Dentistry Uncensored with Howard Farran

How to perform dentistry faster, easier, higher in quality and lower in cost. Subscribe to the podcast: https://podcasts.apple.com/us/podcast/dentistry-uncensored-with-howard-farran/id916907356

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Howard: It's just a huge honor today to bring in Ed, Edward O. Comitz Esquire he's a nationally regarded for his disability practice an unparalleled track record of success over the last 26 years his practice is unique unlike other disability attorneys he only represents professionals dentists physicians executives but 1% has just dentist?

Ed: I would say probably 75%

Howard: Yeah they're very rare, it's a great treat for assay but as he will discuss most of his clients are dentists that is consistently named on the top 500 business leaders here in Arizona by Arizona business magazine. His firm is ranked number one in healthcare at Arizona over national firms because of his niche professional disability practice and has sought out for his expertise in the industry and media outlets such as the Wall Street Journal and US News and World Report reach out to him when they have questions about our industry and developments we've had Ed on the podcast before and it's always great to get his input on what's going on in the disability industry and specifically how dentists are impacted that's also done some CE's on articles on dental town that are available in dentaltown.com and is working on another CE article for our continued education for dentaltown that will be coming out in the next few months he's got a BA in journalism from Creighton University that's where I went great school and a Juris Doctor from Seattle University does that mean you're a Seahawks fan?

Ed: Yeah

Howard: Are you oh my god cancel the show the podcast is just officially ended so how are you doing Ed?

Ed: I'm doing really great.

Howard: Thanks for coming back on the show

Ed: Thank you

Howard: Everybody it's one of those things that you never want to think about because you don't want it to happen I mean you didn't go to school eight years so you could be disabled so how so the first thing I want to start out since we have so many kids in dental school still watching this show how likely is it that someday you're really gonna need disability insurance?

Ed: I think for dentists it's it's a usually likely

Howard: Unusually likely?

Ed: Yes because uh you know I'm an attorney and so it's it's it's highly unlikely that I would ever be able to qualify for disability unless I were in a freak accident or I became paralyzed or something like that you can chop off my limbs I could have my head I can think I can talk I can still work with dentists there are two things that really kind of impact their their need to have disability insurance one is just the occupational hazards associated with dentistry so the majority of my clients have musculoskeletal issues who are dentists that are related to using vibrating instruments being in hunched positions for long periods of time you know working within just a small cavity of the mouth for long periods of time your surgeons but unlike other surgeons who work one or two days a week in surgery you're working eight hours a day in surgery so the vast majority of my clients have conditions like degenerative disc disease of the cervical or lumbar spine or they'll have repetitive use injuries carpal tunnel syndrome ulnar neuropathy essential tremor that sort of thing no unfortunately those types of conditions are easily undercut by the insurance industry because there's often not a lot of objective proof of the disability so for example I was in an accident when I was 40 I hit my head bluntly on the ocean

Howard: Scuba diving?

Ed: Trying to surf

Howard: Trying to surf

Ed: I was surfing yeah and and so I her needed two discs in my neck and there was some spinal cord involvement and so I still have some numbness on the left side of my body I have a double discectomy infusion and you know in my neck it took the doctors a long time to figure out where they would do the fusion because you know I have other herniated discs in my neck too and they have to figure out you know which disc is contributing to the problem so I had to go through steroid injections and you know a lot of imaging to try to figure things out for dentists who have cervical issues you know the insurance company realizes that everyone who's over 40 or 45 is going to have degenerative changes in their neck and so how can you show that this MRI definitively proves up that you have this condition that it's affecting a nerve and exactly how much pain you're feeling or how much of a limitation you have because of this condition so the companies try to take advantage of some of that you know lack of objective proof same is true of things like an essential tremor there's very little you can little in terms of objective evidence to prove that you have a term or you have to look at things like you know familial history you have to videotape the person who has the tremor that that sort of thing so you know for dentists, it should be easy for you to collect because you are surgeons and I think the second group of people who I represent besides dentist are you know physicians who are surgeons and that's because with a dentist if you have an essential tremor or you have cervical radiculopathy and you have numbness in your hands and that sort of thing there's a date there's a danger to your patients and so what happens is you know I have a client from New York who had radiculopathy from cervical degenerative disc disease and she dropped a small instrument in a patient's throat and the patient aspirated and died and even as experienced

Howard: A dentist?

Ed: Yes and as extreme as that is she got pushed back from the insurance company you know and so this isn't like you know...

Howard: How long who was that?

Ed: That was about ten years ago.

Howard: Wow did it make the newspaper?

Ed: It did not it did not make the newspaper it was an elderly woman and she didn't, you know her family didn't pursue any.

Howard: You know just real quick not to deviate too far but I'm what percent of MD's there's a million MDS license in America $211,000 what percent of MDS are really like dentists were there they're primarily surgeons versus what percent of MD's don't ever use her hands in surgery?

Ed: I mean I think a lot of MDS don't use their hands I mean even if you go to a family practice doctor or your internal medicine...

Howard: Do you know the percent?

Ed: I don't know the percentage

Howard: Well you think it's 80/20 or less than that

Ed: Surgery I would say I think probably surgeons were probably like maybe ten percent.

Howard: Yeah that's why I know in this country you're not allowed to say anything good about the old Soviet and the if they you know even though they fluoridated their water in Moscow you know they can't do anything right but what I see in the Soviet Union model where the dentist is just especially out of medicine so we go to the same four years undergrad we go to the same two years a medical school then you decide you're gonna be a dermatologist I decide I'm gonna be a stomatologist and then down the road if I decide I can't do stomatology for whatever and I want to be a dermatologist you know any I just go back to med school I've already got my six year track and I do another residency right and that is just not available in the United States and I just think it I wish it was.

