Professional Impairment: Licensure and Disability Insurance

Aug 20, 2014 - Articles by

Mark F. Seltzer, Esq., presented the poster, “Professional Impairment: Licensure and Disability Insurance Issues,” designed to help guide monitors and practitioners. This presentation focused on the complex interaction between factual disability that is a result of injury or sickness — often with a psychiatric and/or addiction component — and the frequently concurrent legal issues a medical professional faces regarding their license to practice. Disability policies require that an insured physician establish that he or she is “factually disabled” and receiving appropriate care in order to be entitled to total or residual/partial benefits. On the other hand, state boards of medicine require (among other things) that in order to maintain a license, a physician should establish that he or she is “fit to practice” medicine with reasonable skill and safety to patients. While being medically “unfit to practice” from a regulatory standpoint can be consistent with the medical inability to perform the duties of a physician specialty, this is not necessarily the case from a contractual standpoint. Conversely, it is possible to be medically “fit to practice” and simultaneously eligible for benefits. Reconciling these concurrent issues is in reality not only complex but can have debilitating consequences on an insured’s claim. Often an impaired physician will have to choose between pursuing disability benefits, which will provide immediate financial security to allow him or her to obtain the treatment he or she needs, and protecting and maintaining their license to practice medicine.

The aim of this presentation was to educate conference participants on how to satisfy the contractual requirements of a disability insurance policy and maintain a disability claim, to show the role practitioners’ play in helping to protect and restore a license to practice, and to show the interaction between the disability insurance policy and the license to practice. Based in Philadelphia, Mark F. Seltzer & Associates is a nationally recognized disability insurance firm that concentrates in working with addicted and impaired professionals around the country in their disability insurance claims.

-Mark F. Seltzer, Esq.

“Professional Impairment: Licensure and Disability Insurance” was published in Volume 19, Number 2 of Physician Health News, The Official Newsletter of the Federation of State Physician Health Programs in August 2014.