By Dr. James M. Dahle, WCI Founder
The greatest financial risk for physicians is losing the ability to turn the knowledge and skills you spent a decade learning into a huge pile of money by working in your profession for decades. There are risks that could show up in your life that would prevent you from being able to accomplish this task. One of the most common of these risks is an extended or even permanent disability. Insurance companies estimate that as many as one in seven doctors will be disabled at some point during her career. While many imagine this will occur in a sudden traumatic accident, medical illness is actually a more common cause of disability that prevents a doctor from working.
Physician disability is a complicated type of insurance. This post will give you the “must-know” information to secure the best protection and help you avoid common disability insurance mistakes. To start, I've partnered with Pattern in providing this crash course video. Pattern is one of our recommended disability insurance agents.
What Is Disability Insurance?
Disability insurance gives you an income to live on if you become so disabled that you can no longer work.
If you become disabled, a long-term disability insurance policy pays a predetermined amount each month until you either recover from your disability or reach age 65-67 (policies vary).
Why Do Physicians Need Disability Insurance?
One out of seven doctors end up having to use their disability insurance. Losing the ability to turn the knowledge and skills you spent a decade learning into a pile of money by working in your profession for decades is one of the most expensive risks that physicians face. Your most valuable asset is your ability to work.
How Does Disability Insurance Work?
Disability insurance is a pretty straightforward proposition. You buy a policy and pay your premium monthly or annually. If you become disabled, you (and your doctor) fill out the paperwork to prove it to the satisfaction of the insurance company and then they pay you the promised monthly benefit until you either recover from your disability or the insurance company meets its contractual obligation to pay the benefit.
Short-Term vs. Long-Term Disability
Disability insurance is most commonly divided into short-term and long-term.
Short-Term Disability
A short-term disability policy generally begins paying just as soon as you get disabled and then pays for a maximum period of 3-12 months. These policies are often provided by an employer as an employee benefit. Short-term disability, while inconvenient financially, is not generally a financial catastrophe for a physician saving for retirement with an emergency fund. As a result, many doctors do not buy short-term disability policies at all.
Long-Term Disability
A long-term disability policy generally does not pay immediately, but only begins to pay after a waiting period ranging from 1-6 months. Then, the policy will continue to pay you a benefit each month until age 65 or 67, depending on the policy. Since losing your ability to earn a living for the rest of your life is a financial catastrophe, any doctor who is not financially independent should buy a long-term disability insurance policy.
What Does Disability Insurance Cover?
Disability insurance covers all kinds of disabilities. The best (and unfortunately most expensive) policies cover the widest range of potential disabilities.
The Definition of Disability
The most important feature is the definition of disability. Disability insurance differs from life insurance in numerous ways, but none is more significant than in defining exactly when you become disabled (and when you become enabled again). The broader the definition of disability you get in your policy, the more the policy will cost.
Unlike life insurance, where life and death are pretty black and white, disability has 50 shades of gray. You want a policy with a strong, broad definition of disability that will cover any possible type of disability? That means “true own-occupation, specialty-specific” and no limitations on things such as psychiatric conditions or addictions. This is the main difference between the “Big 5” companies and others. Even among the “Big 5,” there are slight differences. It is OK not to purchase the policy with the very best definition of disability, but the weaker the definition, the bigger the discount you should expect.
Own-Occupation, Specialty-Specific
Probably the most important aspect of the definition for doctors is that it be specific to your occupation. For instance, if I lost my left thumb, there are a number of procedures in emergency medicine that I could no longer do. I would be completely disabled from managing a busy emergency department by myself. But I could probably still go do urgent care work. A specialty-specific definition of disability in my policy would provide me with my full disability payments in addition to the money I make at the urgent care. Sometimes, the “specialty-specific” clause is inherent to the policy, and at other times it is an additional rider (a piece of paper added to the policy for which you pay an additional premium). Either way, you almost surely want to get this in your policy. Here are the various definitions, starting with own occupation and progressing to any occupation.
Own-Occupation Definition
Under this definition, your policy will pay if you cannot work in your occupation/specialty, even if you can and do work in another field and make as much money as you want.
Own-occupation policies cover people based on the occupational duties they are performing at the time of claim. If your policy includes an own-occupation definition of total disability and you are exclusively performing the customary duties of your medical specialty or sub-specialty at the time of the claim, the policy will cover you when unable to perform your specialty or sub-specialty. If you have transitioned into a different role or expanded into a new career path that requires much less direct patient contact or procedural duties, you may no longer be considered totally disabled when unable to work in your specialty or sub-specialty. This is because your “occupation(s)” involves additional material and substantial duties, no longer limited to the performance of your medical specialty or sub-specialty. In these instances, you may be considered partially disabled or not disabled at all, depending on the exact circumstances.
Transitional Own-Occupation
Your policy will pay if you cannot work in your occupation/specialty, even if you can and do work in another field. But if you exceed your previous income while you now work in another field, your monthly benefit from the policy would likely be lowered.
Modified Own-Occupation
Your policy will only pay if you can't work in your occupation/specialty AND if you are not working in another field. This definition is also sometimes called “Own-Occupation, Not Engaged” or “Own-Occupation, Not Working.”
Any-Occupation
Your policy will only pay if you cannot work in any occupation. Note that some policies are own-occupation for a couple of years and then transition to any-occupation.
One company out there (Northwestern Mutual) sells a policy with a definition that they claim is BETTER than own-occupation. They call it Medical Own-Occupation, but in reality, it is just a form of modified own-occupation. Learn more about the NML Medical Own-Occupation Definition.
Do You Really Need an Own-Occupation, Specialty-Specific Policy?
Some non-procedural physicians argue that they might not need a true own-occupation policy. They reason that if they are so disabled that they cannot practice their specialty, they probably cannot do anything else. So, they accept a less broad definition of disability to save some dollars on the premium. If you choose to do this, make sure you understand the exact circumstances under which your policy will and will not pay out.
Mental Disorders/Substance Abuse
Many policies will only cover mental illness or substance abuse-related disabilities for a period of two years. I know an attorney who couldn't practice law after developing bipolar syndrome in his 30s. It took over a decade to get it under control. He had a policy that covered mental illness indefinitely, which prevented financial catastrophe from striking him and his family.
According to the April 2011 issue of Current Psychiatry Magazine, physicians are not immune to depression and have an increased risk of suicide. Additionally, the lack of distinction between a psychiatric diagnosis and impairment stigmatizes physicians and impedes treatment.
You'll need to decide whether this is a risk you're willing to run. If you want mental illness covered like every other illness, you'll be paying more.
Presumptive Total Disability
As you well know, disability can be defined in many shades of gray. In the event of your disability, you can expect a paperwork fight between you, your physician, the disability insurance company, and maybe even your attorney. However, most policies contain a section that defines “presumptive total disability” where you can be assured there won't be much arguing from the insurance company. The policy I used to have read like this:
“Presumptive Total Disability – Your total and permanent loss, because of Your Injury of Sickness, of one of the following:
- Speech;
- Hearing in both ears, not restorable by hearing aids
- Sight in both eyes (see below);
- Use of both hands;
- Use of both feet; or
- Use of one hand and one foot.
Total and permanent loss of sight in both eyes means: Both eyes must measure at or below 20/200, after reasonable efforts are made to correct their vision, using the most advanced medically acceptable procedures and devices available.”
Anything short of that, and you're going to have to get your doctor to certify your disability and get the insurance company to accept it. At times, this can involve visits to multiple specialists and even hiring an attorney.
Cosmetic Surgery/Transplant Surgery
Some policies will cover you if your disability is the result of cosmetic surgery or the result of donating a kidney or other body part to someone else. Others will not. Best to read your policy carefully and know what it does and does not cover.
Disability Insurance Exclusions & Limitations
Disability insurance policies generally exclude any medical conditions you have at the time of applying for insurance. For example, if you already have chronic back pain, the policy will not provide a benefit if you are disabled due to a back condition. In addition, if you admit to participating in dangerous activities such as scuba diving, rock climbing, flying, and sky-diving, the policy will likely be issued with a rider that excludes those activities from coverage. Other exclusions may also apply, such as acts of war, normal pregnancy, and foreign travel. Here is a list of common exclusions:
- War or Act of War (this could probably be interpreted pretty broadly)
- Active Military Duty (having served, this is pretty stupid since 95%+ of our military folks are never in any kind of serious danger of being hurt by a combatant)
- Normal Pregnancy (don't want to work because you're eight months pregnant? Don't bother trying to get disability benefits for that)
- Foreign Travel (varies by policy, but many don't cover you during that European vacation, much less that humanitarian trip to Sudan—read the fine print)
- Mental/Nervous Disorder (many companies limit benefits to two years, where they might pay for “physical” disorders until you're 65 years old)
- Medical Exclusions (any medical conditions you have at the time the policy is issued will likely be excluded, meaning if you have heart disease at the time of issuance and it leads to you being disabled five years later, the policy isn't going to pay. Again, apply when you are young and healthy and/or when you haven't had medical problems for several years to minimize this.)
