| Dental
CE Digest 1/2006 (Volume 3, No. 1)
The dental
professional faces a wide array of occupational hazards
in the workplace. Many may be able to function fully or
partially with musculoskeletal, hand, or arm problems,
such as Carpal Tunnel Syndrome, but if these symptoms
become pronounced enough to affect performance, the consequences
can be physically (and financially) devastating.
If your pain
is so great it interfaces with your ability to treat patients,
something must be done. In some instances, all it takes
is cutting back on those office hours and working part-time,
but in others, walking away from the profession is necessary
to avoid causing permanent damage. In either case, a disability
claim is likely in your future.
Many individual
disability policies available to dentists provide partial
or total disability benefits, usually to age 65 and sometimes
for life. Their working is often occupation-specific,
meaning that the insurance company will pay you the full
benefit amount if you cannot perform the substantial and
material duties of your occupation.
Despite the
promises your insurance company may have made in your
disability contract, it’s almost guaranteed that
you’ll need to wade through a sea of red tape and
fine print before you receive any benefits.
Many insurance
companies use defensive measures to control and substantiate
claims. Unfortunately, these also make the process more
difficult and time consuming. Here’s a brief rundown
on what your claim might entail.
FIELD INVESTIGATION.
A field investigation is a visit from a representative
of your insurance company. This is generally by appointment,
although it could be unannounced, and you may be asked
to sign a statement prepared by the investigator. Read
it carefully and make any necessary corrections before
returning on another day. Take as much time with the statement
as you need to insure its accuracy.
IMES. Independent
medical examinations, or IMEs, are preformed with most
claims even when the claimant’s symptoms can be
verified by the attending physician.
FCES. Functional
capacity evaluations, or FCEs, are used frequently with
the claims a dental professional is most likely to file,
such as those involving back or hand pain.
SURVEILLANCE.
Video surveillance is used to determine whether your medical
symptoms are in conflict with your lifestyle. Insurers
closely monitor athletic and social activities early in
the life of your claim and may continue to do so on a
long-term basis.
FINANCIAL INVESTIGATION.
Insurers frequently use forensic accountants on partial
disability claims to dispute the pre- and post-disability
earnings figures provided by the claimant.
Generally speaking,
it’s inadvisable to discuss financial calculations
with your insurer. Instead, ask them to send a written
statement for your accountant to review and, if necessary,
discuss with your insurer’s accountants.
Your attending
physician may need help with the policy language and documentation.
In fact, most attending physicians, don’t know the
difference between a Workers’ Compensation claim,
a Social Security disability claim, and your personal
disability policy. A disability claim consultant can help
clarify all aspects of your claim for you and your physician.
Art Fries is
a disability claim consultant in Newport Beach, CA who
provides advice nationwide. To learn more about disability
claims, call 800-567-1911 or visit www.afries.com.
_____________________________________________________________
Back
to Top
|