Ed: It's difficult I mean if you are a dentist and you've worked for you know however many years to become a dentist and to specialize then if you can't do it, you don't have a lot of great great options I mean my clients who have filed disability claims have ended up doing things that are more like esoteric like you know becoming you know getting involved in real estate or teaching at the dental school I mean at the dental schools here you know you know half the school are people who ever represented before.

Howard: Oh really?

Ed: Yeah so I think that you know you don't have the ability to kind of specialize and in something else you can go back to school and just take you know a couple more years and you know not be a dentist and be some other sort of specialist.

Howard: You think it'll ever and like say a century from now do you think it'll ever be more transferable back and forth like the Soviet Union ones?

Ed: I mean it makes sense for it to be I don't understand why they're the two different tracks I think that you know when it comes down to it I mean dentists do more surgery than probably any other you know occupation within both you know you know MDS and DO's.

Howard: I know we sit in an operatory.

Ed: That's you know eivol they're just enormous amounts of time I think it's you know it's very difficult and you probably know more about surgery then you know a lot of you know surgeons because you I mean at least from the practicalities perspective because you see it every day all day.

Howard: Yeah so yeah it's tough because I'm we're basically like professional athletes I mean we're one you know these guys in hopefully it's the Seahawks not the Cardinals but you're just one tackle away from blowing out a knee and are losing an eye I had a teacher in dental school who lost a left eye so he no longer had 3-dimensional view and then so he was condemned to a life of instructor.

Ed: Right right I mean but it doesn't have to be that severe I mean when you think about it if you're a dentist and you have an essential tremor and you know essential tremors will often not not only affect your hand but they'll affect your your head and you can't you know hold an instrument steady and your patients are looking at you and your head is moving and your hand is moving well you can't be a dentist and so what the companies try to do is they try to look at you and say well you know how can we undercut this dentists claim and potentially not pay them I mean when you're talking about disability insurance when you file a claim there's an analyst there's an attorney and there's a doctor that are all involved on your claim and so it's not like life insurance where you provide a death certificate and they're automatically going to pay you so deep so the policies when I first started practicing almost 30 years ago used to be like five pages long well now they're like 40 pages long so the attorneys look for things in the policies that might impact your ability to collect the doctors talk to your doctors they try to figure out ways to like maybe not not have you get paid and and the analysts do things like you know do surveillance do interviews visit your office that sort of thing so what's important here is that I think that the insurance companies for a long you know in large part ignore what dentistry what is required of dentistry so when I dippose you know high-ranking people at you know in the claims departments at these various insurance companies and I'm saying okay so you say this dentist just got an essential tremor can do an implant or he can do what they don't even know there's like well he can practice dentistry because no one knows exactly I mean everyone has this like very crude perception of what a dentist does you know and so I'm like well you know tell me about implants or tell me about you know seating a crown and what types of instruments are used and what's the importance of holding your hand steady and do you have to have a you know up you know go on when you're doing this procedure you don't and they don't know the answers to any of those questions and they what they do is they tried to focus in on the fact that most people don't understand dentistry and part of what we do is educate them about what dentists do and why you can't despite the fact that you have neck pain or osteoarthritis or whatever why you can't practice and the practicalities is it you know if if this were a heart surgeon and they had an essential tremor would you want them operating on your heart probably not well why do you want them operating on your mouth and why do you want them not able to don't grab a you know a tool or instrument or crown out of your mouth you know quickly if you know if something were to drop or why do you want them to shake and have the risk of something like that occurring so I think that the naivete associated with with the practice is something that the insurance companies ignore and what we call that in in law is like willful neglect you know they know that something exists and they know that it'll end up proving up the case for the dentist but they like to they like to ignore it.

Howard: Yeah you created a course on dental town which gradually you only have five star reviews on it no one even gave you it for and you the name of that course is disability insurance roulette why is it so hard to collect on my policy I mean and the answer is money's the answer what's the question.

Ed: Right and when I collected premium they know what it paid claims I think we've seen this with some dental insurance ooh so um to nip it all at the but if they're young and in dental school should they be buying disability from certain companies instead of other companies or...

Ed: That's a great question and it's not one that I can answer because my malpractice carrier doesn't allow me to say who to buy from but I can give you some pointers on what to look for when you're buying a disability insurance policy so when I when I started out there was one disability insurance policy that was sold by every company and it was an own occupation disability insurance policy and it meant that if you were

Howard: Is it browning company?

Ed: It was all companies they all sold you know Provident MetLife MassMutual they all sold basically like a 5 or 6 page policy that said the same thing it said if you can't perform the substantial and material duties of your own occupation then you're going to be considered disabled so what this policy allowed you to do is you look at the occupation at the time of disabilities so if you're clinical dentist at the time of disability then that's going to be your occupation and they look to whether or not you can do it and if you can't do it you can go and work doing something completely different and you can open up a wine bar you could be a real estate agent and you can essentially double-dip so you get the full amount of your policy and you can work doing something that's unrelated to dentistry and you can collect that. So that was the true owner occupation policy now in this environment agents are saying oh well we have a true own occupation policy we have a true own occupation policy but I don't think that any of them really realize that this true own occupation policy the one that was sold in these true own occupation true own occupation and what that means is the