Residual Disability
Residual disability refers to being only partially disabled. This may occur from the initial injury or illness or be part of the process of recovery. You generally need to buy an additional rider to cover this. Read this rider carefully, it can be a bit complicated. The definition of residual disability that was in my policy is listed here:
“Residual Disability/Residually Disabled – Residual Disability means You are not Totally Disabled, but because of Your Injury or Sickness:
- Your Monthly Earnings are reduced by 20% or more of Your Indexed Prior Monthly Earnings; and
- You are under the regular care of a Physician appropriate for Your Injury or Sickness; and
- You are able:
- To do some, but not all, of the substantial and material duties of Your Regular Occupation; or
- To do all of the substantial and material duties of Your Regular Occupation, but not for as long a time or as effectively as You did immediately prior to Your Injury or Sickness.”
Imagine developing painful lumbar radiculopathy that keeps you from working more than 20 hours a week. This is the part of your policy that will cover that. This rider will also explain how much you get if you are partially disabled. My old policy says it pays the whole benefit (total disability) if I can't earn at least 20% of my “indexed prior monthly earnings,” which is basically the money I earn at my job. It doesn't count my investments, other disability income policies, rent from a rental property, or my nonvocational activities. It doesn't pay anything if my earnings aren't reduced at least 20%. If I am making between 20%-80% of what I made previously, I get the total disability benefit times the ratio of my loss of income for that month divided by my indexed prior monthly earnings.
Partial Disability vs. Residual Disability
Partial disability and residual disability are generally considered to be the same thing, but there is a technical difference at some companies. For example, at one company, a partial disability rider requires total disability during the elimination period and the residual disability rider does not. With another company, partial refers to the disability, such as one that only affects one part of the body (such as one arm), while residual refers to a decrease in earnings. Either way, the key is to understand how the residual/partial rider works in the policy you actually purchase.
Disability Insurance Riders for Physicians
Disability insurance policies are generally sold with “riders.” Disability insurance riders are additional features of a policy that may or may not cost an additional premium. There are a half-dozen or more of these riders, and some are more important than others.
Residual/Partial Disability
This rider should be purchased by everyone. It covers a partial disability and provides a partial benefit as you recover from your disability.
Inflation Protection
Sometimes called a Cost of Living (COLA) rider, this rider indexes your benefit to inflation, usually starting one year after you become disabled. This is a particularly important rider if you are disabled at a young age, so I recommend it for anyone buying a policy in their 20s-40s. If you are already 55 and the policy is only going to pay until you are 65, you can probably skip this rider.
Future Purchase Option
This rider allows you to buy a larger benefit at a later date without any pesky questions about your health or hobbies. If you are in a position (such as a resident) where you cannot afford as much as you need, purchase this rider. Given the stress and relatively unhealthy lifestyle most residents lead, it is not unusual to develop a medical condition during training. If that occurs, you may not be able to buy another policy at all when you become an attending. Even if you can, that condition is likely to be excluded. A future purchase option rider allows you to buy that additional needed coverage.
Catastrophic Disability
This Catastrophic rider pays out an even larger benefit if you are REALLY disabled, usually defined as not being able to do two or more activities of daily living. Unless you are already up against the maximum amount you can purchase, I think you are probably better off just buying a larger primary benefit instead of this rider.
Retirement Benefit
This rider, in the event of disability, causes the insurance company to put some money into some type of retirement vehicle for you in addition to paying your monthly benefit. Unfortunately, these are generally high-expense, insurance-based investing products and not the best way to save for retirement. You are better off purchasing a larger primary benefit with the money that would have gone toward this rider. Just don't forget you need to continue to save for retirement using your disability benefit money since the policy will only pay to age 65 or you will be living only on your Social Security benefits. If you're interested in the details of this rider, check out this post on disability retirement protection.
Non-Cancelable and Guaranteed Renewable Rider
If your policy is not non-cancelable and guaranteed renewable, you'll need to buy a rider to get these important features. It's important to understand these terms.
Conditionally Renewable
This means the company gets to decide what the conditions will be for you to renew your policy and at what price. You DO NOT want a policy that is conditionally renewable. In fact, it would be unusual for a salesperson to even try to sell you one.
Guaranteed Renewable
This means the company can change your premium, so long as they change it for everyone in your state, your policy year, or your occupational class. But they must renew the policy at some price.
Non-Cancelable and Guaranteed Renewable
This means the company cannot change anything about the policy—not the premiums, not the monthly benefits, and not the policy benefits up until age 65 (or whatever the specified age in the policy is). Even if you change occupation to something in a more risky class with a lower income, the benefit will remain in place at the same price.
The policy I used to have technically wasn't non-cancelable by itself, but the company gave me the non-cancelable rider for free. That's my favorite price. I recommend against buying any policy that isn't at least guaranteed renewable, but I have seen a few reasonable arguments to not buy a non-cancelable policy if it saves you a significant amount of money.
Recommendations for Physicians on Disability Insurance Riders
Here's an easy cheat card to help you know at a glance what we think about all of the various riders available.
Who Needs Disability Insurance?
Nearly every high-income professional in their first decade or two out of school should own a policy. Your most valuable asset is your ability to work. So, if you do not own a disability insurance policy, you need to go get one, now. If you have an income, it's time to buy a policy, even if money is tight as a resident. The only exception is if you do not rely on your income to live. If you are already financially independent, it's OK not to buy disability insurance. However, even if you are frugal and married to another high earner, you may wish to still have a policy. You could both become disabled, or you could become divorced.
Is My Employer's Plan Good Enough?
The most important rule of disability insurance is that any disability insurance is better than no disability insurance at all. If you are disabled without disability insurance, you will be limited to what is offered by the Social Security Administration, which provides relatively low payouts and can be difficult to qualify for. My last Social Security statement says my disability benefit would be $2,471 a month. Living on that would be a dramatic decrease in our standard of living.
Many employers (and professional associations) also offer disability insurance. If your employer is paying the premiums, be sure to take advantage. If they are not, you will have to compare the group policy to the individual policies that an independent agent can sell you. As a general rule, individual policies have a stronger definition of disability and higher (but flat) premiums but can be taken with you from one job to the next. Group policies are less expensive (although premiums generally rise as you age) and often don't ask pesky questions about your health and hobbies but cannot be taken with you when you leave.
In some cases, an individual policy is best. In other cases, the group policy makes sense. Occasionally, it can make sense to have both. Owning a pre-existing individual policy may limit how much of a group policy you are allowed to purchase.
How Much Physician Disability Insurance Do I Need?
As a resident, you typically cannot afford to buy as much as you need, but you should be able to do so even as a brand-new attending. Basically, you need to buy enough disability insurance to cover both your living expenses and your retirement savings if you were to work to age 65 but not your taxes. Physician disability insurance payouts are generally tax-free since they are usually paid with post-tax dollars.
Note that how much you need has little to do with your income and everything to do with what you spend. The less you spend, the less insurance you need to buy. Insurance agents would love to sell you the largest possible policy (which usually works out to be about 2/3 of your gross income, but it is possible to combine two companies to get even more), so you'll need to decide how much you need on your own. Resident physicians typically buy a $5,000 per month benefit and attending physicians typically buy a benefit in the $10,000-$15,000 per month range, but there are plenty of docs who buy both more and less. If your plan in the event of disability is to rely on the income of your spouse, you may not need disability insurance at all.
Average Cost of Disability Insurance for Physicians
Unlike cheaper insurance policies like term life and umbrella policies, physician disability insurance is expensive, although not quite as expensive as your malpractice insurance. The reason it costs so much is it actually gets used. The likelihood of you acquiring a long-term disability during your working years is approximately seven times as high as your risk of dying in those years. A typical policy bought on a healthy doc in their 20s or 30s will cost something between 2%-6% of the benefit. If your monthly benefit is $10,000, expect to spend $200-$600 per month for that. Perhaps the sticker shock you get upon being quoted prices will motivate you to reach financial independence as soon as possible so you can cancel the policy.
