A doctor in our WCI Facebook group went through months of neurological symptoms and underwent surgery, and they were back to work 96 days after symptoms took them off the job. Thankfully, they had a disability insurance policy, and it did pay. However, the amount was nowhere near the actual loss of income (well more than $100,000 across those three months). The check they got from the insurance company? About $1,500. It was a shocking amount to the physician—until you realize why.

The reason: the elimination period, which is the policy’s waiting period (think “deductible” in time, not dollars). If your disability ends around Day 96 and your elimination period is 90 days, you’re only getting paid for the six days after satisfying the 90-day wait.

In this post, I’ll break down how elimination periods really work, why they exist, and how different periods change cost and risk. We'll also talk about the nuances (consecutive days; residual/partial rules; recurrent disability; hospital riders; premium waivers; and how short-term disability (STD), paid time off (PTO), and your emergency fund fit in).

All of this so you’re not caught off guard when purchasing disability insurance for the first time or learning about your current plan.

What Is the Disability Insurance ‘Waiting Period?'

From the day you’re disabled to the day the policy starts paying, the clock runs. Most physician policies let you pick an elimination period of 30, 60, 90, 180, 365 (one year), or 730 (two years) days; 90 days is the common middle ground because it balances premium cost with cash-flow pain. Your deductible isn’t dollars like your car insurance; it’s time. Contracts don’t back-pay the waiting period, and the first check typically arrives a few weeks after you clear it because benefits are paid in arrears. Translation: you need a plan for Days 1-90.

Nuances matter, too. Many policies, especially employer-sponsored group long-term disability, want those days to be consecutive—stepping back into work for a bit during the elimination period may restart the clock. Some carriers let partial/residual disability satisfy the waiting period. Others, like association-sponsored plans and employer-sponsored group long-term disability plans, want total disability to satisfy the waiting period before they’ll pay a partial/or residual benefit after. If your condition relapses within a set window after satisfying the waiting period, a recurrent disability provision can waive a new waiting period (that's huge if symptoms flare). Built-in policy features and some riders can tweak the rules and completely waive the waiting period (hospital confinement, presumptive total disability), but if you’re currently covered, don’t assume you have them.

Why Most Doctors Pick the 90-Day Waiting Period

As the waiting period gets longer, premiums drop, but your self-funding burden rises. For most physicians, 90 days works. It’s meaningfully cheaper than 30/60 days (which can sometimes double the cost of a disability policy). If you keep 3-6 months of expenses in an emergency fund, 90 days usually plays nicely. You cover the early runway with PTO, STD, or cash, and the policy kicks in before your savings diminish and/or coverage runs out.

Sure, a 180-day wait can work if you’ve got robust STD and a truly comfortable emergency savings fund. But for the average medical student, resident, or attending who wants good protection, the 90-day wait seems to be the sweet spot. Also note that those with a 90-day wait still have to wait an extra month until they actually get paid. Basically, you'd need an emergency fund of at least 120 days even if you have a 90-day waiting period.

More information here:

People Aren’t Buying Disability Insurance, But They Should

Disability Insurance Misconceptions: Common Assumptions Physicians Can’t Afford to Make

Calculating the Best Waiting Period for You

Picking an elimination period can be easy with a little math. You’re trading extra premium for a shorter wait vs. extra cash you must float for a longer wait. Do a quick check using:

Cash Needed = Monthly Spend × (Waiting Days ÷ 30)

If that number fits comfortably inside your emergency fund (and you hate paying premiums), go longer. If an extended wait makes you uncomfortable, shorten it.

Example (90 vs. 180 days)

  • Monthly spend: $15,000
  • Cash for 90 days: $15,000 × (90/30) = $45,000
  • Cash for 180 days: $15,000 × (180/30) = $90,000
  • Extra cash to “stretch” from 90 → 180: $45,000

Now compare premiums (sample quotes, use your real ones):

  • 90-day EP premium: $260 per month
  • 180-day EP premium: $220 per month
  • Savings if you choose 180: $40 per month = $480 per year = $2,400 over five years

Is saving $2,400 worth needing $45,000 more runway if you’re out six months? If not, pick 90 days. If yes and you have a decent emergency fund, 180 is fine. The “right” waiting period is the one you can cash-flow without panic.

Coordinating the Waiting Period with PTO/STD/GLTD

Don’t buy coverage you already have. Stack employer benefits first, then start your individual DI where those dollars stop.

  • PTO/Sick Leave: If you reliably have 60-90 days paid time off, you could push the wait period out further.
  • Short-Term Disability (STD): This often pays between 90-180 days, and you can have a short wait period. Piggyback this with a wait period that complements the plan.
  • Group Long-Term Disability (GLTD): It's a useful base, but definitions are often weaker than individual DI when it comes to own occupation limits, offsets, caps, and taxes. Your individual own occupation disability insurance fills those gaps, and it is generally tax-free if you are the one paying the premium.

Here's how to think about it:

  1. List real PTO days.
  2. Confirm STD length/percentage/cap.
  3. Note GLTD definition/offsets.
  4. Pick your DI waiting period, so DI starts when the employer money stops.

Other Considerations That Impact the Waiting Period

Residual/Partial Rules

With the Big 5 disability carriers, the residual/partial rider generally lets you satisfy the elimination period while partially disabled (i.e., if you have a qualifying loss of time, duties, and/or income due to sickness or injury). Several carriers explicitly count those losses toward the waiting period, so you don’t have to be totally out of work to meet it.

