Physical Therapists and Their Disability Claims

Welcome to Season 5, Episode 14 of Winning Isn't Easy. In this episode, we'll dive into the complicated topic of "Physical Therapists and Their Disability Claims."

Join attorney Nancy L. Cavey, a leading expert in disability claims, for an insightful discussion on the unique challenges physical therapists face when it comes to Long-Term Disability benefits. From the daily occupational hazards to the kinds of injuries and conditions that can end a career, today’s episode dives into what happens when the healer becomes the patient. We’ll break down the real-world risks physical therapists face, how specific disabilities can impact your ability to perform your job, and what you need to know to successfully navigate the claims process. Whether your coverage is through an employer, a professional association, or an individual policy, this episode is packed with essential guidance on protecting your income and your future.

In this episode, we'll cover the following topics:

One - Occupational Hazards for Physical Therapists

Two - Disabilities That Can Sideline a Physical Therapist

Three - Long-Term Disability Benefits for Physical Therapists

Whether you're a claimant, or simply seeking valuable insights into the disability claims landscape, this episode provides essential guidance to help you succeed in your journey. Don't miss it.


Listen to Our Sister Podcast:

We have a sister podcast - Winning Isn't Easy: Navigating Your Social Security Disability Claim. Give it a listen: https://wiessdpodcast.buzzsprout.com/


Resources Mentioned in This Episode:

LINK TO ROBBED OF YOUR PEACE OF MIND: https://mailchi.mp/caveylaw/ltd-robbed-of-your-piece-of-mind

LINK TO THE DISABILITY INSURANCE CLAIM SURVIVAL GUIDE FOR PROFESSIONALS: https://mailchi.mp/caveylaw/professionals-guide-to-ltd-benefits

FREE CONSULT LINK: https://caveylaw.com/contact-us/


Need Help Today?:

Need help with your Long-Term Disability or ERISA claim? Have questions? Please feel welcome to reach out to use for a FREE consultation. Just mention you listened to our podcast.

Review, like, and give us a thumbs up wherever you are listening to Winning Isn't Easy. We love to see your feedback about our podcast, and it helps us grow and improve.

Please remember that the content shared is for informational purposes only, and should not replace personalized legal advice or guidance from qualified professionals. 

Transcript

Nancy Cavey [00:00:00]:
 Foreign hey, I'm Nancy Cavey, national ERISA and IDI disability attorney. And welcome to this week's episode of Winning Isn't Easy. Before we get started, I have to say this. I have to give you a disclaimer. This podcast is not legal advice. The Florida Bar association says I have to say this. And now that I've said it, nothing will ever prevent me from giving you an easy to understand overview of the disability insurance world, the games that disability carriers play, and what you need to know to get the disability benefits you deserve. So off we go.
 
 Nancy Cavey [00:00:43]:
 Now, today's episode is going to be dedicated to some of my favorite people in the world, physical therapists and the unique challenges they face when it comes to long term disability claims. Being a physical therapist takes years of dedication and hard work. And you spent countless hours in school, in clinical rotations and professional development to help people like me recover their functionality and improve their quality of life. But what happens when you are the one who gets hurt or develops a condition that limits your ability to perform your job? You find yourself on the other side of the table facing the prospect of a disability claim. So today what I want to do is break down what you need to know about long term disability claims and the benefits that you might be eligible for. And we want to focus on the types of disabilities that can sideline you, how to navigate the claims process. Whether you've got insurance through your employer, a professional association, or an individual policy going to provide you with some guidance on how to make sure you're covered and how you can protect your financial future. So I'm going to talk about three things today.
 
 Nancy Cavey [00:01:53]:
 Number one, the occupational hazards for physical therapists. Number two, disabilities that can sideline a physical therapist, and three, long term disability benefits for physical therapists. Got it? Now, even if you aren't a physical therapist, I think you should be listening to this because these are common problems that people will have regardless of your occupation. And you can learn lots about the games that will be played in the disability claims process. But let's take a break. All right.
 
 Speaker B [00:02:26]:
 Have you been robbed of your peace of mind by your disability insurance carrier? You owe it to yourself to get a copy of Robbed of your peace of Mind, which provides you with everything you need to know about the long term disability claims process. Request your free copy of the book@kvlaw.com today.
 
 Nancy Cavey [00:02:50]:
 Welcome back to Winning Isn't Easy. Let's talk about the occupational hazards for physical therapists. Now, physical therapy is undoubtedly one of the most rewarding careers I think it allows you to directly improve a patient's lives by helping them regain their mobility, reduce pain and restore functionality. However, as with many healthcare professions, physical therapists face a unique set of occupational hazards. And in this section, we're going to take a dive into what those hazards are, why they pose a risk, and how they can lead to a long term disability claim. Now, I have had multiple knee surgeries, a failed knee replacement, revision of my knee, actually two revisions of my knee and surgeries after the revisions. And I spend a lot of time with physical therapists and I obviously get to see what it is you guys do. I know as a physical therapist, your day is often physically demanding.
 
