Christopher P. Foley, Of Counsel, Michael Hack, Partner, and Claims Paralegal Christine Kingsley
A highly successful New York orthodontist built a thriving practice through years of dedication and expertise. But in October 2024, everything changed. Following serious right knee issues, including anterior cruciate ligament (ACL) reconstruction and medial meniscus repair, the orthodontist was no longer able to perform the precise, physically demanding work that the profession requires.
The practice remained operational by pivoting to general dentistry, with remaining staff members continuing to help patients. But as the orthodontist was unable to continue performing the hands-on, specialized work central to the profession, the individual filed a claim for long-term disability benefits. The insurance company initially approved benefits but subsequently terminated the orthodontist’s claim.
The Challenge
The orthodontist’s initial appeal, handled by prior counsel, was unsuccessful. Despite their efforts, the submission – which was limited in scope – was denied in March 2025. The denial letter, however, offered one final opportunity: an option to file a second appeal.
The Solution
At this point, the orthodontist hired Schwartz Conroy & Hack, PC. We immediately recognized that this case required more than argument; it required strong evidence. Attorneys Christopher P. Foley, Of Counsel, and Michael Hack, Partner, along with Claims Paralegal Christine Kingsley, focused on building a comprehensive, irrefutable record. Our team coordinated evaluations with two trusted experts: a doctor specializing in physical medicine and rehabilitation, who thoroughly examined our client, and a physical therapist, who conducted a functional capacity evaluation. Both professionals independently reached the same conclusion: given the knee’s condition, the client could not safely or effectively perform orthodontic procedures.
We then structured the appeal around that evidence, presenting the medical findings in a clear, organized manner that aligned with the insurer’s requirements.
What followed was a familiar pattern: delay. The insurer issued a steady stream of requests, primarily for financial documentation, to confirm that, although the practice continued to operate, our client was not working. Tax returns, profit and loss statements, and operational records were requested in waves. Each of our submissions was met with another request.
We remained disciplined and responsive. But when the process became circular, we drew a clear line: The record was complete. It was time for a decision.
The Result
Shortly thereafter, the insurer reversed course. Faced with sound legal arguments backed by irrefutable evidence, the insurer realized it had no choice but to grant our client’s appeal. Because of our expertise, thoroughness, and persistence, we forced the insurance company to pay the full disability benefits it owed to our client.
If your disability insurance claim has been denied or is being challenged, contact Schwartz, Conroy & Hack, PC. We have the expertise and tenacity to make insurance companies keep the promises they made to policyholders like you.
