Long-term disability insurance is essential for dentists. Dentists are at unusually high risk for disabilities precisely because of the physical demands of patient care. Dentists spend hours doing repetitive work with their hands, often in non-ergonomic positions. This leads to a higher incidence of neck and back problems and repetitive motion injuries like carpal tunnel. Because of the fine dexterity and strength required for patient care dentists it doesn’t take much in the way of impairment to cause productivity to suffer.
Because so much of a dentist’s livelihood relies on being physically capable, it’s understandable that many dentists decide to safeguard their income with an individual disability insurance policy.
But what happens when you file a claim under your long-term disability (LTD) policy, only to discover the insurance company has denied it? Denials can be devastating, particularly if you’re already feeling the financial strain of keeping your practice afloat while you’re out of commission. At Robinson & Warncke, our attorneys understand the unique challenges dentists face and are prepared to help you fight for the benefits you rightfully deserve under your policy. This article explores common denial reasons, why legal representation is so important, how a denied claim can affect your career, and how our Atlanta, GA attorneys at Robinson & Warncke can guide you through the appeals process—and if necessary, litigation—to safeguard your financial well-being.
Understanding the Importance of Long-Term Disability Insurance for Dentists
If you’re a dentist, your ability to work depends on several key factors: your physical health, your manual dexterity, vision, and your capacity to perform precise, detail-oriented tasks for extended periods. A single injury that compromises your hands or wrists can temporarily compromise or even end your career overnight. Chronic conditions affecting your neck, back, or eyesight can also hinder your ability to perform dental work safely and effectively.
That’s why investing in an individual long-term disability policy is often prudent. Unlike group disability plans that might offer limited coverage or certain restrictions, individual policies can be tailored to fit your specific needs and may include “own occupation” clauses. These clauses stipulate that if you can no longer practice dentistry, you will receive benefits—even if you could, in theory, work in some other capacity.
However, acquiring a policy is just the first step. When a legitimate claim is wrongly denied, you’re left dealing with the potentially overwhelming consequences. Suddenly you’re facing mounting bills, staff salaries, and overhead costs—on top of your personal living expenses—all while you’re unable to practice full-time. The stress can feel unbearable, and if the denial isn’t handled promptly and effectively, it may jeopardize not only your financial stability but also the future of your practice.
Common Reasons Insurance Companies Deny Claims For Dentists
Insurance companies often point to several reasons for denying claims—even if those claims are valid. Sometimes they allege that the policyholder provided insufficient medical documentation to prove the severity of the disability. Other times, the denial can hinge on policy definitions, such as whether the policy is “own occupation” or “any occupation.”
If you have an “own occupation” policy, the insurer is supposed to pay out if you can’t perform the duties required of a dentist, regardless of whether you could do some other type of work. Unfortunately, insurers may still argue that you could carry out certain tasks—like administrative duties—that don’t involve hands-on clinical work. This interpretation might lead them to claim you’re not totally disabled, despite the fact that you can’t actually see patients.
Exclusions and limitations buried in the fine print can also become hurdles. Many “own occupation” policies describe the insured occupation as “the occupation or occupations (plural) that you were performing immediately prior to disability.” A very common scenario occurs where dentists run multiple practices, so the insurer concludes you are “dual occupation” as both dentist and owner. Even if you can’t treat patients, the insurer says you can perform your managerial duties. This commonly leads to a finding of partial rather than total disability with a corresponding reduction in benefits. Many policyholders are surprised at this outcome, but disability cases support the insurers position in many circumstances. Managing these claims is complex and esoteric – specialist attorneys should anticipate these issues and assist the policyholder in maximizing benefits.
Most policies also limit mental health coverage and exclude pre-existing conditions, leaving dentists with certain chronic illnesses at a disadvantage if the insurance company attempts to label their condition as “pre-existing.” Additionally, insurance carriers sometimes claim you haven’t followed up with your doctor often enough or that you aren’t receiving the type of treatment they believe you should. This supposed “lack of ongoing care” can give them ammunition to dispute the severity of your disability.
Even minor misunderstandings can lead to denial. When the insurance adjusters don’t fully comprehend your job responsibilities as a dentist, they might assume you’re capable of returning to work. For example, they may overlook how crucial fine motor skills are for routine dental procedures or how standing (or sitting hunched over) for long periods could aggravate spinal injuries.
