Cognitively and Emotionally Demanding

Medicine is an intellectually and emotionally demanding profession. O*NET details some of the cognitive skills and abilities required by physicians and surgeons. These include: critical thinking; active listening; judgment and decision making; complex problem solving; and inductive and deductive reasoning. The DOT, on the other hand, hardly lists any cognitive requirements. Neither the DOT nor O*NET describe the emotional demands in detail.

The Work Requires the Ability to Communicate Effectively 

A physician must be able to speak, hear, and observe patients to elicit information essential for diagnosis and treatment. The ability to develop and maintain relationships with patients, families and other members of the health care team is also required.

The Work Can Require Long and Unpredictable Hours

These occupations are not typically maintained on a 9-to-5 schedule.  Physicians and surgeons often put in a full day at the office and remain on call overnight and on weekends. They may have to leave home in the middle of the night to attend a patient. They may be called on to quickly assess an emergency situation and make a life or death decision. 

Conclusion

Physicians and surgeons have a lot to lose if their long term disability claims are denied.  The challenges that they face are unique, given the high-level and multifaceted work that these occupations demand.

If you’re thinking about filing a long term disability claim as a physician or surgeon, you should preemptively consult with a long term disability attorney to obtain critical guidance.  An ERISA long term disability attorney can explain your options and help guide you out of work protected.  This will be your safest bet to seamlessly leave work while increasing your chances of claim approval.

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