Graded vs. Level Premiums
One way to save money on your policy is to get graded premiums. Not all policies offer this feature, but those that do will charge you less in the first few years and more in later years. Level premium policies charge you the same amount in premium every year. A graded premium policy accounts for the fact that you become more likely to become disabled as you go through life. However, it can be very beneficial to you because your need for insurance actually falls continually throughout your career as your build your retirement nest egg.
Once you become financially independent, you can drop the insurance completely. This is a good idea since the total benefits a policy could potentially pay are also dropping throughout your life (since the policy will generally only pay until you are in your mid- to late-60s). Many white coat investors who are great savers hit financial independence by mid-career. If you are one of those, you are likely to come out ahead using graded premiums instead of level premiums.
Why Is Disability Insurance More Expensive for Females?
Disability insurance generally costs more for women than for men. This is simply due to the fact that women are much more likely to make a claim than men are, partly due to the unique risks of pregnancy. As a result, men should generally buy a “gender-specific” policy and women should generally buy a “unisex” policy whenever possible. It is also best to buy a policy prior to becoming pregnant. Note that unisex policies are becoming less and less common every year.
What Disability Insurance Discounts Are Available for Doctors?
Like other types of insurance, disability insurance is sold by agents who are paid commissions by the insurance companies to sell their products. It is a very competitive business. The insurance companies want agents, especially the independent agents you should be buying from, to preferentially sell their products. To incentivize the agents, they offer discounts that are only available through certain agents. Experienced, high-volume agents can often provide you with the same policy at a cheaper rate than a newer, lower-volume agent. Thus, it pays to use an experienced agent and shop around with two or three of them. Nearly every doctor should qualify for some type of discount on their policy—10%-30% premium discounts are not unusual. Types of discounts include:
- Unisex discounts
- Trainee discounts
- Multi-life institution discounts
- Guaranteed Standard Issue (GSI) institution discounts
- Association discounts
Learn more about physician disability insurance discounts.
How Do I Buy Disability Insurance?
The key to physician disability insurance is the independent agent. The agent is going to be paid a great commission by the insurance company no matter which policy you choose. Assuming policies with similar benefits, the commission isn't going to be all that different. Plus, these agents get plenty of business and none of them are starving, so they have little incentive to sell you an inferior policy for a slightly higher commission. Their reputation is worth far more than a few extra dollars in commission. Since you are (indirectly) paying the agent a very nice commission, don't feel bad about using their time and expertise to fully understand this complicated product.
For most doctors, this is a purchase that is only done once or twice in their life. Have the agent quote you different physician disability policies from each of the “Big 5” companies and show you the strengths and weaknesses of each. If you have a policy from work or your professional association, bring it in with you and have it included in the comparison. Then, you can know you made an educated decision and you can buy it and forget about it. Also, be sure to ask for a discount. The vast majority of doctors will qualify for a 5%-30% association or employer-related discount, and a top-notch agent will help you get that.
What to Know Before Shopping for a Disability Policy
There are a number of things you should know prior to beginning the process. These will help you decide how much insurance and which policy to buy.
These items include:
- Your income (check your last W-2, 1099, or tax return)
- How much you spend each month
- If your employer or professional association offers any disability insurance
The process of buying disability insurance is best done by following these steps:
- Figure out how much insurance to buy
- Choose an agent or agents to purchase from
- Find out if you are eligible for group or association policies and bring them when meeting with the agent
- Have the independent agent quote the best policies for your specialty, state, and gender, including discounts
- Make a rational selection of base policy and needed riders
Application and Underwriting Process for Physicians
Underwriting is the process an insurance company uses to determine the final terms and conditions of your policy. After selecting which disability insurance policy to apply for, you will need to go through the two- to six-week underwriting process for approval. After submitting an application, it takes 3-6 weeks to receive an offer. However, that period could be shorter or longer, depending on how long it takes to receive and underwrite (review) the required medical, financial, and occupational information. In fact, there are several unique strategies to consider when putting your insurance in place.
What Type of Disability Insurance Should I Buy?
There are two main types of disability policies: individual policies and group policies. As a general rule, individual policies have stronger definitions of disability. Many group policies are not own-occupation policies. Individual policies are also portable, in that you can change jobs and take them with you.
Individual Disability Policy
There are a number of benefits of an individual policy. The main one is that you are in control of all the details. You get to choose how much insurance you want to pay for. You get to choose which of the bells and whistles you are going to pay for. The policy is also “portable,” meaning you still have it if you change employers (or if your employer just decides to change the policy). As a general rule, the policy is also “stronger,” meaning it is more likely to actually pay you if you get disabled.
Group Disability Policy
A group policy provided by your employer is usually not portable, although sometimes you are allowed to take over the entire premium and take it with you. Group policies also frequently have premiums that increase every year or every five years, whereas an individual policy usually has level premiums. Group policies paid for by your employer may also pay a taxable benefit, rather than the tax-free benefit provided by an individual policy. Aside from the lower cost, the main benefit of a group policy is that it may be easier to qualify for. It may not require any sort of medical exam or blood work, and it may not ask any pesky questions about your medical conditions and dangerous hobbies such as rock climbing, skydiving, scuba diving, or flying.
Choosing a Waiting Period
Policies will usually give you a choice of a 30-, 90-, or 180-day waiting period. I recommend the 90-day period. A waiting period is the time between the date you are disabled and the date when the policy starts making payments to you. With a three-month emergency fund, you can easily self-insure for those first 90 days, avoiding the need for a short-term disability policy. Policies with 30-day waiting periods are too expensive and a policy with a 180-day waiting period does not provide much of a discount over one with a 90-day period.
How to Compare Disability Insurance Policies
The most important feature is the definition of disability. You want a policy with a strong, broad definition of disability that will cover any possible type of disability. That usually means “own-occupation, specialty-specific” and no limitations on things such as psychiatric conditions or addictions. This is the main difference between the “Big 5” companies and others.
Since disability is complicated, disability insurance policies are complicated. There are dozens of differences from one policy to another, making them difficult to compare. Use your independent agent for recommendations on what matters most. Just for an example, take a look at this chart of all the differences you could see between one policy and another.
See what I mean? The differences between the policy from one of the “Big 5” to another are not quite so large, but they still exist. Comparing one policy to another may be the most time-consuming part of the process of purchasing. Take your time and don't be afraid to use your agent's knowledge. They get paid about the same no matter which policy they sell you, so at least in this regard, you can trust their advice. (By the same token, you probably don't want to necessarily trust their advice on how large of a policy to purchase. Decide that before you go see them.)
When to Buy Disability Insurance?
You should buy disability insurance just before you become disabled. Since you don't know when that time could be, earlier is generally better. However, disability insurance is also expensive, and when you are young and poor, you have lots of other great uses for your money. A good compromise is to buy a small policy as you enter residency and then upgrade to a more robust disability insurance plan just before leaving residency. The younger you are, the healthier you are, and the fewer dangerous hobbies you engage in, the cheaper your premiums will be for the same benefit.
Who Do I Buy Disability Insurance From?
Disability insurance should be purchased from an independent agent. An independent agent can sell you disability insurance from any of the “Big 5” disability insurance companies. These include The Standard, Guardian/Berkshire, Principal, Ameritas/Union Central, and Mass Mutual (+/- Ohio National). Each of these offers a strong “own-occupation” disability insurance policy appropriate for physicians. Note that Northwestern Mutual is NOT one of these companies. Aside from the fact that its definition of disability is weaker than those of these other companies, the experience of many white coat investors is that their agents also often use disability insurance as the “gateway drug” to sell you an unnecessary and expensive whole life policy.
Best Disability Insurance for Physicians
I keep a list of those I consider the best disability insurance agents in the country. Save yourself the work of finding a good one you can trust and use the same agents that have been used by thousands of WCI readers in the past. You do not need someone local that you can sit down across the table from. It is better to have someone who has sold policies to hundreds of docs this year working with you by phone, Skype, Zoom, and email than someone you can sit down with who has only sold four policies. In addition, if there is some issue with one of these agents, I can usually help you resolve it quickly.