 Nancy Cavey [00:03:48]:
 From the moment you begin your work day until you leave, you're on your feet, you're bending, you're squatting, you're moving patients in ways that require a high level of physical strength, endurance and flexibility. So whether you're assisting a patient in performing exercises, demonstrating proper movement techniques, using manual therapy to alleviate pain, or other therapy modalities, your body is constantly under strain. Over time, the repeated physical movements can lead to cumulative injuries that might sideline you. So let's take the spine, for example. Physical therapists frequently perform motions such as bending, twisting and lifting that leads to stress on the back. Herniated discs and low back pain are two of the most common musculoskeletal disorders that I see in physical therapists. And they can be debilitating, causing severe pain, difficulty bending, and even nerve issues that cause radiculopathy into your legs. Now, the shoulders and arms are another area prone to overuse injuries, rotator cuff injuries, tendinitis, carpal tunnel syndrome.
 
 Nancy Cavey [00:04:54]:
 They can develop over years of working with patients who require hands on manipulation. I know that these injuries can be frustrating because they often start as minor discomfort. They then can evolve into severe pain that limits your ability to use your arms or shoulders for therapy. In fact, one of my physical therapists injured himself motorcycle accident, injured both shoulders and had rotator cuff tears and was out of commission for about seven months. So obviously those kinds of acute injuries can cause disability. But more often than not, I see this repetitive trauma type condition develop. Now, I find them particularly involving the wrists and hands. That's because you're doing repetitive motions, you're manipulating patients, you're adjusting equipment, and obviously if you can't use your wrists or hand, that is going to be a significant impediment to your ability to practice as a therapist.
 
 Nancy Cavey [00:05:53]:
 Now, it's not just the physical nature of the job that can cause strain Physical therapists also experience mental fatigue, particularly when they deal with patients that may not be improving at the pace that they or the patient would like and the mental and nervous emotional toll. Seeing patients in pain working under pressure can really take a toll over time. I find that it's no surprise that physical therapists are at an elevated risk of developing work related musculoskeletal disorders, but also conditions like depression and anxiety. We know that these risks can impact your ability to continue working at full capacity and in some cases they may be severe enough to require a disability claim to protect not only your health but your livelihood. Because after all, you have spent a lot of time learning your occupation and you do make a difference in patients lives. We live in physical therapists office, appreciate what it is you do and we want you to continue to work. So hopefully we now have set the stage for the nature of the medical conditions that we find disabled to physical therapists. Let's take a break and when we come back, I'm going to talk about the specific disabilities that can sideline a physical therapist.
 
 Nancy Cavey [00:07:13]:
 Got it. Let's take a break. Welcome back to Winning Isn't Easy. Let's talk about the disabilities that can sideline a physical therapist. Now we've talked about the risks that a physical therapist can face in terms of their physical and emotional demands from the job. But I want to explore the specific disabilities that can sideline you from performing your duties. Whether it's a sudden injury, like my physical therapist who was involved in a motorcycle accident, or a gradual development of chronic pain, I find that these conditions can become debilitating and can have a serious impact on your ability to do your job. So let's start with the most common one.
 
 Nancy Cavey [00:08:05]:
 I see a herniated disc in the low back. And you know, because of the demands of your occupation, the lifting, the patients, the bending, the twisting, your spine is under a great deal of stress. A herniated disc can cause severe pain and numbness and it can be causing you difficulty not only sitting but standing like your occupation requires. I find that those therapists who have herniated discs, particularly with radiculopathy, find it nearly impossible to continue performing manual therapies or to be on their feet for an extended period of time. I also find rotator cuffs to be common among tears and injuries to be common among physical therapists, especially those who are engaged in a lot of manual therapy. Obviously, the rotator cuff can limit your ability to move your arms, lift objects, even assist patients, and repetitive overhead motions of lifting and stretching and guiding patients do increase the likelihood of this injury. Now, another debilitating condition I find is arthritis, particularly arthritis of the wrist and the fingers, knees and the hips. I think you're particularly vulnerable to developing osteoarthritis in your hands and wrists due to the constant use of your hands to manipulate or to use equipment that, as you know, can cause pain, swelling, stiffness and loss of function and, and that can really impact your ability to perform your occupation.
 