Howard: Three words true own occupation

Ed: That's right

Howard: Okay

Ed: So it means that you if and that's contrasted with what's called an any occupation policy so if you have an own occupation policy it means that if you can't perform your own occupation then you're going to be considered disabled and any occupation policy says if you can't perform any occupation like any occupation the national economy then you're going to be disabled so obviously it's a lot easier to collect or it should be easier to collect on an own occupation policy which is much narrower than in any occupation policy because the analysis is can a clinical dentist still be a clinical dentist not can a clinical dentist be a toll booth operator so what's changed is the occupation policies now often have a plural definition of occupation so they'll say you're totally disabled if you can't perform your occupation or occupations at the time of disability and what the companies are doing is as you can imagine if you have a you know a slowly progressive condition you might slow down working you might not work on certain teeth let's say back molars or top molars you might stop doing root canals that sort of thing you might start teaching at the dental school or you might start you know man your practice more than being kind of hands-on so then the companies come in and they say okay let's see what are the duties of your occupation and then looking at it they're like oh you're a part-time you know professor at the dental school you're working part-time and you're managing your practice so you're not a clinical dentist anymore you're occupations in the plural are a practice owner and manager a dentist and a professor at the dental school so that's the first way the own occupation policies have differed because they add the plural definition to occupation and the second thing that they do is they've gotten rid of this double dip option so where most people think that they can you know collect and work at another occupation a lot of the own occupation policies really to dentists surprise will say you're disabled if you can't work as a clinical dentist but you're not allowed to work doing anything else and if you work doing anything else you're not going to be able to collect that causes a lot of dentists concerned because they might not have purchased enough insurance they might have seven thousand dollars a month or ten thousand dollars a month and they think well I'm gonna have to work doing something else but if you work doing anything else, even for a short period of time it you know eviscerates your insurance so you want to look at policies from the perspective of do they allow you to work the second thing you want to look at is the fact that the new policies will have oftentimes will have offset provisions so you'll have a disability benefit of let's say ten thousand dollars a month but if you work in another occupation the salary that you receive will offset your disability benefits to us you know by a certain percentage. There are also policies that our own occupation for a period of time like four five years and then are converted into an any occupation policy so these are the types of things that you want to look at when you're buying the policies do you have at least a policy that's own occupation that allows you to work is an occupation to find in the singular rather than in the plural the singular is obviously about better and you want to make sure that the policy doesn't convert or offset if you were to work you know doing something else.

Howard: So it's amazing I'm I threw that in dental town and um it pops up an article you wrote on your website post out on a dentaltown and push on social media what is the difference between an own occupation and any occupation policy and theirs yours truly right on your website your um well is your your website is disabilitycouncil.net?

Ed: Yes right

Howard: because you have you have a couple of websites you have

Ed: We have our firm website

Howard: Which is

Ed: Cobe law

Howard: Cobe law and explain where the name Cobe law where does that come from?

Ed: Well my last name is Comitzs and my law partners last name is Beethe so yeah.

Howard: Okay my walnut brain did not figure that out so would you recommend dentist going to your disabilitycouncil.net website for more information?

Ed: I do, we've prepared a pretty robust website that provides a lot of information to dentists about the claims process the differences between the different types of policies kind of what to expect in the process and we've we decided that we were going to make it you know intellectual because dentists are obviously very smart and they can read things and understand them and I think that that's a great place to start if you're thinking about you know buying a policy or you're thinking about filing a claim.

Howard: Now you have offices in Phoenix where we're at today Scottsdale Tucson and you're just you're opening one in Salt Lake City?

Ed: That's right

Howard: but what if my homies live in the East Coast I need are you doing it this national?

Ed: We've represented people all over the country we have to get local counsel in the particular state but you know my practice is an incredibly narrow niche and so you're not going to find another attorney in the country who has 30 years experience in this particular industry and who's only done this for that for that length of time so we don't handle like Social Security disability claims we don't handle you know a lot of group policies. I started off working for a very large international law firm and then I started doing some of this type of work there and I just decided you know the insurance industry is really taking advantage of people who are filing claims who don't know what to do when their heads are turning and I saw an opportunity in this market to really help people and I've enjoyed it and you know they're only maybe 20 companies that sell this type of insurance and so I have relationships with senior claims management and in-house counsel outside counsel at all of the companies and if we're involved in a case they know that we know their playbook and they're not going to be able to get away get away with anything and so it's just something that that we've developed and you know we are sought out by other attorneys on cases we're often called in by other attorneys who are just business attorneys or health care attorneys who don't know anything about the industry we serve as expert witnesses in cases involving disability insurance so it's just a small niche and and it's something that...

Howard: It's the most important it's there's always a market for being the best at something anywhere and I tell accountants all the time you know they're telling me that they're having a tough go of it and I say when I get out of school there wasn't any accountants especially as on just dentistry now the most successful CPAs that I know they only do dentist because you is something so my gosh um there there will always be a market for being the best of something and so you mainly just decided that you're gonna focus on one small niche area.

Ed: That's right and we decided that we really wanted to be the best at it too so I mean one of the things that we do is you know we staff each claim or case with at least two attorneys sometimes three attorneys we really have an unparalleled track record of success in the 30 years I've been doing this I haven't had a bad result I can't guarantee that I knock on wood but...

Howard: You haven't lost yet?

Ed: We haven't we've gotten everyone paid and it's something

Howard: Stop for your second can you quickly disable me...

Ed: You know we only take legitimate claims and you know and so we

Howard: That's what I wanted to ask you, do you ever get the call where you said they're thinking come on?

Ed: Of course of course so we vet these you know we vet the claims quite a bit the same way that disability insurance companies do so if a client calls us and we talk to them on the phone in addition to like wanting to look at their policy and look at their medical records we'd like to see what their online presence is and so all of these insurance companies check out your Facebook they checked out check out your LinkedIn they check out your Instagram they do friend requests to your friends they try to find pictures of you and and really they try to figure out you know are you telling the truth or aren't you telling the truth but at the same time they're taking advantage because like for example I told you I have a double discectomy infusion in my neck now I can climb Camelback Mountain and I do some CrossFit I do you know some tennis I'm not good at these things because of my you know my limitations but I can do them and so they want to catch dentists unaware and they're like you know if a dentist can't work within a small cavity because he has a he has a numb hands in problems but can like hit a golf ball poorly that doesn't mean they're they're not disabled from being a dentist you're still allowed to have a happy and productive life so they try to take snippets out of context when they interview you for example they'll try to get you to say things emphatically like oh I can never bend over I can never do this I never do that and then they send out a surveillance team and they throw some quarters by your car and lo and behold you said you could never bend over and you're bending over trying to trying to get everything so it's it's important that when you find out...

