Page 20 - Bulletin Vol 31 No 1 - Jan. - April 2026 FINAL_

Legal Article | Long Term Disability (Cont.)
For example:
• Reporting that you worked reduced hours may be framed as evidence you can sustain work.
• Attempting ergonomic modifications may be portrayed as successful accommodation, even if they
only marginally help.
Downplaying symptoms out of professionalism or optimism may later be cited as inconsistency.
Like most professionals who enjoy their work or are in no hurry to give up their income, dentists try to
work through their condition before filing a claim. While admirable, this approach can unintentionally
undermine the credibility of your disability claim.

The Policy Is the Rulebook—Not Common Sense
One of the most common mistakes we see is assuming the policy will be interpreted reasonably or in
light of real-world dentistry. LTD policies are contracts, and insurers enforce them strictly.
Key provisions that frequently affect dentists include:
• The definition of disability, particularly how your “own occupation” is defined.
• Residual or partial disability provisions, which may reduce benefits based on income or work
activity.
• Mental health limitations, which can cap benefits regardless of severity.
• Reporting and proof requirements, which impose ongoing obligations on the claimant.

How you describe your occupation, your limitations, and your income must align with the policy’s lan-
guage.
Documentation Includes More Than Medical Records
Many dentists assume that strong medical records alone will carry their claim. Medical documentation is
essential, but it is rarely sufficient by itself.
Dentistry involves fine motor control, sustained posture, visual acuity, decision-making under time pres-
sure, and patient interaction. Generic medical notes often fail to capture how a condition interferes with
these specific demands. Occupation evaluations are needed to document the tasks and duties a dentist
must perform as part of their work. An effective LTD claim often requires detailed occupational descrip-
tions tailored to your specialty, clarification of why certain procedures are no longer safe or sustainable
and consistent reporting across providers and forms. Reports must also provide context for fluctuating
symptoms or failed attempts to continue working.
Not knowing how the insurance company will evaluate the medical, vocational, and financial records will
undermine a claim and make an appeal more challenging.
Surveillance and Social Media Can Undermine a Claim
Insurers frequently conduct surveillance, both physical and digital. Dentists are often surprised to learn
that routine activities like driving, shopping, or attending family events can be mischaracterized as evi-
dence of work capacity.
Social media posts, professional updates, and even continuing education attendance may be taken out of
context. A photo from a conference or a post about “staying engaged” with your profession can raise
questions about disability, regardless of pain, fatigue, or accommodations.
The Value of Early Legal Involvement
Many professionals wait to consult an attorney until a claim is denied. At that point, options may be lim-
ited, deadlines tight, and harmful statements already embedded in the record. Early involvement of an
LTD attorney allows for strategic framing of the claim from the outset.
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20 | Nassau County Dental Society ⬧ www.nassaudental.org