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Disability Insurance and Depression

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  • Avatar kzbt19 
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    I will be starting residency in July and after reading the WCI book and several posts, I’ve learned it’s best to buy disability insurance now. I am a 28 year old healthy female, but was diagnosed with depression in my second year of med school. I was originally on 2 meds for it, now am on 1, and could probably come off it. The depression never caused me to miss school/exams or a day of rotations. No other medical problems.

    I am worried this will cause me to be denied for DI. My residency program offers group DI but they have a warning on the website stating I would be ineligible if I applied for and was denied DI elsewhere.

    I appreciate any advice you could offer!

    #116768 Reply
    Avatar Peds 
    Participant
    Status: Physician
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    Joined: 01/08/2016

    you wont be denied. you might have to pay more and you will have a mental health clause likely.

    also why not wait to see if by the end of residency your health has improved? (hold the comments for those of us who have finished!!!)

    #116836 Reply
    AnjaliFIT AnjaliFIT 
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    Status: Financial Advisor, Small Business Owner
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    Joined: 04/01/2018

    If your medical history only has depression that shouldn’t be a reason to get denied coverage.  Most likely if they address it then they will just put an exclusion in your policy for depression. A lot of the carriers usually limit mental/nervous disorders in general so if you potentially have an exclusion for it anyways then you may want to consider one of those carriers (Principal for example) since the premiums tend to be cheaper than some of the other carriers – Berkshire/Guardian and Standard.  I would have a disability person look at your stuff and provide you with recommendations.  I don’t know if waiting will help because it takes a number of years before the carrier will take it off their record.

    Anjali Jariwala CPA, CFP®
    [email protected]┃847.863.6836
    http://www.fitadvisors.com

    #116848 Reply
    Liked by Vagabond MD
    MPMD MPMD 
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    Status: Physician
    Posts: 2106
    Joined: 05/01/2017

    I was on AD for like 6 months during med school and it was a big deal when underwriting my DI policy. It ended up being ok but several phone calls, supporting documentation etc.

    I was very surprised by what a big deal it was, I hope your experience is better.

    Kind of funny to me b/c I don’t think docs try to claim permanent disability due to mental health issues very often, I would have happily accepted a clause that wouldn’t allow me to claim this. I don’t have any data but I’ve never heard of a doc quitting due to depression.

    #116851 Reply
    Liked by Tim
    Avatar kzbt19 
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    Kind of funny to me b/c I don’t think docs try to claim permanent disability due to mental health issues very often, I would have happily accepted a clause that wouldn’t allow me to claim this.

    Click to expand…

    Yes I would happily accept a clause as well. Was this an option for you?

    #116860 Reply
    Avatar Peds 
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    Status: Physician
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    Joined: 01/08/2016

    I don’t have any data but I’ve never heard of a doc quitting due to depression.

    Click to expand…

    yea they kill themselves instead……

    your statement is definitely ridiculous.

    #116870 Reply
    Avatar frickshin 
    Participant
    Status: Student
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    Joined: 03/19/2018

    I don’t have any data but I’ve never heard of a doc quitting due to depression.

    Click to expand…

    yea they kill themselves instead……

    your statement is definitely ridiculous.

    Click to expand…

    I don’t think he’s saying physicians don’t suffer from depression. I think he’s saying that from an insurance actuarial perspective, disability from depression is probably not a significant risk.

    #116873 Reply
    Liked by Vagabond MD, MPMD
    Avatar Anne 
    Participant
    Status: Physician
    Posts: 887
    Joined: 11/07/2017

    I’ve known two doctors who have gone on extended leave of absences (>1 year) due to depression, although understandably neither wanted it generally known that it was due to depression so both had another stated reason.  Both eventually returned to work.  I have no idea if either was on disability claim during that time.   I suspect it’s more common than we know—just nobody announces it’s due to mental health reasons.   Much safer for your future career options (sadly) to give another reason.

    Hopefully one of the disability insurance brokers will jump in here with their advice.   If not, I would recommend calling one of the disability brokers that WCI endorses and talk it over with them.

