Disability Insurance
Frequently Asked Questions
A physicians most valuable asset is their ability to earn income. The best way to guarantee their income continues regarless of accident or illnesses for their entire career is with a specialty specific disability insurance plan.
- Monthly Benefit
- Benefit Period
- Elimination Period
- Own-Occupation
- Partial Disability Insurance
- Future Increase Option
- Cost of Living Adjustment (COLA)
- Catastrophic Coverage
- Mental Health Coverage
- Special Benefits
- Student Loan
- Retirement Protection Benefit
- Other Definitions
The Monthly Benefit is the monthly income protection you would receive in the case you became sick or injured, and ultimately unable to work. This amount is adjustable but is based on your gross income. You are only eligible to insure approximately 60% of gross income through all disability insurance sources, however, there are some exceptions to this rule when you are graduating from training.
The Benefit Period is how long your income can be replaced in the event of a long-term disability.
Available Options
- 5 Year Benefit
- 10 Year Benefit
- To Age 65
- To Age 67
- To Age 70
Provider Definitions
Ohio National
This is the longest period of time that base monthly benefits or rider benefits will be paid for one total disability caused by the same or related injury or sickness.
Mass Mutual
The maximum length of time we will pay monthly benefits for a disability.
Standard
The maximum period of time we will pay disability benefits for any one disability.
Guardian
The benefit period is the longest period of time for which we will pay benefits for a continuous disability.
Ameritas
Means the maximum length of time we will pay you a base monthly benefit as long as you are totally disabled.
Principal
Starts after the satisfaction of the elimination period and is the longest time for which benefits will be paid for any one continuous disability.
The Elimination Period is how long you have to wait after filing your claim for your income replacement to occur.
Available Options
- 60 Days
- 90 Days
- 180 Days
- 360 Days
Provider Definitions
Ohio National
This is the period of time you must be totally disabled before base monthly benefits begin.
Mass Mutual
This is the period immediately following the start of disability during which benefits do not accrue.
Standard
Means a period, measured from the first day of your disability throughout which you must be disabled before benefits become payable.
Guardian
This is the number of days that must elapse before benefits become payable. You must be disabled for the entire period.
Ameritas
This is the period of time you must be totally disabled before we start paying benefits. Benefits will not accrue or be payable during the elimination period.
Principal
This is the number of days of disability from the start of a continuous disability for which no benefits will be paid.
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.
While some disabilities can prevent you from working completely, other conditions may only reduce your working capacity partially. For example, chronic pain or degenerative conditions may force doctors to work fewer hours or meet with fewer patients which can substantially reduce their earnings without qualifying as a total disability.
A residual or partial disability rider can ensure that your income is supplemented in the event that:
- You are able to perform some but not all, of the material and substantial duties of your job.
- You are unable to work in your job for a certain percentage of time.
Different policies will offer different definitions, requirements, and benefit periods for partial disabilities. For example, many policies require that a physician has lost at least 15-20% of their income before they can qualify for a partial disability benefit. Partial disability benefits usually constitute 50% of a full disability benefit, but the exact percentage may vary by policy.
Most carriers will allow physicians to purchase basic or enhanced disability riders. Every physician needs at least some financial protection in the event of a partial disability. While an enhanced residual rider will cost more money than the basic version, you can expect to receive longer guaranteed benefit periods, less restrictive partial disability definitions, and higher residual benefit payments.
Available Options
- 15% Loss of Income
- 20% Loss of Income
Provider Definitions
Ohio National
For the first six months of disability, if you have a sickness or injury that limits your time or duties, you will receive benefits in proportion to your loss of earnings. The benefit you receive will be equal to the base monthly benefit amount for total disability, times the percentage of your loss of earnings after the date of residual disability. After the first six months, you must also show that you have a loss of earnings of at least 15% because of that residual disability. If this percentage is greater than 75%, full total disability benefits will be paid. The minimum benefit for the first six months of residual disability is 50% of the total disability benefit. You do not need to be totally disabled first to receive residual benefits.
This benefit will continue for your maximum benefit period as long as you remain residually disabled.
We will increase your monthly earnings before disability each year you remain disabled by the percentage increase in the consumer price index-urban dwellers (CPI-U). At no time may we reduce your adjusted monthly earnings before disability if the CPI-U is negative.
Mass Mutual
This rider provides a benefit if you are working and you suffer a minimum 15% loss of income resulting from a reduced capacity to perform your occupation due to sickness or injury. In addition, during the first 6 months of disability, you may also qualify as partially disabled if due to sickness or injury, you suffer a 15% loss of time from work or you can do some, but not all, of the main duties of your occupation.