Why a Denied Claim is Especially Devastating for Dentists
When an LTD claim is denied, the financial and emotional ramifications are immense. If you own your own practice, you likely have multiple monthly financial commitments: office rent or mortgage, staff salaries, equipment leasing or maintenance, and continued loan payments for costly specialized dental machinery. These expenses don’t stop because you’re unable to work.
It’s also worth noting that many dentists are sole practitioners. If you’re out of commission, your entire practice might grind to a halt. Without a consistent cash flow, you may dip into personal savings or take on debt just to keep the lights on. Beyond that, the emotional toll of being unable to care for your patients—while struggling to preserve your business—can amplify stress and even delay your recovery.
A lengthy gap in practicing could also affect your professional standing. If you’re not able to keep up with continuing education requirements or stay involved in new developments in dentistry, it could hinder your eventual return. In some cases, a long or indefinite absence can cause you to lose loyal patients, especially if they’re forced to find another dental provider in the meantime.
How Legal Representation Makes All the Difference
The above examples are a small subset of the complexities dentists face in presenting disability claims. Navigating the claims appeal process on your own can feel daunting. Insurance policies are notoriously complex, full of dense language that can be difficult to interpret. Moreover, insurance companies have teams of adjusters and attorneys trained to protect their bottom line, not necessarily to look out for your best interest.
That’s where a team like Robinson & Warncke steps in. They’re deeply familiar with the intricacies of disability insurance, especially for medical professionals. By engaging experienced attorneys, you signal to the insurer that you take this claim seriously and won’t be easily discouraged by procedural hurdles. Skilled legal representation also ensures you meet strict deadlines that govern the appeal process. If you miss a filing deadline, you can lose your right to challenge the denial entirely.
Attorneys can also assemble a compelling package of medical evidence. This may involve reaching out to specialists who can provide more in-depth assessments of your condition and how it impacts your ability to practice dentistry. Insurance companies often respond more favorably when claimants present thorough, well-organized documentation that aligns with policy requirements.
If all else fails and the insurer still refuses to pay a legitimate claim, Robinson & Warncke can file a lawsuit on your behalf. Taking a case to court isn’t always necessary, but when it is, having a legal team experienced in disability litigation can be the deciding factor in winning the benefits you deserve.
How Robinson & Warncke Guides You Through the Process
When you first connect with Robinson & Warncke, they’ll review your policy to clarify its language and identify any specific clauses that might be relevant to your claim. By understanding whether you have an “own occupation” or “any occupation” policy—and whether there are any exclusions—they can create a tailored strategy aimed at challenging the insurer’s reasoning for denial. They will look at whether you might be at risk for a “dual occupation” finding, even if the insurance company hasn’t brought it up yet. They will consider whether a partial disability claim might be your best bet in terms of overall finances and quality of life. The attorneys act as expert advisors, but the client decides what is the right approach for them.
From there, they’ll help you gather comprehensive medical evidence. This could involve collecting more detailed statements from your physicians, scheduling additional tests or evaluations, and perhaps consulting experts who understand the unique demands of a dental practice. If the insurance carrier argued that you could still perform “limited duties,” Robinson & Warncke will show why that’s not feasible in a real-world dental setting.
They’ll also handle all communication with the insurance company on your behalf, ensuring that nothing you say can be misconstrued and used against you. In many cases, thorough documentation and strong legal advocacy can convince an insurance company to reverse its decision without the need for prolonged legal battles. But if the insurer continues to deny or delay, Robinson & Warncke is prepared to escalate matters—whether that’s filing an administrative appeal or pursuing litigation in court.
Throughout the process, you’ll be kept in the loop. The firm takes a client-focused approach, which means they want you to understand every step and feel comfortable asking questions. The goal is not only to secure the benefits you need but also to relieve some of the stress that accompanies a denied LTD claim.
Consider seeking a consultation early in the claims process.
Many of our clients contact us right up front, when they are thinking about filing a claim. This is the best time to do so, as we can identify pitfalls in your policy and factual issues that need to be clarified. We can identify potential problems before they arise so you can make an informed decision as to whether and how to proceed with the claim. This is almost always better – and cheaper – for a policyholder than waiting for a denial to call an attorney.