    #116880 Reply
    DK Unger DK Unger 
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    Joined: 01/08/2016

    It will ultimately come down to what diagnosis code(s) are in your medical records along with the treating physician(s) notes. Mental health disorders are one of the leading causes of disability so insurers will scrutinize all your medical records should you apply. There are a wide variation in underwriting decisions for a proposed insured with mental health history. I’ve seen physicians get declined for coverage, receive a policy with a 5 year benefit period, no future benefit increase option, a premium surcharge, and mental health exclusion, or receive a policy with just a mental health exclusion. It does help that you have reduced your medication usage and are not on multiple medications. I recommend first checking to see if your training institution has a “guaranteed standard issue” (GSI) individual disability plan option available which requires no medical disclosures (if you message me I can check for you). If there is no GSI plan available and you still want to try for an individual policy, I would gather as much medical history detail as possible in order for an experienced broker to conduct an informal inquiry to see what the insurers will tentatively offer you. Otherwise, take the group disability plan offered through your institution and consider coming off the medication completely (of course subject to your treating physician’s advice) and apply for an individual policy after you are no longer under treatment for depression.

    dku(at)di4mds.com

    #116885 Reply
    Liked by Vagabond MD
    Avatar wideopenspaces 
    Participant
    Status: Physician
    Posts: 960
    Joined: 01/12/2016
    Disability Insurance

    Glad to hear you are doing well! I would be very careful about going off meds just for DI as the rates of depression during residency are quite high (over 25 percent) and there is elevated risk for suicide and it’s more important in my opinion to stay healthy and stable than to get good DI at this point. Of course talk to your doctor but if it were me, I would strongly consider staying on the one med during intern year and then weaning thereafter if still doing well. Good luck!

    #117215 Reply
    Vagabond MD Vagabond MD 
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    Status: Physician
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    Joined: 01/21/2016

    For a number of reasons, it’s best for a doc to keep psychiatric diagnoses and medications out of the insurance database. Pay with cash for appointments and meds, if at all possible.

    "Wealth is the slave of the wise man and the master of the fool.” -Seneca the Younger

    #117217 Reply
    Avatar amphora 
    Participant
    Status: Student
    Posts: 65
    Joined: 04/20/2016

    For a number of reasons, it’s best for a doc to keep psychiatric diagnoses and medications out of the insurance database. Pay with cash for appointments and meds, if at all possible.

    Click to expand…

    Sadly this is probably true. However, I don’t think paying cash would necessarily keep it off the radar because the pharmacy could also sell your data.

    #117222 Reply
    Liked by Tim
    Scott at MD Financial Services Scott at MD Financial Services 
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    That does not really work when you get into prescriptions because there is a data base for all prescriptions filled to your social security number and then the carriers use what is called scriptcheck service to pull and confirm med usage.

    S. Scott Nelson-Archer, CLU, ChFC with M. D. Financial Services, Inc.
    Direct Phone 713-966-3932, Email [email protected]

    #117367 Reply
    Scott at MD Financial Services Scott at MD Financial Services 
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    Most of our clients that come through with that medication profile will end up with:

    Currently on meds 5 year benefit period and any mental nervous claim would be excluded.

    1-3 year out of meds with no problems then 10 year benefit period and sometimes age 65 benefit period, mental nervous exclusion.

    3+ years out typically no policy modification or exclusion.

     

    You should can also look for a GSI offering at your residency, they will just simply issue you an individual policy with no medical review except for a couple of severe health issue questions.  If you have questions about that just drop me an email, there are a number of the GSI programs around.

    S. Scott Nelson-Archer, CLU, ChFC with M. D. Financial Services, Inc.
    Direct Phone 713-966-3932, Email [email protected]

    #117369 Reply
    Liked by EndoRobert
    Avatar kzbt19 
    Participant
    Status: Student
    Posts: 8
    Joined: 02/05/2018

    Most of our clients that come through with that medication profile will end up with:

    Currently on meds 5 year benefit period and any mental nervous claim would be excluded.

    1-3 year out of meds with no problems then 10 year benefit period and sometimes age 65 benefit period, mental nervous exclusion.

    3+ years out typically no policy modification or exclusion.

     

    You should can also look for a GSI offering at your residency, they will just simply issue you an individual policy with no medical review except for a couple of severe health issue questions.  If you have questions about that just drop me an email, there are a number of the GSI programs around.

    Click to expand…

    That’s really helpful to know. My residency program does have a GSI option that @DKUnger helped me identify. As many people suggested, I’ll probably stay on my one med through intern year and re-evaluate with my doctor after that.

    I appreciate everyone’s thoughts on this. Although I understand it logically I personally think it’s kind of a shame it has to be this way and could potentially preclude people from seeking the treatment they need. But I’m going into psychiatry so I’m all about fighting stigma.

    #117373 Reply

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