Information in this space rapidly changes. While we try to keep The White Coat Investor website as up-to-date as possible, our recommended agents are going to be our best source for updated information. I cannot emphasize how strongly I suggest you use them, whether buying your first policy or simply reviewing what you already have.
Use a WCI-Vetted Agent to Get Disability Insurance Today!
How to File a Disability Insurance Claim
Legitimate disability claims are processed quickly and without much hassle. You have to fill out a form as the claimant and your employer has to provide some information, and then they request records from your primary doctor. These are the steps for filing a claim.
- Read your policies and understand your coverage
- Check the definition of disability
- See if you are eligible for partial or residual disability
- Consult an experienced attorney
- Get a diagnosis
- Gather additional medical evidence
- Collect other documentation supporting your disability
- Establish a date when your disability started
- Plan administratively and financially for your disability
- Beware of under-reporting your symptoms and restrictions
Do I Need to Get an Attorney Before Submitting My Disability Claim?
In most cases, you do not need to hire an attorney for individual disability income claims. Most cases of disability are pretty straightforward. I think if the insurance company hears first from your attorney, the first thing it's going to say is, “Why did this person get an attorney? Maybe we ought to look at this more closely.” If you're in a gray area, maybe. Otherwise I'd wait until there's an issue. The company does assign you a claims consultant whose job is to help you get all the necessary information to the company and walk you through the process. They may ask you for more information, but I'd just try to be as cooperative as possible. However, if you start running into problems or feel the company is not doing what it should, go ahead and get that attorney. Just recognize they do not work for free.
How Often Do You Have to Be Recertified as Disabled?
It depends on the disability. For a serious condition that you're obviously not going to recover from, you may never have to do anything again—certainly no more than a form once a year from your doc who you're going to be seeing more often than that anyway. For a soft tissue injury or something from which you're expected to recover relatively soon, more frequent certification may be required.
When to Reduce or Cancel Your Disability Insurance?
Disability insurance is a temporary type of insurance, like term life insurance. When you no longer have a need for it or it is no longer a good deal, you should cancel it and use what you would have spent on premiums to save, spend, or give more than you now do. The idea is to have disability insurance in place from the time you start earning money until the time when you no longer rely on that earnings stream. Since any type of insurance is, on average, a losing proposition, you should only insure against financial catastrophe. Acquiring a long-term disability while your family relies on your income is a financial catastrophe. Becoming disabled after you are already financially independent or for only a short period of time is not. So, when you reach financial independence, you can cancel your disability insurance (and your term life insurance).
In addition, since most disability insurance policies only pay out until age 65 or 67, the possible payout becomes less and less as you age. As you move into your 60s, you may decide it is no longer worth the premiums to only get a few years of benefits in the event of long-term disability. If so, it's time to dump your disability policy. I have dumped mine, and if you follow the advice on this site, someday you will wealthy enough to dump yours too.
Key Takeaways
- Your most valuable asset is your ability to trade your time for money at a very high rate for the next few decades. Insure it as soon as you come out of school.
- The best policy is an individual, portable, own-occupation, specialty-specific policy.
- Purchase disability insurance from an independent agent who can show you policies from all of the major companies.
- Buy as much disability insurance as they are willing to sell you as a resident. Include a future purchase option and a cost of living rider. You will probably buy more when you finish training.
Frequently Asked Questions (FAQ)
Didn't find the answer to your question above? Add it to the list in the comments section. Here are some additional questions we have received on disability insurance.
How Much Does the Social Security Disability Insurance Benefit Provide?
It depends on your age, how long you have been working, and how much money you have been making over that time period. The length of period you must have worked just to get anything at all varies by your age. Usually, you will need to have worked and contributed to Social Security in 20 quarters over the last 10 years, but there are exceptions, particularly for the young.
Assuming you have a long enough work history to qualify and you qualify medically, the amount generally goes up over time depending on how much you have earned and paid into Social Security. The easiest way to tell is to check your Social Security statement. At mid career, mine is about $2,471 per month. That's just under $30,000 a year, not exactly living it up.
Can I Add or Remove Riders and Exclusions Later?
The rule of thumb for policy adjustments is that you can reduce the insurance company’s liability without needing additional underwriting. In other words, you can reduce your coverage level or benefit period, increase your elimination period, or remove optional riders with a simple change application that does not require additional underwriting. But anytime you want to increase their liability—such as when adding riders, increasing coverage levels, or removing medical exclusions—they’ll want to review updated information. If you still qualify, you can add riders later, but it might cost you more. Exclusions can be removed, and it is worth pursuing medical exclusions after a certain period of time has passed, such as a five- or 10-year cancer-free period. Risky activity exclusions are much more difficult to remove. Think about it. If you are no longer rock climbing or scuba diving, why do you need the exclusion removed? If you are, why would they remove it?
What Are Some of the Differences Between Disability and Life Insurance?
Perhaps the greatest differences between these two commonly purchased products is complexity and cost. Life insurance, at least term life insurance, is a very simple and straightforward contract because people are either dead or alive. By comparison, disability is “50 shades of gray.” Term life is also much less frequently used than disability insurance, so the premiums are much cheaper. Life insurance is really to protect your loved ones, whereas disability protects you (and your loved ones indirectly).
Is Disability Insurance Tax-Deductible?
As a general rule, no. Individual policies are paid for with post-tax dollars and pay out tax-free dollars. Employer-provided policies can be paid for with pre-tax dollars (a tax deduction for the business) and thus pay out fully taxable benefits in the event of disability. However, self-employed doctors generally do not have a business structure (C corp) that allows pre-tax disability benefits.
Do You Pay Taxes on Disability Insurance Benefits?
If the premiums were paid with post-tax dollars (like most policies), the benefits will be tax-free. If the employer provided the policy, the benefits will be taxable as ordinary income. Social Security disability benefits are taxable, although few on them have enough other income to result in any tax being due.
Does Guardian Really Have the Best Policy for Doctors?
Some agents that sell primarily Guardian policies would love you to believe that, but it is not necessarily true. Guardian does have an “enhanced” True Own-Occupation definition of total disability, which it claims is a stronger definition compared to other insurance carriers. The enhanced specialty language for physicians adds extra language that provides additional ways to qualify as totally disabled based on how you earn your income, even if you continue working in your practice or you work in another occupation. Examples where Guardian might pay but other own-occupation policies might not include specialists like Ophthalmology, Urology, OB/GYN, or ENT where a doctor may gain substantial income from non-surgical clinic work. If these specialists cannot operate but can still make most of their income in clinic, the other policies might not pay out. But Guardian would. Other situations include docs doing some side gig work such as blogging, medicolegal work, pharmaceutical work, or directing a medical spa.
Some Guardian policies have other features that may be slightly stronger than those of other carriers. You should still compare them side by side and decide whether those features are worth a potentially higher premium. You almost surely want a specialty-specific, own-occupation policy from one of the “Big 5 (or 6)” providers, but it does not necessarily have to come from Guardian. As one agent told me:
“Guardian's enhanced true own-occupation definition can only help an insured and never hurt an insured. However, if the sole reason that someone is buying Guardian is for their definition, I would say that they should look at how the overall cost and benefits of the policy compares to the others. Short of a unique side gig or surgical specialist with substantial non-surgical income, unless the cost difference was minimal, I would find it difficult to justify the purchase of their policy solely based upon its ‘Enhanced' Medical Specialty definition of total disability.”
Does the Military Provide Physicians with Disability Insurance?
The military does provide some disability benefits to its members. But compared to a good individual disability insurance policy, most physicians would view what the military offers as grossly inadequate. It can be very difficult to get an individual policy while on active duty, although if you have a policy in place prior to going active, it can usually be maintained during active duty. Two companies that offer policies to military members are Mass Mutual and Lloyd’s of London. Bear in mind that a policy will rarely pay benefits as a result of an act of war, but if you are disabled due to medical issues or a non-war related accident, it should still pay out. More information at these links:
- Disability insurance for reservists
- Disability insurance for federally employed civilian physicians
- Disability insurance for military physicians
Should I Get Disability Insurance as a Resident?
Yes. My general recommendation is to buy your coverage as soon as you get out of school (i.e., your first month or two of residency), although it is possible to buy a very small policy even as a medical student. Then, upgrade your policy (either by purchasing an additional policy or exercising a future purchase option rider) upon completing your training. The younger you are, the less expensive and the more valuable the policy is. Waiting until your last year of residency, until you graduate, or until “you can afford it” leaves you uninsured and may cost you more money in the long run anyway. The insurance companies price them by age and medical problems—the younger and healthier, the better. Residents get disabled from time to time, and they often develop conditions during their long years of training that result in them paying more for insurance, having a policy with exclusions, or not being able to buy a policy at all.