Howard: It's like a movie

Ed: It is

Howard: Like a James Bond movie

Ed: I mean it's been on I mean they've there have been sequences on 60 minutes and 48 hours about how how these insurance companies really try to take advantage of you know you know of people and not not pay the claims the claims are worth you know upwards of a million dollars or more and so if the companies don't pay then they're in a good position.

Howard: So what are what are your red flags that you don't want to take a policy?

Ed: If someone comes to talk to me?

Howard: Yeah

Ed: I mean one is I I can kind of get a sense I think I have so many medical conditions myself that I can kind of read a person and figure out you know if they're telling me the truth they're not telling me the truth I I think you know obviously the medical record is critical like what what the doctors have documented so this is a third party we often ask to speak to the person's spouse to interview them to see what they think not from necessarily from the position of like are you telling the truth but a lot of times you know doctors will be you know very you know they'll just kind of hunker down and have a lot of pain and not want to tell people about it and so will ask spouses or children or whatever what they're their parent or spouse is feeling.

Howard: You know our colleague here in town who wrote the book influence remember that book?

Ed: I don't remember that

Howard: He was Peters and all the year anyway he started out his big favorite thing as he was studying how people influence the other he became a palm reader because he you know like when you go to parties and there's a real science to what those people ask and what cards show.

Ed: Yeah right

Howard: and what you're describing is just natural intuition.

Ed: I think so

Howard: and what do you think it's coming from do you think the dentist wants disability because he's depressed or just why would someone...

Ed: I think that as you can imagine to I mean with the type of work that you do there's a there's a high burnout rate in dentistry where people are like you know I've been doing this for 15 years 20 years or whatever day in and day out eight hours a day you know I you know I'm just tired of it I'm tired of like you know insurance companies cutting my reimbursements down I'm tired of dealing with staff issues I'm tired of you know of doing this so the insurance companies know that they have actuaries who study dentists and they and they look at dentists and they think okay so you know we know the dentists have to for example sell their practice so if you sell your practice and then you file your disability claim well you want to keep the practice value up so you work as hard as you can you muddle through you sell to sell the practice you don't tell the seller the buyer that you're thinking about filing a disability claim but the insurance company looks at it and says well you work 40 hours a week before now you say you can't work at all you know what's the rub other people try to file their claim before they they sell their practice but then the company is like well you work this many hours to stay this many hours that day why as of the are you not going to be able to to work anymore so what happens is is we have to develop strategies for dentists that the actuaries have have thought of because the actuaries look at this and they're like you know what we're gonna do we're gonna say that these dentists who are selling their practice practices just want to retire that they don't like dentistry but they've had a board complaint or they've had a bad experience or there's been a malpractice lawsuit and they are either malingering which is that they you know they don't really have this disability or they're just malingering

Howard: Malingering?

Ed: Yeah

Howard: I have not heard that word, new word of the day malingering.

Ed: Malingering yeah basically like you know not being honest and truthful about their medical condition and the other is that you know that the dentist just wants to retire just wants to get out of dentistry and so that's why they try to do things like look at your Facebook and your Instagram and say well how are you will to do all these fun things but you're not able to work on this patient and the answer is often really simple I mean the things that you're doing that are fun are completely different than practicing dentistry.

Howard: Wow I did not know that weird malingering is too exaggerated or feign illness in order to escape duty Wow that is yeah but just real quick I mean you know the insurer doesn't pay you know that that's tough but when you don't like your staff that blows my mind a lot of burnouts they pay people twice a month that they don't want to be in the same room with just stop doing that I think the coolest thing about coming to work is to see your assistant that you've been doing this with for twenty years.

Ed: I think for most people that's true.

Howard: Yeah I mean my gosh I've been in dental office so many times where you're talking to the dentist is a break room and he says come on let's get out of here because I hear my hygienist coming it's like we're leaving your private office cuz you hear your hygienist coming why don't you fight what an I fire her right now and you and you hire someone you want to. Just answer for the kids if you're a senior in dental school when do you need to be thinking about getting disability and if they plan on going and getting a job at a major DSO like Hartland, Aspen, Pacific will they provide it for you so they don't need to think about this or?

Ed: Those are really really good questions so to the first question which is you know when should you buy disability insurance I think you should buy it you know I don't sell it I have no you no you no reason to tell you this but you should buy it as soon as possible and you should buy an individual policy if you can in the highest amount that you can afford because you'll never be healthier than you are right out of dental school and...

Howard: I can vouch for that right trust me.

