Connecticut Court Rules Dentist is Partially Disabled under Northwestern Disability Policy Because He Can Perform Some Dental Procedures
Dr. Eric Klein, a practicing dentist, was insured under two disability insurance policies with Northwestern. Both policies defined total disability as being unable to perform one or more of the principal duties of his occupation.
Dr. Klein suffered nerve damage to his non-dominant left hand that left him unable to practice dentistry in the same capacity as he did prior to the injury. So, Dr. Klein filed for disability benefits based on his injury. He and his doctor advised Northwestern that he is limited in the types of procedures he can perform, has to contort his body in different ways and requires an assistant at all times.
Based on the information from Dr. Kelin and his doctor, Northwestern approved his claim but for partial disability as opposed to total disability.
What does principal duties really mean?
Under the policies at issue, the ability to perform some of the principal duties of dentistry left Dr. Klein partially disabled. Since he was able to perform dentistry in some fashion, even though it was not at the same level as before his injury, Northwestern determined he was partially disalbed.
One notable question that remains unanswered is what are the principal duties? In a case like this, it is important to clearly and definitively define what principal duties define the occupation. Perhaps Dr. Klein could perform some duties of dentistry but it was never clear whether those duties were principal duties. That could have changed the course of his claim.
Our goal as disability insurance attorneys to understand that kind of nuance and use it to our advantage. We have handled similar cases - total vs partial disability - and use our experience to push back on the insurance company to clearly define what the occupational duties entail. There should be no gray area in a case like this.
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Because we specialize in long term disability, our clients get the benefit of:
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