Do I Need the Student Loan Disability Insurance?
Insurance companies and their agents are always coming up with new products to sell you. I came across a new one recently from a firm called InsureSTAT. It was offering you disability insurance for your medical school loans. The idea is that if you get disabled, this insurance kicks in and pays off your loans. Except you don't have to use it for your medical school loans. You could use it for anything you want.
Say what?
That's right. The whole student loan disability insurance thing is just marketing. Some policies may even offer a student loan rider on their policies, which would make your student loan payments in addition to paying you a benefit. They only do this for total disability, not partial disability, and there are minimum and maximum payments that might surprise you. In general, I see this as a gimmick rider. Spend the money on just getting a larger base benefit rather than this rider.
What Is the Difference Between GSI, Individual, and Group Disability Coverage?
Individual coverage almost always offers better policy definitions, and coverage continues as long as you pay premiums. However, it’s generally more expensive.
Group insurance is typically inexpensive or even employer-paid. Often there is little to no medical underwriting. However, the coverage may not be “own-occupation,” and rates may increase over time. The employer, rather than the employee, owns the policy, and you may not get to keep the policy if you change jobs.
Guaranteed Standard Issue (GSI) coverage is individual coverage, so GSI includes all the same advantages as traditional individual insurance. If you are healthy with no risky hobbies, you can likely get an individual policy that costs less than a GSI policy, but if you have any health problems at all, a GSI policy may be your best or even only option.
What Is the Elimination Period in Disability Insurance?
The elimination period is the period of time between the onset of the disability and when you start receiving payments. The standard is 90 days, but you can get a period as short as 30 days on a long-term disability policy. Short-term disability policies generally have no elimination period. Keep in mind that your payment often does not come until a month later, so a 90-day period is effectively a 120-day period. As a general rule, you should have an emergency fund to cover the first 90-120 days so you do not have to pay extra to get a shorter elimination period. However, there is not much savings in extending that period from 90 days to 180 days, so we generally recommend the standard 90-day elimination period.
Can You Have Two Short-Term Disability Policies?
As with most things related to insurance, the answer to this question will depend on the exact terms of the short-term disability policies that you purchase, but generally yes, you can collect on multiple short-term disability policies. Having multiple short-term disability policies is referred to as stacking disability insurance.
What Mistakes Do Doctors Make When Buying Disability Insurance?
While most doctors have lots of questions about disability insurance, the answers are generally pretty easy to find—either on the internet or from the independent agent you are buying a policy through. Doctors make lots of mistakes when buying disability insurance, but the biggest mistake by far is not getting insurance at all. Here are some other common mistakes:
#1 Buying a Policy Through a Captive Agent
Captive agents are subsidized and incentivized by insurance companies. In return, agents are obligated to sell products for that insurance company, irrespective of the client’s best interest. An independent agent (broker) better serves their clients’ best interests rather than the insurance companies. There are still conflicts of interest, but they are smaller. Even independent agents may receive higher commissions or other benefits for selling policies from one company over another.
#2 Focusing Too Much on Cost
Many physicians shopping for coverage focus too much on low cost, instead of attaining comprehensive coverage. Removing the Own-Occupation Rider or the Partial/Residual Disability Rider is not worth the cheaper premium, because the conditions to file a claim are so much more limited that they end up paying for coverage they will never qualify for.
#3 Waiting Too Long to Apply
Don't wait until you graduate residency/fellowship to apply in order to save money. Many individual disability carriers offer deep discounts for residents and fellows. These discounts often lock in for any increases in the future. In addition, residents and fellows may be offered coverage without a physical exam or blood testing. As an attending physician, even a small policy can trigger blood, urine, and paramedical examinations.
#4 Waiting Until Something Happens to Buy a Plan
Policies are issued based on medical underwriting. Once you are issued a policy, it cannot be taken away or repriced—even if your health changes. If you wait to buy a policy until you are symptomatic or have been diagnosed with a medical problem, chances are you will end up with one or more exclusions and/or modifications of benefits.
What do you think? What have you learned about disability insurance that everyone ought to know? How have you structured your coverage? Comment below!
[This updated post was originally published in 2017.]
Thanks for your input! I got the MetLife DI policy with the necessary riders listed on your book through Joe Capone from Insuring Income which you have recommended. I really appreciate the things you do for us. Glad I stumbled-upon your 2015 article in PracticeLink which led me to your book and blog =) More power to you!
I heard there are policies for ppl with pre-existing condition, are those policies still around? Is it likely for me to be disqualified completly from disability insurance because i have a pre-existing condition. Lastly, I had a blood splash on my forhead by a patient who had Hep c, but is now tested negative. I have filed a report and I need to get re-tested in 6 months. Will that affect my application? Should i wait to apply after i get my 6 months result back?
I don’t think the blood splash is an issue. You know as well as I do that the likelihood of you getting Hep C from that is zero and everyone might get a disease in the future. Besides, Hep C is curable these days and would take a long time to disable you anyway.
An individual policy would likely exclude your pre-existing condition. A group policy may not, so I would look into what group policies might be available to you.
You should talk to a qualified agent that has dealt with disability insurance a long time. It might surprise you what a carrier considers a pre-existing condition or one that can be covered. As for the Hep exposure, if you applied prior to the 6 months re-check you probably will be approved since you have an initial test of negative.
As for group vs. individual, that comment of a group policy won’t exclude you is not totally accurate.
Virtually all group plans have a pre-existing condition clause that states if you get hired and go on to the group plan any pre-existing conditions you had at the onset of the policy will be a pre-existing condition for the next 12-36 months depending on the policy language. They have to do this since they don’t get to have a medical review up front thus they don’t know what they are insuring. It protects them from an unhealthy person joining a group just to get insurance in place in order to file a claim. In regards to group association plans those are fully underwritten and often times have a more harsh underwriting outcome than individual policies because they don’t have the flexibility to make a modified offer (change a waiting period, benefit period, put an exclusion, rate up a policy and so on), they are typically either approved or declined.
Certainly talk to all options, ask for an informal review of your situation by an underwriter with the individual, group, or association plan, and just see what is best potential outcome for you.
No I haven’t put in my application yet. I was about too and got the splash the same week. Should I apply later then? After I’m cleared? I don’t want to be declined or have something negative on my record permanently. Also, any recommendation on experienced disability insurance agent?
I think you should do an informal application so the agent can send your profile information to the carriers for their feedback. If the carriers come back and say no problem then great. If the carriers come back with an answer of “don’t apply yet” then all is perfectly good since you did not make a formal application thus you do not have a decline/modification on your record or MIB.
As for experienced agencies you can PM/email us your details if you like, or you will see commentary and dialog on WCI from Larry, Jamie, Joe, and Michael, all are very good at what they do so you should have no reservations about engaging any of us in this process.
I’m not sure you understand why people like Scott comment on blogs like this. I mean, I’m sure they love helping people but they’re also hoping to pick up some business. Were you hoping he would recommend someone besides himself?
At any rate, here’s my list of recommended agents: https://www.whitecoatinvestor.com/websites-2/insurance/
You’ll notice Scott is on the list.
I see! I just realized that from his username. Thanks for the list. I will start from there.
I’m an incoming intern at a hospital system that offers a group policy by The Standard, premiums are payed by my employer. I’m trying to decide if I should buy an individual policy now or later in residency. I’m not sure if I’ll be able to convert the group plan to an individual plan, which I guess is a major factor here. The plan covers 60% of my (resident) income up to 10k/month. We haven’t been briefed on the details yet so that’s all I know.
Should I be content with my group policy or go ahead and buy individual in addition to what my employer offers?
Sorry for the limited information, but I’m just trying to get an idea of what to do before July 1 gets here.
Thank you!
These are tough decisions. The most important thing is to have something, which you will. There is some risk there that you’ll become uninsurable during residency, and if that group policy isn’t convertible, could be hosed upon leaving. How much you want to spend to insure against that risk is up to you.