However, this isn’t universal. Group LTD and many association plans (e.g., AMA) often require you to be totally disabled for the entire elimination period before residual benefits begin. If you’re partially disabled for a long stretch or you never meet their total-disability definition, you may never satisfy the waiting period, and benefits won’t pay until (and unless) you become totally disabled under the contract.

Bottom line: review the contract language around residual/partial and how this rider interacts with the wait period.

Continuous vs. Cumulative Clocks

Some policies run the waiting period clock continuously. That means you might need 90 straight days, generally totally disabled, or you start over. Others give you an accumulation period (the term for the time allowed to meet the waiting period by stacking disabled days within a set window). In those accumulation designs, if you hop back to work because you think you’re better, only to realize stepping back in wasn’t a good idea because you’re still sick or hurt, your progress doesn’t reset. Those days still count, and you pick up where you left off.

No Retro Pay

Benefits usually don’t back-pay to Day 1 the disability started, and they are paid in arrears.

Skip the ‘Waiting Period' Features

  • Presumptive total disability: For most carriers, the waiting period is waived, and benefits start immediately if you lose things like sight in both eyes, speech, hearing, or the use of two limbs.
  • Recurrent disability: Most individual DI policies include a recurrent disability provision. If you go back to work and become disabled again within a set window (often 6-12 months) from the same or related cause, the insurer treats it as a continuation of the prior claim. You'd have no new waiting period, and benefits would just resume (subject to the original claim’s remaining benefit period).
  • 5-year waiver of elimination period: A close cousin of recurrent—a waiver of elimination period (waiting period)—is offered by at least one of the Big 5 disability insurance companies. After a long, paid claim (past a stated threshold), any new disability you have within the next five years that lasts at least 30 days means you can skip the waiting period, even if it’s unrelated to the previous disability claim.
  • Hospital confinement riders: Some contracts/riders will waive the waiting period and begin paying earlier if you’re admitted to a hospital for a set number of days.

Paperwork Timing

Report the disability on Day 1, follow your policy’s proof-of-loss deadlines, and send every form/doctor note on time. If you don't, the benefits' timing and the claim outcome can be impacted. Set calendar reminders and treat it like rounds.

When Does the Disability Waiting Period Clock Start?

It's not when you file, and it's not when the adjuster calls. It starts the day you’re first disabled under your policy’s definition (i.e., when you can’t perform the material/substantial duties of your occupation, or you experience a partial/residual loss). That onset date is your starting point: write it down, tell your employer, and get it documented! Note the exact onset date, notify the carrier early, and keep paying premiums until the insurance company confirms otherwise in writing (if your policy has a waiver of premium feature).

More information here:

The Physician’s Guide to the Best Disability Insurance Companies

Why Do Some Doctors Get Declined for Disability Insurance?

After You Clear the Waiting Period: What Actually Happens

Once you’ve satisfied the waiting period and the claim is approved, here’s what happens:

  • The waiver of premium kicks in. If the policy has a waiver of premium feature, you typically stop paying premiums while you’re disabled (and eligible for benefits). Until the carrier confirms this in writing, keep paying. Don’t risk a lapse.
  • The premiums you paid after the onset are usually credited/refunded. Most individual policies treat the date of disability onset as the point from which premiums are waived. After approval, the company will refund or credit premiums you paid from that onset date forward. Important: this is not the same as back-paying benefits to Day 1. It’s just premium money coming back, not income benefits.
  • Check the timing on the first benefit. Benefits are paid monthly in arrears. Your first check covers the first month after the waiting period ends, so it often lands a month after you clear the waiting period. For example, if you have a 90-day waiting period, the first check received may not be until the 120th day or a little later.
  • If you’re on residual (partial) disability and benefits are payable, the waiver of premium generally still applies for as long as you meet the policy’s residual definition and payments continue.
  • With recurrent claims, if you recover and then get disabled again within the policy’s recurrent window, you typically don’t have to satisfy a new waiting period.
  • When you no longer meet the disability definition (or you hit the max benefit period), the waiver ends and premiums resume. Put a reminder on your calendar so the policy doesn’t lapse during the transition back.

Final Thoughts

The waiting period (elimination period) is a time deductible, so set it to match your short-term income needs. Line it up with things like PTO, STD, or emergency savings you may have in place; document the exact onset date; and expect benefits in arrears (with premiums typically waived/credited once payable).

If you want fewer surprises and lower blood pressure, 90 days fits most doctors; go longer only if your cash cushion is truly strong. And don’t DIY the fine print. Contract language (own occupation, residual during the waiting period, recurrent rules, offsets, taxability) is where claims live or die. Work with a WCI-vetted disability insurance agent who can walk you through your policy and quote the right riders, so you’re paying for the right protection.

How long is your disability insurance waiting period? Do you prefer the 90-day length, a shorter window, or a longer period? Why?

The White Coat Investor may receive compensation from White Coat Insurance Services, LLC; licensed in all states including MA and DC; CA license #6009217; NY license #1758759 (exp. 6/2027); Registered address: 10610 S. Jordan Gateway, #200 South Jordan, UT 84095. This does not affect the cost or coverage of insurance.