 Nancy Cavey [00:09:31]:
 I find that physical therapists also can have chronic pain, much like the patients that they're treating. And that can cause lack of sleep and cause stress. And the pain can interfere with your ability to concentrate and focus. So you might struggle to be alert to make decisions during patient care. And you certainly don't want to jeopardy, jeopardize the safety of your patient or affect the quality of care. It's just not the physical pain that can impact your ability to do your occupation, but it's those other conditions. So I want you to understand that as you do that many of these conditions will not resolve on their own without proper treatment. Meaning that if you have the ability to collect shorter long term disability benefits, you might want to file a claim because after all, you are telling your patients that they need to take the time to recover and you need to take the time to recover.
 
 Nancy Cavey [00:10:28]:
 You need to take your own advice. And that ultimately might mean applying for benefits. So in my next segment when we come back, I'm going to talk about long term disability benefits for physical therapists. Got it. We'll be back in a second.
 
 Speaker B [00:10:44]:
 Are you a professional with questions about your individual disability policy? You need the Disability Insurance Claim Survival Guide for Professionals. This book gives you a comprehensive understanding of your disability policy with tips and to dos that will assist you in submitting a winning disability application. This is one you don't want to miss. For the next 24 hours, we are giving away free copies of the Disability Insurance Claim Survival Guide for Professionals. Order yours to today@disabilityclaimsforprofessionals.com.
 
 Nancy Cavey [00:11:22]:
 Welcome back to Winning Isn't Easy. Now, as a physical therapist, you have patients who have been involved in motor vehicle accidents and they're dealing with a claim against the insurance company. You probably have workers compensation clients who have been sent to you by the workers comp carrier and you're dealing with forms and you may have patients who are claiming Social Security disability benefits. And again, there's lots of forms, not necessarily forms that you're involved in, but there's also disability insurance claims. And so you might have some clients who are actually on short or long term disability benefits. And I'm positive you've heard all sorts of complaints from all four of those groups about the claims process. Now, the claims process is unique. What you have to prove in a motor vehicle claim is different than what you have to prove in a workers comp claim, which is different than what you have to prove in a Social Security disability claim, which is different than what you have to prove in an ERISA disability or IDI disability claim.
 
 Nancy Cavey [00:12:33]:
 So let's put aside your notions or understanding of those types of disability claims clean slate. Now, you may have gotten your disability insurance policy one of several ways. You might work, for example, a hospital and that hospital is offered you as a benefit, short and long term disability benefits. If that particular hospital is church affiliated. It may not be what's called an ERISA disability plan or but the concepts are the same. Now you also might be eligible, as many of my clients are, to have a policy through a physical therapy professional association that is probably not an ERISA disability plan. And if you have bought your own disability policy through an agent that's called an individual disability policy that is generally governed by state law as opposed to the ERISA federal law that will govern employee provided benefits and professional association benefits. So the two carve outs are going to be, hey, ERISA disability, most likely an employer provided plan or policy, so long as it's not a church plan.
 
 Nancy Cavey [00:13:54]:
 And over here you have a policy offered by a professional association, probably an ERISA policy. On the other hand, you've got a policy that is being offered to you by your employer, but they're a church based, probably not erisa. And certainly if you've gone out and bought your own IDI policy not governed by erisa, those two would be governed by state law. But regardless of what law is applicable, and that is important to know, the first step in this whole process is getting your disability insurance policy or plan. You have to really understand the terms and conditions of your coverage. Because there is no uniform disability policy or plan. Many disability policies or companies like Unum have multiple versions of the same policy or plan. This isn't like a workers comp statute where the statute is a statute and there's some case law that interprets it.
 
 Nancy Cavey [00:14:53]:
 Every policy or plan is different. So we want to start out by getting it and we want to read it cover to cover. One of the things that we want to understand from the very beginning is is there what's called an elimination period? You have to wait a certain Period of time before you can actually collect your benefits. Some policies or plans will have like a 90 day waiting period where you're on your own for the first 90 days. Another important element is the definition of disability. Now why is that important? Some policies or plans will define disability as the inability to perform your own occupation. Which means that if you're unable to do your job duties as a physical therapist due to injury or illness, you qualify for the benefits. But there are other definitions.
 
 Nancy Cavey [00:15:42]:
 The inability to do the material and substantial duties of your occupation can also be a definition. So sometimes carriers might say, well, charting is an important duty and you can do that so you're not disabled. So again, it really is important that you understand what that definition of disability is and definition of occupation. Now what will often happen is that after two years, the policy terms will change from an inability to do your own occupation to an inability to do any occupation. And that period of time that two years can differ from carrier to carrier. Could be one year, could be two years, could be five years. But what happens is that the definition of disability changes from an inability to do your own occupation to an inability to do any occupation. And that means that if you're able to do any other type of work, particularly of a sedentary nature, you may not be qualified, you may not qualify to receive your benefits.
 