I had a question about the difference between the benefit purchase rider and the future increase option rider. It’s my understanding that both allow you to increase your disability monthly benefit but the benefit purchase rider requires your financial records to be submitted and reviewed every 3 years to determine if you’re eligible for more coverage whereas the future increase option rider doesn’t require any evaluation of your increase in income. On one of my quotes, the future purchase rider is like $29.00 and the benefit purchase rider is free. It would appear to me that the benefit purchase rider would still allow me to increase coverage as I graduate residency as my income increases and I would think it would be approved based on that increase. This would allow me to save money on the monthly premium and still have the ability to increase my disability coverage after residency. Am I missing something here?
You pretty much got it but there are a couple of things I would mention because there are some reasons to buy one or the other.
Benefit Update is controlled by the carrier with triggers for increase every 3 years, a 50% income increase or loss of group coverage. Since they control when you can do things they don’t charge you for it.
Future Purchase Options you do pay for but then you get to decide when and how you use it, there are no forced events. In addition as you use that Future Purchase Option then the cost for that goes away. As an example if you cost for the FPO is $29, if you exercise those rights to buy more then the cost of that $29 goes away and your premium on the original policy goes down.
If we can help further let us know.
So I have never had DI as of yet in my career. I was told that “locking in a rate” for DI was a good idea before graduating fellowship over obtaining a rate once becoming a new attending… is this true? Is there something special about obtaining a DI rate as a clinical fellow prior to starting as an attending or is this nonsense?
Yes, for the most part that’s true. Not only do you get a slightly cheaper price (you’re younger), and lock it in while you’re still insurable (you’re healthier), but you also won’t have issues with conflicts with a future employer’s group plan.
Some exceptions may exist- like perhaps a trainee in a specialty isn’t in the same risk category as an attending, but I think that’s pretty rare, or you’re moving to a state where the coverage is better or cheaper than where you live now. But for the most part, it’s best to buy it before finishing training and probably getting something in place as you start training.
The benefits of locking in a disability plan early, it can be one or more of these:
1: you are younger now so the rate will be lower it will be next year as you are then older
2: sometimes there are institutional discount plans in place to access while you are there but once you leave you can’t
3: you are currently healthier than you presumably will be later in life
Lock it in at $1,000 of benefit, control the contract going forward, and have future purchase options to $15-$17k…all for probably $30 +/- a month.
Which companies let you buy a $1000 policy with a $17K FPO? My understanding was that ratio was usually much less useful.
We have done it with Principal and Guardian.
That’s worth a guest post. Do you have any interest in doing one about just how much FPO you can get with each company?
There’s a great strategy there for a med student. Buy the $1000 you can afford, while locking in insurability for $17K more. You can activate some as a resident and some as an attending.
I currently have MassMutual and have looked at Ohio National via an agent I contacted through the WCI. I wanted to let everyone know about Ohio National’s exclusionary riders for women, which I am extrapolating from my own experience. I have undergone oocyte retrieval for cryopreservation. That is all, not for IVF or for any fertility problems, just freezing for possible future use, which I have not even determined I will do. As many women, physicians included, have had to face delaying starting a family for their careers, egg freezing is an option to preserve our choice for the future. I can understand Ohio National’s exclusion of infertility — and, really, disability is not likely to result from infertility — but Ohio National has excluded pregnancy as well from coverage.
Their rationale on this makes no sense. I learned from the agent that it is known by insurance carriers that women physicians have undergone egg freezing, which I inferred from the agent as not posing a problem before. Ohio National was considerably cheaper for me, without any medical problems and no prior history of medical issues. Yet, Ohio National has determined that because I have undergone egg freezing, any future pregnancy is excluded from disability coverage. Complications from pregnancy are a risk for any woman in general, so does it follow that women should have an exclusion rider for pregnancy? Egg retrieval and freezing pose no more risk than ovulation, but pregnancy in general does for all women, yet I do not see pregnancy as excluded in other DI. MassMutual did not exclude pregnancy as an exclusion — of course I obtained the policy before I decided to freeze my eggs. I do not know if the exclusion of pregnancy from DI is unique to Ohio National or if this will be commonplace across all insurers, but this is disturbing and irrational, and women physicians who may be considering egg freezing should consider obtaining their Disability Insurance prior to any plans for oocyte cryopreservation or else risk having pregnancy be excluded from coverage.
I am looking at other companies now and hope rational sense prevails.
For sure look at other companies. There is a lot about disability insurance that isn’t rational. For example, backcountry skiing and road cycling, both very dangerous activities, are not excluded. But toproping and SCUBA diving is. SCUBA kills 80 people in the US a year. Cycling kills 722. Even if you just look at the 400 person professional peloton in Europe, it seems like 5 of them a year get hit by a car and 1 of them gets killed.
1) How long are quotes good for? I was told in the past for the remainder of the year until your birthday.
Comment modified at commenter’s request.
I don’t know. Why not ask the agent and post the response here?
But I wouldn’t expect a quote to be good for more than a month or two personally. It seems unreasonable to ask for a price one year and then want to come back the next year and get it for last year’s price.
Quotes are usually good until your birthday or until the carrier changes the rates.
I am working with Finity Group who gave me quotes from Ameritas, Principal, Guardian, and Standard. Ameritas had the best price so they are only showing me options from them, but there is no future increase option or benefit purchase rider. I’m still in residency. Do I go without an FIO, or what should I tell the financial advisor I am working with?
Thanks
I would tell the financial advisor you only want to see quotes that include a future purchase rider because you’re still in residency and plan to buy more when you become an attending and that you expect the insurance agent to show you all your options for what you’er paying him/her.
Is Baird Financial Group one of the recommended agents for DI?
Here’s the list:
https://www.whitecoatinvestor.com/websites-2/insurance/
Baird is not currently on it. I do have a Beaird Harris Wealth Management on the list of recommended financial advisors and they may also sell insurance as many advisors do.
Thanks for your message. Could it be a licensing thing? I believe I went through the MD Financial Services link to obtain a DI quote. Could our place of residence determine that someone besides them handles it?
I was surprised too, because I had expected one of the names from your link.
Gary Baird is one of my business associates, he has been in the Disability Insurance business for over 25 years. The reason he followed up with you vs. me is that I am currently out of town and I wanted your inquiry to be addressed right away.
Good to know. Thank you.
Can the agents here please share all the carriers that have gender neutral rates?
After reading about Ohio National- not too thrilled.
In reality all of the Big 6 have unisex rates in some states and some situations. As an example, Principal who left the unisex market in the spring of 2017, actually just left the unisex market for residents, not practicing physicians or attendings. Ameritas does not have unisex as a general rule but they do have it in certain states and certain residency programs. It is not as easy as saying, “this carrier has it and that carrier does not” as every situation is different.
Hope this helps
What are the negative things you’ve been hearing about Ohio National? I’m in the process of getting a quote from them because they are significantly cheaper than my policy with Principal. I was told they were comparable to the other big companies.
I would include them in your search. They’re certainly trying to establish themselves as one of the big six.
I currently have a standard policy with Guardian that pays around 8,000 a month after 90 days. Worried that I may max out this policy at some point and have to find a new policy with a different company. Id rather find a second policy and take my physical now at a younger age/presumably more healthy and get a very low payout per month at 180 days. I would then have the option to increase both of them over time and not have to take another physical later on.
Is that a possibility? Any problem you see in doing that?
Thank you
Yes, you could do that. And not a bad idea. But the way I look at it is my need for DI is never higher than in the beginning. As time goes on (and your nest egg grows), you should need less, not more (ignoring the residency years of course.)
Yes you can do that, many times we might simply add a contract that does not have a multiplier on the benefit that dictates the FIO cap so that seems like the direction you should head for the most efficient policy design today.
Does anyone have comments on the American College of Surgeons Group Insurances with New York Life?
Similar upsides and downsides to most group policies.
https://www.whitecoatinvestor.com/why-i-bought-a-group-disability-insurance-policy/
https://www.whitecoatinvestor.com/should-i-purchase-life-or-disability-insurance-from-professional-societies/
Here are the pros/cons as I see it:
Pro-
Cheap today
Cons-
The waiting period has a the word ‘Total’ in it which is problematic.
Not a true own specialty policy definition policy which is typically need by surgeons
They can change the rate in addition to the every 5 year rate increase that will happen as you hit 40, 45, 50, 55, and 60.
They can change the language anytime they want/need to help keep claims down the profits up.
Let me know if we can help further.
Here is an article that I wrote on the American College of Surgeons Long-Term Disability policy
https://drcorysfawcett.com/look-before-you-leap-with-disability-insurance-acs-plan-review/
Keller’s article and Scott’s synopsis are accurate. In general, group disability insurance, should be for those individual physicians who cannot obtain private disability insurance due to medical history, extra-career hobbies/interests or for those who find themselves in devastating financial situations with absolutely no choice.
