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It is not uncommon for disability policy holders to develop opioid pain medication addiction after undergoing surgery. Opioid addiction can be even more problematic when the policy holder is a medical professional like a certified registered nurse anesthetist.
The American Association of Nurse Anesthetists has a return to work program for recovering nurses to re-enter the work force which provides, in part, that nurses
“may return to work in a ‘supervised setting’ following treatment for addiction”
recognizing “more time away from the workplace may be needed to reduce risk of relapse.”
The Guidelines recommend that a recovering nurse may practice under supervision.
How Do Disability Carriers, like United Heritage Life, Consider the American Association of Nurse Anesthetists Guidelines?
The case of Wilstead v. United Heritage Life Ins. Co, 2020 WL 5441911 (D. Idaho Sept. 9, 2020) is a good example of how disability carriers consider return to work programs for addicted medical professionals and whether opioid addiction limits a policy holder’s ability to return to work.
Wilstead was a certified registered nurse anesthetist who became addicted to pain medication after undergoing shoulder surgery. He submitted a claim for long term disability benefits based on his shoulder injury, depression, and substance abuse.
Many disability carriers or plan administrators have a stable of doctors with subspeciality in addiction to review the medical records to determine if the medical professional is addicted to medication, whether they can return to work, with or without supervision.
As part of that paper review the carrier’s addiction experts should consider:
– The applicable professional association Guideline re-entry recommendations,
– The return to work recommendations of any therapists,
– The medical records.
– The participation in any support group,
– The risk of relapse or future disability.
However, the Guideline recommendations do not constitute a disability in and itself nor does limits on a professional license.
In the Wilstead case, the Idaho federal judge upheld the claim denial noting that United Heritage Life’s addiction and psychiatric experts considered the facts outlined.
What Every Medical Professional with Addiction Issues Should Do?
Obviously, treatment and participation in the professional addiction return to work is key! However, consulting with an experienced ERISA disability attorney should be the next step so you understand your disability policy, have a thorough review of your medical records and develop a plan to get the long term disability benefits you deserve.
Anesthetists Nurse ERISA Disability Insurance Claims
If your claim has been denied, you will only have 180 days to file an appeal that can make or break your right to long term disability benefits. Call today at 727-477-3263 for a free consultation
