A true own-occupation disability definition is the single most important aspect of any physician’s disability policy. Own-occupation language ensures that a physician will receive their full benefit if a disability prevents them from working in their own specialty. Every physician should make sure their policy includes a strong own-occupation definition.
Weaker definitions of disability will only pay benefits for a claim if the disability prevents you from working in any occupation, including teaching, research, consulting, administration or even jobs outside of medicine. For example, if a plastic surgeon develops arthritis in their hands that disables them from performing surgery, but still has the physical ability to do administrative work or patient consultations, they will not qualify for disability benefits.
The technical language of disability policies can be deceptive and opaque, so make sure you have an independent expert or advisor review your policy’s definition of disability. Adding a strong own-occupation rider can ensure that you are protected in the event of any accident or illness that prevents you from earning income in your own specialty.
Provider Definitions
Ohio National
Your regular occupation is the occupation(s) in which you are regularly engaged on the date of disability. If your regular occupation on the date of disability is limited to a professionally-recognized specialty in medicine, dentistry or law within the scope of your degree or license, we will deem that specialty to be your regular occupation. If you are unemployed, retired, or otherwise not working on the date of disability, your regular occupation means any occupation you are able to do based on your education, training and experience.
Mass Mutual
Provides benefits for a condition caused by a sickness or injury in which you cannot perform the main duties of your occupation and are working in another occupation. You must be under a doctor’s care and the disability must begin while this rider is in force. If the extended partial disability benefits rider is attached to the policy, monthly benefit payments under the own occupation rider will be in lieu of any monthly benefit under the extended partial disability benefits rider equal to the monthly benefit for the own occupation rider. We will evaluate eligibility for monthly benefits under the extended partial disability benefits rider for the amount, if any, that exceeds the monthly benefit of the own occupation rider.
Standard
Receive full disability benefits if you can’t perform the substantial and material duties of your regular occupation, even if you work and earn money in another occupation.
Guardian
You will be totally disabled if, solely due to injury or sickness, you are unable to perform the material and substantial duties of your occupation. As long as you are totally disabled, benefits will not be reduced even if you are working in another occupation. You will also be considered totally disabled if you are an MD or DO and more than 50% of your income is from:
Performing surgical procedures and, solely because of injury or illness, you can no longer perform surgical procedures – or- performing hands-on patient care and, solely because of injury or illness, you can no longer perform hands-on patient care.
Ameritas
Your occupation means the occupation or occupations that you were engaged in, based on the duties you were performing for wage or profit, at the time disability began. If you are not employed at the time of disability, your occupation means a reasonable occupation you are able to perform based on your education, training and experience. If you are a physician or dentist and have limited your duties to the performance of the usual and customary functions of a specific, professionally recognized medical or dental specialty, we will consider that specialty your occupation.
Principal
Regular Occupation Rider
If you become totally disabled from your regular occupation and choose to work in another occupation, you receive full benefits, regardless of the income you earn from the other occupation.
Transitional Occupation Rider
You will continue to receive disability benefits if you become totally disabled in your occupation, but are working in another occupation. Benefits will be paid up to 100% of your prior earnings, but will not exceed the total monthly benefit. Benefits are payable until the end of the transitional occupation period to age 65. If your policy has both the residual disability and recovery benefit rider and the transitional occupation rider, benefits will not be paid out under both riders at the same time. If you meet the definitions and terms of both riders, your monthly benefit will be the great of either Residual or transitional occupation benefit.