Ed: Right so after you know you know if you if you um you know start seeing a doctor because you're having back issues or you know pain later on down the line even if it's kind of benign and you buy the insurance later on they're gonna ask you questions on their underwriting form saying you know have you ever had back pain if you ever seen a doctor for this now if you don't answer them correctly your insurance is going to be void and so you have to answer those questions correctly and there's no better time to do buy insurance and answer those questions honestly because there's none you don't have any problems when you're like 20 to 23 years old then right right when you're out of school in terms of these like group policies or employer sponsored policies the group policies tend to be better like policy suit for example the American Dental Association to Great West then a lot of the employer sponsored policies the problem with the employer sponsored policies is that there's a federal statute that governs them called ERISA and ERISA is supposed to be a statute that helps employees by expediting the process for which you have to appeal and go to court if you get a bad decision so for example like it applies to health insurance too so let's say you want to have a surgery and the surgery is considered an experimental by your insurance company and they don't want to cover it you can go through a very quick appeal in a quick lawsuit and get everything resolved from an insurance company's perspective they love ERISA from a disability perspective because the insurance company has given a lot of deference in the decision that they make in fact if the insurance company decides that you're not disabled the only way that decision will be overturned by a court is if the decision was arbitrary and capricious which means that there wasn't a single rational basis for the company's decision. ERISA also deprives you of your right to punitive damages it deprives you of your right to a jury trial you have a bench trial in front of a judge and then the judge decides whether or not the company acted without a single rational basis and in most instances if you litigate an ERISA claim it's not going to be overturned the insurance company's decisions not gonna be overturned with individual policies state law applies and that means that you don't have to go through an internal appeal with the insurance company you can file a lawsuit in state court you can get a jury and in states like Arizona and California if the insurance company acted in bad faith or did something egregiously there's the prospect of getting what's called bad faith damages or punitive damages and so that serves as a deterrent from the insurance company doing you know bad you know bad things to you in addition a lot of the group policies have exclusions and limitations that you don't see in the individual policies often for example most group policies will exclude or limit on mental health conditions and so we have a lot of dentists who come to us who you know will suffer from depression or panic disorder and things like that and so if you have a history of that in your family and you're relying on on a group policy you might not have the coverage if let's say you have you know a panic disorder.

Howard: So you the first thing you said was on so you like the ADA group policy?

Ed: I guess I won't say I like any particular policy but I'd say if I had to rank policies I'd say your best typically typically going with an individual policy second best is typically a group policy and third best is an employer-sponsored plan and if you look at it this is the easiest way to look at it, which is the most expensive which is the least expensive so most expensive policies are usually the most expensive because they end up having to pay out more so those are typically the better policies ADA has a good policy um you know it's a long policy um and and it's a policy that I think that you know you want to study if you're going to if you're going to purchase it but I've had a lot of clients who've had that policy and who's collected on that policy. The employer-sponsored plans tend to be the worst because of the statute and because the policies are written I mean they could be like 50 60 70 pages long instead of like a 10 or 15 page policy and you know when insurance companies give with one hand they they take away with the other and I'll give you a quick example of that you know when I started practicing there was a care provision in every policy which just said you have to be under the regular care of a physician in order to collect on the policy well now a lot of the policies will say you have to be under the regular care of a physician who is who is specialized in an area particular to your to your to your condition we have to approve of the treatment plan you have to have a treatment plan that is aimed at getting you maximum medical improvement and a return to work well those provisions might not be good for you if your work is what got you disabled to begin with so like if you have a repetitive use injury and you stopped working and that's what your doctors recommend instead of surgery and your insurance company is like well no I think that you should have surgery but there's a chance even with surgery if you go back to work you could reinjure yourself it just doesn't make any sense so the care requirement which used to be one sentence in a lot of policies now is several paragraphs long and the same with the investigative paragraphs so usually the insurance company conduct a reasonable investigation hire an independent medical examiner now the companies say okay you have to sign an authorization that allows us broad discretion to contact your employer directly contact your doctor directly we can do surveillance we can interview you at any time and instead of saying we can conduct an independent medical exam of you it says we can conduct an exam of you by a doctor of our choosing and anytime that we wish. So I think that what we used to do is look at these disability policies and just look at how total disability was defined and how your occupation was defined but we also have to look at the paragraphs at the end and see you know how is you know appropriate care defined on your policy is it something that you're going to be able to accomplish or not accomplish what are the investigative tools that the insurance company is going to use let's see what do I have to expect when I'm gonna file this claim are they going to do surveillance are they going to do are they going to contact my drop doctor directly do I have to sign this authorization can I modify it or does the the agreements say I can't even modify the authorization that allows them to speak to whomever I want.

Howard: So you're recommending they by a senior of dental school?

Ed: For sure

Howard: Senior year is that...

Ed: I think so I think that our senior year if you don't do it senior year do it within the first year or two it's it's okay to have a...

Howard: but if you're a kid and you buy a senior year would you be looking down the road to also have an office overhead expense disability insurance...

Ed: For sure for sure

Howard: Would you recommend doing that senior year even though they don't know when they're in their own office or?

Ed: If you get insurance at the beginning with a particular company they will often allow you to do what are called like future increase options where they don't go through underwriting again they'll say like every two years or every five years you can buy X amount more insurance so you can get the best policy right when you graduate and then you can keep adding to it with future future increase options if you buy your practice and most people do right after they graduate the same company will typically offer them an office overhead policy and yeah I think it's worth worthwhile to get one of those policies.

Howard: Well if you go to the ADA website and you want to go with the a da the first thing it says on there is as a dentist you have a one in four chance of becoming disabled.

Ed: That's true, in fact...

Howard: That high?

Ed: You know statistics show that I think it's like 82 percent of all dentists will suffer from chronic pain at some point in their career relating to the practice of Dentistry and and one of four dentists did they say one in four dentists will have to file a disability claim?

Howard: This is as a dentist you have a one in four chance of becoming disabled.

Ed: I mean that's enormous compared to the population I mean the general population has probably like a two or three percent chance of becoming disabled.

Howard: Let's say that you bought this policy when you were very young senior first out and now you're an old dog you pass the big 50 I'm not saying that you and I did that but let's just say hey you're your you've lived half a century and you think you know this it's time to file a claim, do they contract do they contact their insurance company I mean what's what's the best...

Ed: That's a great question to Howard.

Howard: Okay

Ed: I think that what I think the best thing you can do is to contact an attorney to help you with the process because like I said the claims are staffed with three experts and it's not life insurance where you provide a death certificate and you get paid so...

Howard: Even the deaths occur there's a threat on dental town work and the person died in a foreign country and the first thing the insurance company says well we don't accept non-us death certificates so now they're gonna have to jump through and and don't lay it's gonna take you know a real long time to get a death certificate in America and obviously the insurance company knows she's dead.