For help reviewing your personal disability coverage(s) both private and group, please contact a licensed INDEPENDENT disability insurance agent (NOT associated with a single company)… this can be done in addition to whomever your financial advisor/financial company is currently. Reviews should be done every 3 to 5 years on many aspects of your financial health and they should be conducted by 3rd parties. There exist too many conflicts of interest within the financial representation world. The best financial advisors will have absolutely no issue with you having their work reviewed or the products they suggested reviewed.
The best doctors have no issue with any patient saying, “I want a second opinion,” because the best doctors know that they are giving the best advice to that patient with all the available data they have at that moment.
~Chris
Dear White Coat Investor,
I suggest you add Dr. Stephanie Pearson to your recommendation list for physicians seeking disability insurance. She is a physician who has had first hand experience with disability and the complexities of insurance. She arranges a call to understand your specific needs and is really personable and committed to helping physicians.
http://stephaniepearsonmd.com/
Without naming names of any of the other agents on your website (one of whom I tried working with before I contacted Dr. Pearson), I found Dr. Pearson to be want to work with me as an individual and understand my needs. The other agent seemed too busy to communicate other than by rushed emails and was not detail oriented enough to leave me feeling confident about the products he is selling.
Thanks for sharing your recommendation and I’m sorry to hear about your bad experience. I can’t do much about it without specific feedback though. You can email me at editor (at) whitecoatinvestor.com.
Please pass along cindy (at) whitecoatinvestor.com to Dr. Pearson to see if she is interested in advertising on or partnering with The White Coat Investor.
How much disability insurance is one allowed to buy if you have group disability insurance? Lets say if the pretax salary is 200000$, group offers 66.7% coverage, is there a restriction on how much individual disability you are allowed to buy. Does group disability insurance limit/truncate your max eligibility for individual disability? If so does one have to decline group disability to buy the max permissible individual disability policy?
At $200,000 of income and NO group disability then you would be able to acquire about $8-9k of monthly benefit in individual coverage typically. WITH 66.7% employer paid group coverage and $200k of income you can get about $5k of monthly benefit individual coverage. So yes it does limit the coverage capacity on individual when you have a group policy as you can see. Typically you can’t decline the group coverage due to most of the time it simply being an employer benefit and thus the group buys the plan for all employees, gets 100% of the employees covered and thus the rate is less than if there is the ability to select participation. The reason it is cheaper is if they get 100% then there is zero chance of healthy people not participating and the unhealthy participating thus creating an unbalanced book of business for the insurance carrier. The best thing to do is buy your individual coverage prior to becoming employed with that group and now the coverage won’t come into play on how much individual coverage you can acquire.
Let me know if we can help further.
Thank you. This is very helpful.
Would one be able to exercise an FIO right out of residency just prior to becoming employed? What does exercising an FIO at the end of residency typically involve — just an offer letter?
Have a senior resident that is unable to increase her individual disability to the level she wants even with an FIO due to mandatory group disability at her new employer’s. Would like to know how to avoid such a situation in the future.
Yes. Group disability insurance limits your max eligibility. By how much? I think it varies by company and income. So you would have to decline group coverage if you want max individual. But the better strategy is to buy the max individual, then buy the group coverage. Then you can be overinsured if that is your goal. Personally, if you’re living well below your means like you probably ought to be, you probably aren’t even going to want the maximum individual coverage you can buy once you’re out of training.
For physician couples should both buy disability insurance?
No perfect answer to that one. The other doc can serve as your disability policy if your expenses are low enough….and you don’t BOTH become disabled. In reality, I suspect both docs just buy less than they otherwise would, but still buy something.
Maybe…it really depends on how much money it takes to run the family expenses. If you need the other persons income to pay all of the expenses then the answer is yes you need it on the person that their income is needed. If independently you can pay all of the family expenses then the answer is probably not since the chance of both of you being in the same freak accident is pretty low. Most of my clients when faced with the same question but could afford to pay the family expenses with just one person working still opt to buy some coverage on both, usually something small like $5k of monthly benefit for the “just in case” or that would help soften the blow to get all the bills paid comfortably.
Let me know if we can help further.
I have been working for about 3 years and I recently started looking for a disability insurance which I think is very important. I read that there are the big 5-6 companies but we can’t purchase the insurance directly and I guess I will need an agent which I don’t have. Anyone recommendations?
I recently received a letter in the mail that I qualify for a discount from doctor disability shop but I need to make sure its a good agency before I go with them.
I would also like to know if I could tax deduct the payments under my S Corp. I work as a locum and get 1099.
Thank you
Recommended agents: https://www.whitecoatinvestor.com/websites-2/insurance/
Bear in mind if you deduct the premiums the benefits are taxable. You can’t deduct the premiums in a partnership. An S Corp can, but not for those who own more than 2% of it! (Which is you.) You really have to go to a C corp in order to deduct your premiums.
https://www.massmutual.com/efiles/di/pdfs/di90032.pdf
Ok got It. I will review the agents and pick one.
Any recommendation for the insurance companies for physicians working in California (as a hospitalist)?
Thank you
There is one that is probably best for a male hospitalist in California, but I don’t know which one it is. Those agents will though.
The best priced products in CA at the moment for physicians are Guardian and Ameritas, coming in 2nd is Mass and Principal with Standard after that. Ohio National does not provide disability insurance in CA.
If we can help further let me know.
If you want to find out more about that Doctor Disability Shop then either call Larry or me, we can fill you in on their practice processes.
I currently have 8 months left of my anesthesia residency. I purchased a Guardian Berkshire Disability policy at the start of my residency ($130/month for $5,000 of coverage). I’m married with two kids (3 and 5yo). I haven’t been SCUBA diving or skydiving in over 5 years but may want to start back up, 6 months after I graduate and start my first attending job. 1) Do I need to disclose my new hobbies when I upgrade my resident policy ($5,000 month) to my attending policy ($15,000 per month)?
No. You don’t have to qualify to exercise a future purchase option, either health-wise or hobby-wise. You do if it is a new policy. So I guess it depends on what you mean by “upgrade.”
No disclosure needed, in fact the carrier won’t even ask you those questions again if you are exercising the future purchase options.
Not at all – the Future Increase Option Rider from Guardian – If you bought a monthly benefit of $5,000, and you bought the additional $10,000 of future increase option. Once the policy is approved, no matter what happens to you medically in the future you will be able to exercise the future increase option up to $15,000 a month of personal disability insurance with your attending contract and income statements in support. Guardian should not ask you any questions about activities or hobbies. This is exactly what I did with my own Principal disability insurance policy that I bought as a CA-2 in Anesthesiology. Seven years into my attending work I suffered a career ending diagnosis and lost the good use of my left hand and thumb – can’t do anesthesia with one thumb. I became an advocate for proper and secure disability insurance for physicians. If you run into any issues with the Future Increase Option Rider from Guardian, do not hesitate to reach out to an independent insurance broker who has extensive history and relationship with Guardian and ask for their assistance.
You’re the second doc disabled from medicine who has moved into selling IDI that I’ve met this year. What a great alternative career!
Physicians are by nature, teachers. I just teach disability insurance now. That is why I started Physicians Income Protection and teamed up with the #1 Independent Physician Disability Insurance Broker east of the Mississippi. Not enough young physicians are purchasing quality disability insurance and it is tragic to hear about someone on claim with a poorly written group policy that believed they were covered. https://physiciansincomeprotection.com/
I’m a new attending at a university/hospital affiliated practice. I get employer sponsored group disability insurance coverage up to approx $6,000/month. Recently tried to look into private disability coverage for another $10k/month, going through an independent agent, but was told that I would not be able to qualify for more than $5k/month because of my employer paid group coverage.
Anybody ever hear of that before? ie, my employer sponsored coverage limiting my ability to sign up for personal disability insurance through an independent agent?
Thanks!
Brian,
When buying coverage all carriers go by their Issue and Participation guidelines. So depending on what your income is then this possibly could be true. With the stats of $6k employer paid, new carrier will augment with $5k then my assumption is the income is about $140-$160k? If you income is more then they should be able to get more.
If you want to post or email me your income I will run the ratio for you.
