Disability Insurance Companies Are Using the “Dual Occupation” Defense to Deny Long-term Disability Claims for Doctors

Long-term Disability Claims Denials for Doctors

When doctors experience illness or injury that prevents them from performing their highly specialized medical duties, they naturally rely on long-term disability (LTD) insurance coverage. However, an increasingly common hurdle they face is the “dual occupation” defense, an aggressive strategy used by disability insurance companies to deny rightful claims. Attorneys at Robinson & Warncke specialize in challenging this defense, advocating fiercely to ensure doctors receive the full disability benefits they deserve.

The dual occupation defense occurs when disability insurers assert that a doctor engages in multiple occupations. By doing so, they attempt to deny claims by arguing that the physician is not truly disabled if they can still perform certain tasks unrelated to their primary specialty. For example, insurers might argue that a surgeon who teaches or consults part-time is still capable of working, even if an injury prevents them from performing surgery. Consequently, the insurer tries to reduce or entirely deny the doctor’s disability benefits.

Doctors purchase “own occupation” disability insurance policies specifically because these policies promise coverage if they can no longer perform the core duties of their medical specialty. Unfortunately, insurers often exploit vague policy language, using the dual occupation defense to argue that secondary tasks, such as administrative duties or consulting roles, represent separate occupations. This tactic undermines the very purpose of purchasing specialized disability coverage, creating financial stress and uncertainty for physicians already facing challenging circumstances.

Robinson & Warncke attorneys have extensive experience fighting these unfair denials, employing strategic legal actions to protect their physician clients’ rights. Understanding the complexity of medical professions and disability insurance, the firm meticulously evaluates each case, gathering comprehensive medical documentation, vocational expert testimony, and employment records to clearly establish the physician’s primary occupation.

To counter the dual occupation defense effectively, attorneys at Robinson & Warncke meticulously define the doctor’s occupation as the medical specialty in which they primarily practice, rather than ancillary roles or tasks. By demonstrating how a disability directly impacts the core competencies required for their primary professional responsibilities, the firm decisively refutes insurers’ claims.

Robinson & Warncke’s approach includes carefully reviewing policy language and precisely outlining the nature and extent of the disability’s impact on professional duties. For instance, if an orthopedic surgeon suffers a hand injury, they might still perform some administrative tasks but are unable to perform surgeries—clearly their primary occupation. Robinson & Warncke attorneys effectively articulate this distinction, ensuring insurers cannot dilute the significance of such limitations.

Insurance companies often rely on hired consultants or biased independent medical examiners (IMEs) who might downplay a doctor’s disability, supporting the insurer’s dual occupation defense. The attorneys at Robinson & Warncke counteract these biased evaluations by providing thorough documentation from treating physicians, independent specialists, and vocational experts, underscoring the real-world implications of the doctor’s disability.

Additionally, Robinson & Warncke attorneys understand the psychological toll these disputes take on physicians. Many doctors experience stress and frustration as they face aggressive tactics, such as surveillance or attempts to portray routine activities as evidence of non-disability. Robinson & Warncke diligently advises their clients to help them navigate these potential pitfalls, protecting their claims and reputations from unfair scrutiny.

Timing and detailed preparation are critical in successfully challenging dual occupation denials. LTD policies usually allow only a brief period—typically 180 days—to appeal denied claims. Robinson & Warncke’s swift and decisive legal intervention ensures crucial evidence is promptly collected, strengthening the client’s position and preserving their rights for appeal.

With their strong track record and specialized expertise in disability law for medical professionals, attorneys at Robinson & Warncke offer much more than mere representation; they provide relentless advocacy. The firm’s legal team understands the nuances of medical practice, the demands placed upon physicians, and the unfair tactics insurers use. By aligning their profound understanding of both medical and legal complexities, Robinson & Warncke ensures that doctors receive the full disability benefits to which they are entitled, enabling them to focus on recovery without undue financial stress.

Protect Your Career and Benefits with Trusted Legal Advocacy

Physicians should not have their rightful disability benefits compromised by insurers’ dual occupation defenses. By partnering with Robinson & Warncke, doctors gain powerful advocates committed to challenging unjust denials, securing financial protection, and delivering the justice they deserve.