Ed: Right

Howard: but it's just they want to collect a premium and um for you know and and not pay claims.

Ed: Well it's the same with with the disability policies now a lot of them will say if you leave the country then you're not no longer eligible for benefits so I mean people don't know that that wasn't something that was in...

Howard: Mean leave the country on vacation leave the country for...

Ed: I mean some policies will say that you have to be in the United States for six consecutive months a year and if you're not then your policy lapses you're no longer eligible for benefits.

Howard: and which is just another loophole.

Ed: It is and so...dentists I mean gosh stay in your lane you're a doctor dental surgery and I hear so many nightmare stories like somebody will lease just 2,000 square foot well why would you need an attorney for that and then his roof starts leaking turns out is triple net lease he has to fix the whole roof for this ten thousand square foot building even though he's only running two thousand square foot and the yoga studio next door said oh I'm not doing this so she just walks away from her studio and I ain't saying you know and and I'm like well what who reviewed this policy and the dentists are oh is something about being a doctor in dental surgery they just know everything and I assure you that there's doctors of dentistry in the dental malpractice and the dental disability that for a living all they do is try to avoid playing claim so and stay in your lane you make the worst decisions when you leave your lane.

Ed: Well I think one of the one of the things that's interesting about that is you know a lot of dentists consult with attorneys before they file claims and I think that that's I highly recommend it back in the day a dentist could just contact his insurance company say can you send me the claim forms and he or she would get the claim forms now right when you contact the company they do an initial kind of impromptu interview before you have an attorney present and so and they won't even release the clean claim forms to you until you've like you know gone through this interview, you know that interview and then there's an interview that typically occurs at your house or in your office if you don't have an attorney and the person who's interviewing you sounds nice sounds like they're helpful but it's it's really it's intended to kind of catch you off guard and to get you the same or if they come in and it's like a deposition well you're not going to talk very much and so they're all often very understanding and you say things that you'd normally you know wouldn't say so from that from the start on on a disability insurance claim they're starting to figure out and they're engaging in kind of a studied strategy to figure out how not to pay your claim and one of the ways to do that is to get people who like to talk to talk a lot when they're getting their claim documents when they're at the initial interview you know in their office or you know at their home and then the claim forms themselves have a lot of just very I mean really trick questions that can be answered in ways that really cause you harm and that are hard to kind of undo if you answered them wrong you know right out of the bat right you know right right out of right out of the gate and so what I'm talking about here is not dentists who like you know are in this severe accident and become you know paraplegic you don't need an attorney for catastrophic injuries you need an attorney for situations where someone can arguably say well I think you might be able to still work or at least work part-time.

Howard: and do these often go to trial so it's a jury a sitting jury decides?

Ed: Well if you imagine this so if you don't do it right the first time if you don't plan it the first time the company wants any arguable basis to deny your claim not it doesn't have to be a legitimate basis it just has to be a basis that has some rationale to it so that they can afford avoid bad faith and punitive damages so then all we're really talking about is the liability on the contract so if they can deny your claim typically going to trial it'll take minimally a year and a half to two and a half years before you even go to trial so all that time you're not working you're paying an attorney and you're not collecting benefits all right so many people are like well I have to go back to work and you know and do something so they do and they kind of eviscerate their policy that way because they have no choice then once you go to trial the insurance companies know that what we're dealing with are jurors who like work at the grocery store as cashiers who have bad backs and people who like work in the construction industry and people just your average you know people in the population who don't have these policies that say oh if you can't do this you can collect and you can double dip and go and work doing something else so there's an element of jealousy there too like why so a Facebook post of you like hiking when you have radiculopathy and you can drop things in a patient's mouth might be persuasive to someone who works at fries as a cashier who says well why is this person able to you know collect ten or twenty thousand dollars a month hike Camelback Mountain and work at the dental school and collect that salary too that's not really fair to me so the key here is to avoid going to litigation to begin with and do things you know correctly and to work with an attorney so that the insurance company knows that you have by your side who's going to stop the insurance company from that.

Howard: and how do they contact you would they go to disabilitycouncil.net, Cobe Law?

Ed: Either one either one

Howard: but you recommend they do that or a phone call or what?

Ed: We talk to every single person who contacts us we probably get about anywhere from 150 to 250 doctors a year who contact us even when we don't take the cases and we'd only take ten a year we talk to every single person probably at least an account...

Howard: How many cases?

Ed: 10

Howard: 250 people call you and you only take ten cases?

Ed: That's right

Howard: Holy moly what a funnel

Ed: Yeah well we I mean people come to us because of our of our success rate and so when we're looking at a client and determining whether or not we're going to represent them we look at really three things we look at the nature of the disability is a one that is complex but we think we can prove up you know and a lot of clients have baggage like they will have pictures of them mountaineering or doing things that are like you know that are potentially inconsistent with the disability claim or they will have taken steps that are you know they will started the process you know without us you know and and and and have miss stepped in some in some respects but that's okay you know we'll still take that type of you know that type of claim as long as there's some objective evidence not necessarily objective evidence but as long as there's either a comisity of symptoms over a period of time or some or objective evidence that we can kind of hang our hat on we know that they've got sympathetic doctor so we can help them find doctors who will be sympathetic to their to their condition and then to we look at just the type of person that we have as a client and you know what it's like in dentistry to we're either gonna have a patient or a client who's easy to work with we like seeing and who's gonna cooperate with us or we're gonna have someone who you know wants to drive instead of letting us drive you know we know how to get from point A to point B and so we have to figure out is our client gonna let us do that.

Howard: A lot of dentists physicians and lawyers are not very good backseat drivers.

Ed: They aren't and you know we represent quite believe it or not we've represented probably you know ten or fifteen lawyers in the past two but this is shocking to me but most of them are like IDI just do it you know you know what you're doing I don't you know I'm a real-estate lawyer I'm a business lawyer I'm a healthcare lawyer and you know I don't do what you do and I don't know what the insurance company's reaction is going to be to you know to me and I and you do and so why don't you just take it take it over and do it for me.