 Nancy Cavey [00:16:41]:
 You may. Now again, occupation is important because that definition can be based on how you're performing it, how it's performed for your employer, how it's performed in the national economy, how it's performed. Consistent with the Dictionary of Occupational Titles, four different tests to how occupation is defined. But you don't know that until you read the policy or the plan. Now, hopefully you have a policy or plan that provides what's called residual disability benefits. If you can't work full time, but you can work part time, you might be eligible for residual disability benefits. And that's particularly true with some of my self employed physical therapy folks who have residual disability benefits in their plan. I know that there are not a lot of self employed physical therapists left these days.
 
 Nancy Cavey [00:17:32]:
 But regardless if you are, if you have a policy or plan that provides residual disability benefits, potentially you can work and collect benefits. You are going to have to submit tax returns, pay stubs, records of that lost income, including, you know, your billing records. Billing records obviously will be confidential, but you might be able to get part time benefits while you're working in a reduced capacity. Now the other thing you need to understand is before you stop working and apply for benefits, is that there are policy terms that can impact how much you get. You might be eligible for Social Security disability benefits and your carrier is going to say you have to apply for these benefits and if you don't, we're going to act as if you're getting those benefits for you and your minor children and we're going to reduce your disability benefits by the receipt of that Social Security. Similarly, if your disability is caused by workers compared condition like repetitive trauma or an acute accident or injury, many disability policies or plans will reduce the payment of benefits by what you get for lost wages for your workers comp claim. And again, each policy or plan is unique and some are broader than that. If you were involved in a motor vehicle accident, you can expect that there is a other income offset provision in there that says if you collect or get benefits, we get the right to reduce your long term disability benefits by whatever you get.
 
 Nancy Cavey [00:18:59]:
 Now that again is a unique term in every policy or plan. Some will say, hey, if the settlement that you get or the money you get is for lost wages, that's all we're going to reduce your long term disability benefits by. Others are broad. If you get a settlement that includes compensation for past medical or future medical, the carrier plan may say we still have the right to an offset. Again, it comes back to the terms of the policy or the plan. So you can see that you need to understand the terms of the policy or the plan. Picking the right date to apply for benefits is also crucial. And what's in your medical records is really crucial because if you pick a date that's not supported by your medical records or your doctor doesn't support your claim, that can be a non starter.
 
 Nancy Cavey [00:19:47]:
 Right out of the gate. You, in the course of your profession take an interval history, you ask the patient, well, how are you doing? Did you get any benefit from it? And they'll tell you all sorts of things that carrier would love to know and which they can use to ultimately deny or terminate benefits. It's really crucial that you're giving a very good interval history of your symptoms and functionality. Symptoms, functionality. So you should know that because ultimately what the carrier is looking for, the plan is looking for, is consistency between what it is you say you can't do, what you're reporting to the doctor, what you may be doing on social media and please turn it all off and what your doctor has to say. Because many times disability carriers or plans will say this is inconsistent or you're taking too long to recover and we think you should have recovered by it. Now, what you're doing is inconsistent with the level of pain or the level of the restrictions and limitations that the doctor has assigned. So again, you know this as a medical professional.
 
 Nancy Cavey [00:20:47]:
 It's documentation, it's consistency. You can see that having an attorney help you apply for benefits and manage this claim can be really crucial because there are some mistakes that you can make that cannot be fixed after the fact. The attorney can make sure that the claim is properly documented and filed, assist with required medical and financial records, and you can probably anticipate your statement will be taken. You may have had your deposition taken. It is like a deposition, but you're on the hot seat. And what you have to say can impact whether you get your benefits and how long you get your benefits. So you want to have an attorney who will help you prepare for that statement. Obviously, at the end of the day, you need an advocate on your behalf in the event that your claim is denied or ultimately your benefits are terminated.
 
 Nancy Cavey [00:21:38]:
 Got it? Well, I hope that you have found this episode helpful and insightful as to the nature of the disabilities that we see in the ERISA world involving physical therapists, how to go about filing a claim, learning what your policy or plan has to say, and creating a strategy to submit not only a winning application, but to stay on claim. So you can see that this is complex, but you're used to complex things. You may be tempted to try to do it yourself because after all, you're a physical therapist and a medical professional, but you don't understand insurance law, ERISA law, the kinds of proof that is required, the consistency that's required, and how to manage your own claim. Yeah, I know you've talked to insurance companies about the benefits and dealt with claims, but this is a different animal, so please don't try to do it by yourself. If you found this episode helpful, please take a moment to like our page, leave a review and share it with your family and friends. And of course, subscribe to this podcast. If you have any questions about your rights to your ERISA or IDI disability benefits, please feel free to give us a call at 727-894-3188. We do handle claims across the United States and we're familiar with with every disability carrier plan in the United States.
 
 Nancy Cavey [00:22:56]:
 So got it. Hope you found this helpful. And please, we hope that you subscribe to this podcast and we look forward to having any questions that you have presented to us so that we can help you navigate this process. Thanks.