Brian,
Yes, when applying for private insurance, the policy issuance guidelines will limit the coverage based on your income and existing coverage; in your case, it is likely both the group policy and your income. My advice is that you look at policies that can grow with your income – those that have a guaranteed insurability and future purchase riders. The Guaranteed Insurability rider ensures that you will be able to buy larger amounts of insurance in the future as your need for coverage increases (i.e. – when your income increases but without having to reapply or go through medical underwriting). A Future Purchase Option is a way a policyholder can increase their coverage over time (as your income climbs, you increase your coverage) but lock in the rate at a younger, healthier age.
As many physicians find, their first policy for disability insurance is a group policy and while some disability insurance is better than none, you have discovered the problem with having a group policy in force before your own private policy.
You need to now:
Get the best private policy you can, given your health and age.
Place Guaranteed Insurability and Future Purchase Option riders on the policy.
Consider a COLA (cost of living increase) rider.
If your speciality has a patient population that you can lose if out of work for 12-18 months or longer, you may also want a Residual rider to bridge the gap when you return to work.
Should your practice area have a higher percentage psychological disability claims rate, such as anesthesiology, some companies offer riders that may be important when looking at your career in its entirety.
Lastly but importantly, pay your private disability insurance with post-tax dollars! (Again, pay your private disability insurance premiums in post-tax dollars out of your personal checking account) This means that the benefit will be paid to you in post-tax dollars and you will not have to worry about a changing federal tax rate in the future.
By getting the correct private disability insurance policy today; when you change practices, move or form your own practice you will have an outstanding private disability insurance policy in place and in force. (Doctors change jobs every 6-7 years on average) That private policy can grow to its maximum with your income and then you will also be able to add a group policy on top of that to maximize your total benefits over your career income.
Reach out to me anytime, I’d be glad to assist you,
Dr. Chris Yerington
[email protected]
Are you another doctor who has moved into selling physician disability insurance? I’ve now run into so many of you I think this is a major non-medical career option.
Dear White Coat Investor,
Actually, it is a career option for disabled professionals who see first hand how good or how bad their personal situation is after going on claim for disability. Sadly, most doctors and dentists do not get great coverage and worse, less than 50% of all medical and dental professionals ever review their policies in force just to make sure they are covered correctly.
I began Physicians Income Protection because I realized how many physicians and physicians’ groups do not do a good job of protecting their most valuable asset; their career earnings. I currently advise physician groups, educate residency programs and even medical and dental students, advocate for physicians and dentists struggling with their claims or help those that have been offered or are looking for settlements.
My goal is to educate young medical and dental professionals and get them to understand what having a great private disability insurance policy can do for them and to also show them, through my own and other’s experiences, what having a subpar policy can do to them and the lives of their families.
I’d be glad to assist The White Coat Investor in any manner that would help educate professionals better,
Dr. Chris Yerington
[email protected]
And, yes, when asked, I most certainly get my clients protected with the best disability policies their health and age can qualify them for… with the best companies.
Disability Insurance: A Unisex World in 2018? Maybe no longer… – by Dr. Christopher Yerington
This brief article is for all my female colleagues and the females entering the medical and dental work force as residents. This information will only be helpful for a year, maybe at the most into the first part of 2019. Please share this with any female medical or dental student or resident.
U•NI•SEX
ˈyo͞onəˌseks
an adjective
“designed to be suitable for both sexes”
What? Okay, designed to be suitable for both sexes. But disability insurance? Really?
As ‘unisex’ applies to insurance: It is a construction in statutory law prohibiting insurance companies from taking into consideration gender when constructing insurance classifications, rates or types of coverage for certain types of insurance.
As ‘unisex’ applies to insurance regulation: When unisex legislation applies, all people, regardless of gender, must be give the same rates and types of coverage.
However, not all types of insurance fall under unisex legislation. The example most people are familiar with: Most men pay higher rates than women for identical automobile insurance coverage. Why? Well, gentlemen, the truth is you wreck more cars. Simple statistics. Ask your female counterparts if you do not believe the numbers or your car insurance premiums.
For disability insurance, women pay more than men for the same insurance in most instances.
Why? Women, as a demographic, are costlier to insure than men. This is the exact reverse of auto insurance and the trend has reached the actuarial tipping point. Female physicians will eventually be forced to switch to gender-specific pricing completely by the year 2020. Proactively, for their disability insurance they can prepare for the shift to gender-specific pricing by acting as soon as possible in 2018, at least in Ohio. Go Buckeyes!
Modern physicians are already facing enough financial challenges! Student debt climbs year after year, and physician and dental salary stagnate in many regions of the country. Female physicians are now confronted with the prospect of a 40% to 60% percent increase in premium costs for disability insurance! The Insurance Sector is in the final stages of permanently shifting to gender-specific pricing, forever. Unisex rates for disability insurance are a great deal for female medical and dental professionals, with premium rates about 30% to 40% less than Standard Female-Only Rates at most carriers.
Currently, in December 2017, only a few carriers are offering women physicians, dentists and other medical professionals the ability to purchase unisex rates for disability insurance and giving her the choice TO LOCK THIS PRICING IN FOR LIFE! Over 80% of all disability insurance carries in the United States have already eliminated or will eliminate unisex rates at the end of 2017.
By the end of 2019, actuarially, there will be NO disability insurance carriers offering Unisex Rates. Why is this critical? Why am I writing an entire article on just this subject? My wife, Dr. Lori Meyers, is an Ohio physician. Her friends are Ohio physicians. While I love teaching disability insurance to doctors and dentists, this message is a touch personal. I am a numbers guy. As a physician, I made patient decisions based on data and statistics, and I know most of you do, too. Trust me, no one ever said, “I’m choosing this disability policy with this insurance company because it just feels right.”
The savings over a career offered by unisex pricing on disability insurance is substantial. Using Ameritas, a good disability company who is a carrier for disability insurance for medical and dental professionals, here is an example calculation for the State of Ohio: An otherwise healthy 26-year-old to 31-year-old female resident, over the course of her career, could save as much as $50,000 in premiums!
When insurance companies set their rates, they are based on their claims experience for similar policy holders over the preceding years and decades. Actuaries are like computer-people, literally, they are people connected to computers you and I will never own. They and their big-data technology are employed to create some of the smartest entities on planet Earth. They are extremely skilled at crunching data and are right 99.99% of the time. The actuaries for disability insurance companies continue to predict that they are much more likely to pay claims to female policyholders than they are for men. That’s not all. Here’s the heart of the issue, the insurance companies often pay policy benefits to females much earlier in life, which means they pay more for much longer.
Utilizing Ameritas’ pricing structure for the State of Ohio, the healthy 26-year-old to 31-year-old female resident who becomes an attending physician earning about $350,000 per year would pay the female-only disability premium rate of about $5,000 per year. The unisex rate would be about $3,500 per year. Annual savings of $1,500 times her average predicted career length of 34 years is over $50,000!
So, gentlemen, the truth is you still wreck more cars. Simple statistics. However, you become partially or totally disabled from your medical and dental careers at a lesser rate than your female colleagues. Right now, in Ohio at least, it is time every female physician and dentist, especially residents, to reach out and make sure she is set for the remainder of her career AND protected by the best disability insurance she can get.
Dr. Christopher Yerington
Well, that’s interesting and the first time someone has posted an entire article on the site as a comment. Given the inclusion of the contact information at the end, it seems an awful lot like an advertisement. I”m curious how you would feel if you were running a website where you sold ads to disability insurance agents and spent a lot of time promoting the site to get a lot of eyeballs on those ads and then someone came along and rather than buying an ad decided to post entire articles in the comments section with his phone number rather than buying an ad from you?
Do other websites allow you to post this sort of thing?
At any rate, if you want to submit articles, here are the guest post guidelines: https://www.whitecoatinvestor.com/contact/guest-post-policy/
If you’re interested in advertising, contact cindy (at) whitecoatinvestor.com
In the meantime, I’m going to remove your contact information from your comment. If people love your articles, I’m sure they can figure out how to contact you.
Hummm, got to admit I think you are wrong.
The reason Ameritas has a unisex rate in Ohio is not because they want it rather it is due to state law in Ohio that compelled them to have to have unisex rates if they were going to offer association discounts. Once they past that law a few years ago any carrier that developed a new product with an association plan discount can’t have the discount with utilizing a unisex discount for females. I would disagree and say that there is no fire sale here….buy coverage if you want it, if you need it but not out of fear that a ‘deal’ is going away.