Howard: So do can add the disability insurance oh I say okay Howard you can't do this you're disabled because your neck but our doctors say you shove your spine fused why don't you know why don't why don't you go get fixed and say do disability can they do something like that?

Ed: That is like that's an interesting question and and they have um like I said the care provisions under the policies no longer say just you know go see your doctor they say you know we want to look at the treatment plan we who have never even met you or your doctor need to approve the plan we need you to have maximum medical improvement and have your you know your your medical treatment geared towards maximum medical improvement and a return to work well you know like I have a client who has panic disorder like very severe and it's related to to practicing dentistry she has panic attacks when she's when when she's in the office and and practicing on patients and so she hyperventilates and has all of these issues you she can't practice dentistry but that's the only place that she has them so the insurance companies like well we want her to you know you know she's been in therapy for five years and it's not working and she's taking medications and they're not working and so they then have their doctors they want their doctors to contact our clients doctors and say oh can she do shock therapy or can she do like try these non-fda approved medications so the companies realize that they want to push this stuff on you and they want you to think that it's required but not all of it is required notwithstanding what the policy said because the language of the policies doesn't mean that that's the law, the law can say that that provision of the policy is incorrect so like I doubt that any court would say if surgery is recommended to you that you have to have surgery even if that's part of part of what's in the in the policy but you have to realize to insurance companies rely on attrition they rely on people to look at the policy to hear what the analyst has to say and if they say well Howard you know it says you have to have surgery you're not gonna have served you so you can't collect and a lot of people say okay I guess I I guess I'm not going to pursue this anymore because I don't want to have surgery.

Howard: Yeah by the way I actually got to witness a panic attack by a friend at a Disneyland came out of nowhere it was very frightening.

Ed: It is

Howard: I mean III sat there on the ground for like 20 minutes I know if I should call 911 I couldn't understand what the hell is going on .

Ed: Well think about this if you suffer from panic attacks when you go to work all right if you're practicing on patience and that for some reason that exposes you to this fear element that that puts you into a panic mode all the time so you can't think correctly and you might have a full-blown panic attack and feel like you're having a you know heart attack then why should your care be geared towards having you go back to dentistry when you can live a happy and productive life if you avoid dentistry so for example let's see your panic attacks when you fly a plane should you be in therapy for the rest of your life to get you so that you can so that you could fly in a plane or can you just drive or take a train.

Howard: Madden, remember Madden the guy Monday night football guy of all time just drawn on the screen and they had an RV they had to drive that guy he just would not get in a plane.

Ed: but he lived a happy and productive life without getting in a plane.

Howard: So do then dentists just have multiple do they call you up they have disability from more than one policy two or three policies?

Ed: They can

Howard: Is that is that a good strategy?

Ed: It's not the best strategy I recommend that people have as few policies as possible for a couple of different reasons reasons one their potential conflicts in the policies so like some policies will say you're disabled if you are unable to perform your own occupation and you can't work and some policies actually say you're you can collect if you're disabled from your own occupation and you have to work and so if you have those two policies they can conflict with each other some policies have offset provisions so if you receive disability insurance from another carrier that'll offset the benefits that you receive from the first carrier and imagine you know there's a full-throttle you know investigation that's done by each company so every month you have to complete claim forms from company A Company B and Company C so does your doctor all three companies can do surveillance all three companies can talk to each other so the more companies that you have involved you know the more investigation there is the more like logistical nightmare so you have to deal with and so what we do when people have like two or three or four different policies is we have to look at the policy that provides like the least benefit to you like or is the least actually the most onerous to to collect on and then we have to essentially pretend that all the policies have the same provisions so that you're able to collect on all of them.

Howard: So I wish you would so dentaltown has 50 forums and one of them is insurance and underneath insurance one of them is disability and they have a pole do you have disability insurance and it was surprising seventy one percent said yes and 29 percent said no I wish you would share your thoughts on this thread what would you say to the people who the dentist so don't don't have this I mean?

Ed: I mean I think of all occupations I think Dennis and surgeons are the two that have to have disability insurance I don't have disability insurance but I don't have it because you know the only thing that I would need it for is if I were into some sort of accident or I became paralyzed for dentists like I said there's so many small things that can affect your ability to practice and if you can't practice and make money what are you gonna do like you said before I mean dentistry is not part of up you know it's not part of like an MD program where you can go back and just specialize doing something else you know so you I mean if you can't practice dentistry and you've spent all this time going to school and you have all of these loans you know what are you going to do after you you know if you file a disability or if you can't practice anymore I mean and you don't get disability benefits/

Howard: What if what if you're say you're 60 and you plan on retiring at 65 you do all these if something happened does it all expire at 65 I mean could you be sitting there in your mind thinking well I'm 60 and if I got disabled it into 65 I mean certainly...

Ed: Why bother

Howard: Why bother

Ed: Right

Howard: Yeah do all the benefits in 65?

Ed: I mean some very few but some policies provide benefits for life but if the policy doesn't provide benefits for life and you're 63 and you're thinking you know why am I paying these premiums and I've saved up enough money I was gonna retire in a couple years anyway why should I keep paying premiums I mean it's really like uh it's really like a financial decision that you have to make for yourself at that point.

Howard: and another guy asked on dentaltown are there any writers what riders do you feel unnecessary if you're buying a disability insurance policy he's asking if there's riders?

Ed: Yeah they're all sorts so they're riders are like these tack ons where you get better insurance or better benefits so you know often like the own occupation the best own occupation definition is a rider to the policy so you would you would buy that the cost of living adjustment so where you're...

Howard: you're reading his questions right in order anyway.

