The Challenge
A dentist was entitled to $35,000 in total monthly benefits from several disability insurance policies – three individual long term disability policies, three business overhead expense disability policies and a disability policy to cover a business loan.
However, when first coming to Schwartz, Conroy & Hack PC, the dentist had been out of work due to disability for three years and had not yet submitted a claim, or even a notice of a claim, to the insurance companies. Further, despite a series of medical issues, the client did not have a diagnosis or a doctor supporting the claim of impairment. So we were faced with two challenges: one, the client was late in moving forward with the insurance companies, which have deadlines. And two, we needed to figure out what was wrong with the client to cause this inability to continue working.
The Solution
We sent the client to a series of doctors for evaluation. Ultimately, we were able to establish that the client was suffering from neurocognitive impairment and, secondarily, from psychiatric issues, including depression. The client saw a neurologist, who performed a comprehensive neurological exam, which included an FDG (fluorodeoxyglucose) PET scan of the brain. This state-of-the-art test has diagnostic and prognostic utility in evaluating patients with cognitive impairment. The test, which revealed brain deficits consistent with cognitive decline, provided objective evidence in support of the client’s symptoms and the neurologist’s diagnosis. Additionally, the client was evaluated by a psychiatrist, who concluded that the client was suffering from depressive symptoms and mood disorder secondary to cognitive impairment.
We worked with the client to submit the disability claims, which were now supported by diagnoses, doctor statements and objective test results. The insurance companies conducted detailed investigations, including field interviews with the client, which we managed on the client’s behalf. Further, we were able to navigate around the fact that the client was late in submitting the claims.
The Result
Ultimately, the insurance companies approved the claims on all of the policies, and our client began receiving and continues to receive $35,000 per month. By assisting our client in obtaining diagnoses and objective evidence in support of the impairment and advocating for our client throughout the insurance companies’ investigation processes, Schwartz, Conroy & Hack was able to ensure that the insurance companies kept the promises they made to our client. If you are having a similar issue, contact us today for a free consultation.
Evan S. Schwartz
Founder of Schwartz, Conroy & Hack
800-745-1755
ESS@schlawpc.com