Michigan should reject ‘repetitive sickness’ as a bar to physician disability claims

Media Contact: Barbara M. Fornasiero, EAFocus Communications; barbara@eafocus.com; 248.260.8466

Royal Oak, Mich.—October 29, 2025—The Nolan v. Provident Life and Accident Insurance Company lawsuit filed this week by national employee benefits litigation and ERISA attorney J.J. Conway on behalf of a Michigan vascular surgeon seeks to overturn the Michigan Supreme Court ruling in Nehra v. Provident Life and Accident Insurance Company, 454 Mich. 110 (1997), which narrowly defines injury so as to exclude repetitive injury disabilities prevalent in the nature of a surgeon’s work.

According to published studies, surgeons experience significantly higher rates of spinal problems compared with the general population. By some estimates, nearly 75% of all surgeons suffer from back problems. Some surgical specialties have a rate of spinal injuries as high as 65% of the entire occupational category. Compounding matters, the consolidation of medical practices, highly specialized surgical practices, and increased patient need mean surgeons are seeing their caseloads increase, putting them at greater risk of injury to their spines.

At the heart of the Nehra case – and what Conway is attempting to overturn in the surgeon’s lawsuit – is what constitutes an ‘injury’ in a disability insurance contract. Nehra ruled that repetitive motion injuries, which tend to build slowly before creating a full disability, do not fall under the insurer’s definition of either injury or illness. Conway says the underlying analysis in Nehra is flawed, noting that it is based on the Workers Compensation Act and the Michigan No-Fault Act, which are regulatory guidelines, to determine the meaning of an ’injury.’

“Both of these statutes regulate mandatory insurance systems requiring individuals and businesses to purchase specific forms of insurance, creating a uniformity among huge segments of the state’s population,” Conway said. “A private disability contract is a voluntary contract and its purchase is discretionary. The terms that govern the contract are between the two contracting parties. Michigan should not regulate the definitions that appear in a private disability insurance contract. The Nehra case is bad law that is undermining the long-term financial security of medical professionals like my client.”

Background on Nehra

Nehra filed an insurance claim with his long-term disability insurance carrier. His policy provided coverage in the event he could not regularly perform his specific occupation – dentist – if he became ill or had suffered ‘injuries.’ In his application, he listed bilateral carpal tunnel syndrome as being one of the causes of his disability, along with duodenal ulcer with hemorrhage, and his claim was approved.

After collecting benefits for years, Nehra attempted to change the cause of his disability to ‘injury’ from ‘sickness’ because under the contract, if his disability were a ‘sickness,’ his monthly benefits would end at age 65. If his disability stemmed from ‘injuries,’ on the other hand, he could receive benefits over a lifetime He argued that his diagnosis of carpal tunnel syndrome was the result of a series of repetitive motion injuries that qualified him for the lifetime benefit under the ‘injuries’ provision of his contract. Nehra’s claim was denied, and a lawsuit followed. The trial court dismissed his case, but the Michigan Court of Appeals reinstated it, finding there was an issue of fact as to the cause of Nehra’s disability. From there, the Supreme Court granted leave and reversed the Appeals Court reinstating the dismissal.

Time for long term disability policies to pay up

Surgeons work in physical positions where their bodies are contorted for long periods of time; further, they are required to wear equipment necessary to perform surgery, including magnetic loupes and heavy, protective lead aprons. Collectively, this contributes to putting pressure on the neck and back and often results in spinal injuries -not illnesses – over time. And this is why Conway says it’s past time to eliminate Nehra as precedent in private disability insurance disputes.

“Nehra is the darling of Michigan’s private disability insurers, routinely citing it to try and defeat the legitimate claims of surgeons like my client who have suffered spinal injuries during the practice of their profession,” Conway said. “It is an impediment for legitimately disabled medical professionals within our state who entered into expensive disability contracts in the good faith understanding that their injuries (not just narrowly defined ones), would be covered. Other courts have rejected Nehra’s analysis, with one federal court writing that it had never heard of a “repetitive motion sickness.” (Chapman v. Unum Life Ins. Co. of America, 555 F. Supp. 3d 713, 724 (D. Minn. 2021).) It’s time for the Michigan Supreme Court to do the same for the sake of current and future surgeons.”

About J.J. Conway Law

An employee benefits litigation and ERISA law firm founded by John Joseph (J.J.) Conway in 1999, J.J. Conway Law represents those seeking full access to the employee benefits they are legally entitled to. The firm has been involved with nationally significant employee benefits, disability and pension cases, including class action lawsuits for such landmark decisions as granting Medicaid-eligible Michigan children with previously denied intensive mental and behavioral health care services; requiring private Michigan insurers to cover autism treatments for children through age 18; and protecting the pension rights of City of Detroit employees, police and firefighters as well as Wayne County employees by holding their trustees accountable for investment decisions. The firm’s motto, Conquer Tomorrow®, is dedicated to making the future more secure for their clients across the United States.  Learn more on the firm’s website.

###