Ed: Yeah so yeah so five thousand dollars a month to ten thousand dollars a month today is not going to be the same as five or ten thousand dollars a month in 20 years so you'd like your benefit to go up with inflation so you want to get a cost of living adjustment rider to your policy if you can you know their future increase options that you could buy as well where you know you could buy additional insurance under the same policy without underwriting as your income continues to go up.

Howard: Now do I would imagine if I was a dental student I would think that you would buy all these from one coming like your disability your malpractice is that logical I mean?

Ed: I don't think disability is usually disability is not associated with malpractice and so the carriers

Howard: but they both have the word dental in it.

Ed: That's right

Howard: So those aren't two of the same?

Ed: They're different, they're different

Howard: You can't get both of those at Walmart so I'm trying to think on the questions on these are the disability forms are it's...

Ed: They're robust you know they'll ask you things like you know how long can you sit stand bend kneel can you do it twenty percent of the day thirty percent of the day.

Howard: So this is a great question he says I'm I'm trying to understand disability and he says he got three short questions that's a sick society which you think puts you more at risk personally injury or illness do you have an individual policy or group coverage and what's your a go bracket under forty middle age sixty sixty and up thanks for responding not sure I understand that.

Ed: That's interesting okay so could you tell me what the first question was again.

Howard: the first one is are you more likely an injury or illness it would put you at risk personally injury or illness?

Ed: Typically sickness or illness rather than in an injury

Howard: Really

Ed: Statistically yeah

Howard: Okay so and what what are some low-hanging fruit illnesses that people get that makes him disable?

Ed: I mean a lot of you know I don't think you need to parse it for the most part because the policies all say that they pay for sickness or injury so we don't have to kind of get into like you know you know it's not a distinction that makes a difference when you when you file a claim for the most part although some policies will say if it's an injury because it's less likely to occur they'll provide lifetime benefits for injury but they will provide lifetime benefits for sickness.

Howard: but what are the common sicknesses?

Ed: Like heart disease, heart disease MS rheumatoid arthritis um these are types of things.

Howard: So as you said MS and our rheumatoid arthritis now they're starting to with 23andme and genetic trees and that those are really clusters and families these autoimmune disease that if you have MS there's gonna be arthritis silly X Pru you know all kinds of hypothyroidism your body either and does that or it's not in it's an interesting deal insulin dependent diabetes those those are all in the same cluster yeah which they usually can identify in your family tree and if your family tree is big enough if you've got some insulin dependent diabetics and some hypothyroidism there's probably an MS arthritis other things in there yeah I don't understand.

Ed: and I think I think also that you know like with degenerative disc disease for example which a lot of dentists have like cervical issues with bending forward all the time I mean to what extent is it a disease and to what extent is it a repetitive you know a repetitive injury and so in situations like that will often litigate if there's lifetime benefit for injury but not for sickness and the company will say oh the degenerative disc disease as the name implies is a disease and that's not an injury and then we'll have to take the position that you know it's you know it is a disease but it wouldn't have gotten to this point without the repetitive injury of working.

Howard: and take away just reading these forms it looks like the major issue a lot of these dentists regret is I'm not getting their disability insurance until they had a pre-existing condition.

Ed: That's right

Howard: and they fought some injury for fiber so years after school then they finally got disability and there's a big track record.

Ed: I think the biggest new place that we're seeing litigation is people who are buying their disability policies later and their underwriting requires that they answer these questions these are the type of questions that you get at the doctor's office were like have you out of history of and then they'll like name like ten different like you know muscle diseases and then they'll name different like skin conditions and then I'll name ten different this and the question will be have you ever had been treated for or suspected that you might have any of these following conditions now a lot of people just check no no no no no and the law states in most jurisdictions that if you say something that's inaccurate on those forms even if it's an innocent misrepresentation it can be used to void the policy later on so we're getting a lot of companies coming in and saying oh you know you used to get massages or you know chiropractic treatment and you said you never suspected that you had any back issues but now we have those records so we're not going to pay you on this policy anymore.

Howard: Okay it's been one hour it's been an honor that you've been here but...

Ed: Thank you

Howard: One final question on this dentist post under disability I am a soon-to-be graduate who will be doing a one-year residency at an AEGD next year I'm looking at disability insurance to purchase companies will sell me four to five thousand per month initially with the option increase to fifteen thousand per month is there any downsides to purchase two different policies at two thousand per month with the same writers to increase both of them to fifteen thousand later on without an additional medical exam?

Ed: Well there's the complication that we talked about earlier which is if you have two policies that can from different sources that can be it can be logistically more difficult later on but I don't think two policies is the same thing I mean we've had clients come in with like seven policies so I think that if he wants to pursue the option that he's that he's contemplating I think that that makes that makes sense so I mean he could buy the two different policies and use the future increase options on both so he has the highest amount of insurance possible he just needs to make sure that neither policy offsets the benefit of the other policy if you were to file a claim.

Howard: and when does your Salt Lake City office open?

Ed: Probably in the next week or two.

Howard: Wow I always when you practice in Arizona you really feel like it's Arizona and Utah kind of the same state I don't have any dentist friends around here who are Mormon who don't have family and friends and Salt Lake and you know it's very kind there's a lot of dentists in Salt Lake.

Ed: Yeah what am I my one of the lawyers in my practice Derek Funk just got licensed up there he's he's from Gilbert and he goes back and forth to visit his family all the time and I guess a lot of people do and so I think there's a real need in the Utah area for attorneys to do this type of work and so we're happy to get started there.

Howard: Well it's been fun watching you all your years I you're it's fun I mean you're been berry on top of this thank you so much for all the help you've given us on dentaltown with articles and CE and coming back and doing a second podcast it's just a real honor to know you and...

Ed: Thank you so much Howard I really appreciate it thank you.

Howard: Thank you