Steps Dentists Should Take After a Denial
If your long-term disability claim has been denied, the first thing you want to do is read the denial letter carefully. Look for the specific reasons the insurance company cites, and note any deadlines mentioned for submitting an appeal. Because these deadlines can be incredibly strict—sometimes just 180 days—you’ll want to act quickly.
Next, assemble all the records related to your claim, including medical tests, physician notes, correspondence with the insurer, and your complete insurance policy documents. Share these with an experienced disability attorney, who can assess the strength of your case and advise whether additional evidence or expert evaluations may be needed.
You’ll also want to be cautious about giving any recorded statements to the insurer without your attorney’s guidance. Insurance adjusters might ask leading questions that could undermine your claim, so having professional legal advice can make a major difference in how the insurer perceives your case.
Above all, continue following your prescribed treatment plan. It’s important to show that you’re doing everything in your power to recover, and any gaps in treatment can be used by the insurer to argue that your disability might not be severe enough to warrant benefits.
The Unique Challenges of Dental Disability Cases
Dentists face particular challenges in disability cases because so much of their work is reliant on precise motor skills. Even a slight tremor or reduced grip strength can render performing procedures unsafe for both you and your patients. And because dentistry often requires prolonged periods of bending, twisting, and leaning over patients, back, neck, and other spinal issues are especially debilitating.
The cost of running a dental practice adds another layer of complexity. With ongoing overhead, staff who rely on your payroll, and costly equipment loans, many dentists simply can’t afford a delay in receiving their disability benefits. A protracted denial could force a dentist to close their doors permanently or accumulate large amounts of debt.
Because the stakes are so high, having a legal advocate who understands these nuances is essential. Robinson & Warncke has extensive experience representing not just general medical professionals, but specifically those in highly specialized fields like dentistry. They recognize the critical role fine motor skills play and the extent to which even a seemingly minor injury can end a dentist’s ability to practice safely.
Why Choose Robinson & Warncke
Robinson & Warncke focuses on disability insurance cases, dedicating their energy to understanding the tactics insurers use and the strategies that best serve medical professionals. This specialized approach has allowed them to build a reputation for success in what can be a complex area of law.
They also believe in a client-centered style of representation. You won’t feel like just another case number; you’ll get personalized attention and updates tailored to your situation. The attorneys at Robinson & Warncke know that every dental practice is different, every injury has unique implications, and every insurance policy has its own set of terms and exclusions. That’s why they invest the time to develop a well-researched, customized plan of action for each client.
Finally, they aren’t afraid to push back hard when an insurance company acts unreasonably. If the carrier refuses to negotiate in good faith, Robinson & Warncke stands prepared to take your case to court and present a strong argument to a judge or jury. That kind of tenacity can make all the difference when you’re fighting for the benefits you need to protect your future.
Moving Forward with Confidence
A denied long-term disability claim can turn your world upside down, especially when you’re juggling the demands of a dental practice with the hardships of an injury or illness. It’s easy to feel overwhelmed and uncertain about what steps to take next. But you don’t have to go it alone, and you don’t have to accept the insurer’s denial as the final word.
By partnering with Robinson & Warncke, you gain allies who understand both the legal and practical aspects of fighting for disability benefits. They’ll help you parse through complex policy language, build a robust case backed by medical evidence, and communicate with the insurance company—or even a court of law—on your behalf.
Most importantly, choosing skilled legal representation allows you to focus on healing and recovery. Rather than getting bogged down in paperwork, deadlines, and tense negotiations, you can devote your energy to improving your health and planning for the future of your practice.
If your claim has been denied—or if you suspect your insurance company may be gearing up to deny a legitimate claim—don’t wait. Reach out to Robinson & Warncke to discuss your situation. Our attorneys are ready to stand by your side, advocate for your rights, and ensure that you receive the benefits you’ve paid for and rightfully deserve. Your professional future, financial security, and peace of mind are too important to leave in the hands of an insurance company acting in bad faith or an inexperienced attorney who only dabbles in disability insurance. Let Robinson & Warncke guide you to a resolution that protects your career and allows you to return to what you do best—caring for the dental health of your patients.
