Long-Term Disability Insurance Attorneys for Dental Assistants
Dental assistants and hygienists play vital roles in improving our overall oral health. The job’s chairside nature makes it more customer-facing than some other professions. A severe injury or medical diagnosis can change the course of a dental assistant’s career.
If you can’t work due to a disabling injury or health condition, you might qualify to receive long-term disability (LTD) benefits. The Abell and Capitan Law team has helped clients in the dental field understand their disability insurance policy, apply for benefits, and appeal denied claims. We’re ready to answer your questions in a free legal consultation. Call our Kentucky or Pennsylvania offices at (267) 419-7888 today to speak with an occupational disability attorney.
All About LTD Insurance for Dental Assistants
Many dental clinics enroll their providers and staff in a group long-term disability policy along with other benefits. If your employer doesn’t offer group LTD insurance, or if you desire additional coverage, you can enroll in an LTD policy on your own.
What qualifies as a “disability” will depend on your insurer’s specific terms. Generally speaking, there are two types of disability policies:
- Own-occupation policies – Under these plans, you could qualify for benefits if a disability stops you from performing any duties within your current job. However, insurers can still improperly deny claims based on how they interpret “own-occupation.”
- Any-occupation policies – Under these plans, you could qualify for benefits if a disability stops you from working in any gainful role. Insurers might deny your claim if they believe you could work in another field.
The terms of an LTD policy can change over time. For example, a policy might begin as “own-occupation” and transition to “any-occupation” after five years. When you enroll in an LTD plan, your insurer will give you a document outlining your policy’s scope. If you have questions on the more technical jargon, an attorney can offer clarification and advice.
Why Might a Dental Assistant Seek Long-Term Disability Benefits?
Dental assistants use fine motor movements, keen eyesight, and quick thinking each day they’re on the job. If you’re in the dental field, any of these conditions could hinder your ability to work:
- Eye problems – If an injury or illness affects your vision or even renders you blind, you might qualify for benefits.
- Joint issues – Dental assistants commonly face repetitive strain injuries in their arms and hands, such as carpal tunnel syndrome, tendinitis, and arthritis. Each of these conditions causes pain and limits the range of motion.
- Back pain – Long periods of bending or sitting on a stool can cause back pain, severely impairing a dental assistant’s comfort and job performance.
- Balance disorders – Vertigo, Meniere’s disease, and other balance disorders affect how well dental assistants work while standing.
- Mental health problems – Stress, anxiety, and depression can affect a dental assistant’s abilities and performance on the job.
Why Might My Claim Have Been Denied?
Like other businesses, insurance companies want to make profits and minimize losses. They will not hesitate to protect their bottom line if they believe denying a claim would be justified. Some reasons an insurer might issue a denial include:
- Disability is pre-existing – An LTD insurer will deny your claim if you become disabled before the policy’s start date.
- Disability does not qualify for benefits – Your policy’s documents will state what constitutes a “qualifying disability” and what is excluded.
- Disability happened under specific circumstances – Sometimes, even if an injury would otherwise qualify, an insurer could still deny a claim based on how it happened. This might be the case if a worker was under the influence of alcohol or drugs when the accident occurred.
- Insufficient evidence – A policyholder must submit supporting evidence for their LTD claim. If an insurer doesn’t believe the evidence is enough to justify paying you benefits, they will deny your claim.
- Not following treatment – An insurer might deny you benefits if they believe you’re not adhering to your doctor’s recommended treatment.
Sometimes, an insurer misinterprets a policy or disregards its internal procedures. If your claim was denied due to errors or improper conduct, and if the insurer does not rectify the situation, we recommend hiring an attorney as soon as possible.
How Do Long-Term Disability Appeals Work?
If your insurer has denied your claim, you can file an appeal and ask them to reverse their decision. You’ll need to provide additional evidence, such as:
- Medical documentation – Records from your treating physician can tell the insurer more about your condition and how it affects your lifestyle. Sometimes, an insurer will reverse a denial after seeing new medical information.
- Written statements – Your healthcare professionals, family members, and colleagues can discuss how a disabling condition has affected your lifestyle.
- Expert statements – Medical and vocational experts can provide an authoritative perspective on your condition’s effects.
In most situations, you’ll have 180 days to file your appeal. The insurer will then have 90 days to respond. Some insurers have only one level of appeal, while others have more.
How Can an Attorney Help Me?
Our team recognizes the complexity of each LTD claim, and we aim to guide you through each step of the process. Some ways we can help include the following:
- Consultations – We can help you interpret your LTD policy and determine if you might qualify to receive benefits.
- Applications – You’ll have the best odds of a successful claim with an attorney on your side. We can work on your behalf to collect supporting evidence and submit application papers to your insurer.
- Appeals – Whether your initial LTD claim got denied or an insurer stopped paying you benefits, we can investigate the reason for the denial or change and represent you in the appeals process.
- Disability litigation – Federal law protects you against insurance companies that act in bad faith or improperly deny a claim. If you have exhausted your appeals, you might be able to file a lawsuit for the benefits you need.
Consult a Dental Assistant LTD Attorney
If you can no longer work as a dental assistant due to a debilitating injury or illness, contact the attorneys of Abell and Capitan Law to learn more about your legal options. With offices in Louisville and greater Philadelphia, we’re proud to help Pennsylvania, Kentucky, and New Jersey residents with their LTD claims. For a free consultation, call us at (267) 419-7888 today.