During the first 6 months of partial disability, we will pay the total disability benefit for any portion of the 6 month period that is not used to satisfy the waiting period and during which, due to sickness or injury, you are working less than 20% of the time worked just prior to the start of disability.
Otherwise, for the first 12 months of partial disability benefits, any monthly payment for partial disability will never be less than 50% of the extended partial disability monthly benefit. If your income loss is more than 50% of the extended partial disability monthly benefit, the monthly payment will be the actual loss of income up to the extended partial disability monthly benefit. If the income loss is more than 75%, the monthly payment will be the total disability monthly benefit. Beginning in the 13th month of partial disability benefits, monthly payments will be based on your loss of income.
Standard
Enhanced Residual Disability Benefit Qualify as residually disabled while working in your regular occupation or another occupation if, during the benefit waiting period, you have a loss of income or duties or time due to injury or sickness. After the benefit waiting period, you’ll be eligible for residual disability benefits if you’re still working but you have a loss of income. This rider pays at least 50 percent of your basic monthly benefit for the first 12 months. After that, the benefit is proportional to your loss of income.
Guardian
This option provides partial disability benefits when you are not totally disabled but, solely due to injury or sickness, you suffer a loss of income of 15% or more while working.
Ameritas
We will pay you a residual benefit while you are residually disabled if you suffer a loss of at least 15% of your net earned income, and you are able to perform one or more, but not all, of the material and substantial duties of your occupation or you are unable to engage in your occupation for more than 80% of the time as was usual prior to the start of your disability.
Principal
You are considered residually disabled and receive a benefit proportionate to your loss if you.
Working in another occupation
- Lose at least 20% of your prior earnings due solely to an injury or sickness and
- Are able to perform some, but not all, of the substantial and material duties or
- Are unable to work full time in your occupation or
Every insurance carrier offers the Future Increase Option riders, usually at a no extra cost to the policyholder. An FIO rider allows physicians to increase their disability coverage as their income increases over time. An FIO Rider is strongly recommended for all medical students, residents, or new physicians purchasing disability coverage.
FIO riders make disability insurance affordable even for physicians who are years away from their peak earning years. They also allow physicians to increase their benefit amounts without additional medical underwriting. When you first purchase a policy, your insurance carrier will pore through your medical history to identify any conditions that may increase your likelihood of becoming disabled. Depending on the severity of a condition, they may increase your premium costs, exclude certain conditions from coverage, or decline to offer you coverage altogether. FIO riders allow you to purchase increased coverage regardless of any medical conditions that may arise after the policy’s effective date. Consider the following scenario:
Dr. Rodriguez, a 27-year-old medical resident, purchases a disability insurance policy with an FIO rider. She can’t afford much coverage, so the policy starts with $125/month premiums for a $3,500/month benefit in the event of a disability.
During her first year as an attending physician, Dr. Rodriguez is diagnosed with Crohn’s disease, which puts her at a higher risk of becoming disabled. Six years later, Dr. Rodriguez has a young child and a mortgage payment. She would need substantially more than $3000 to supplement her lost salary in the event of a disability. However, now she can afford to pay higher premiums (still totalling only 1-3% of annual income) in exchange for a larger disability benefit.
Without an FIO rider, Dr. Rodriguez would have to go out and buy a new policy to purchase increased coverage. Due to her Crohn’s disease, she may be unable to find a carrier who will underwrite her medical condition for a new policy. Fortunately, with an FIO rider, Dr. Rodriguez can increase her coverage on the original policy without fear of losing protection.
FIO riders are a crucial provision to provide scalable coverage without additional medical underwriting. Many physicians increase their coverage after major events such as promotions, marriage, or having children. Read more about FIO riders and Benefit Update Riders.
Available Options
- Guaranteed Insurance Option (GIO)
- Future Increase Option (FIO)
Less Flexible: These free options allow you to increase coverage later on without doing additional medical underwriting. However, you can only increase with these features 1-time per every 3-year window. If you have not submitted paperwork to increase by the 3rd year of a 3-year window, you will be required to in order to keep this feature on the policy for another 3 years. The amount of increase available is based on the current maximum policy benefit.
Available Options
- Benefit Purchase Rider (BPR)
- Benefit Update (BU)
- Benefit Increase Rider (BIR)
A COLA rider is designed to counteract the loss of purchasing power that may happen to a physician’s insurance benefit due to inflation.
One important caveat: With a COLA rider, your benefit only adjusts with the rate of inflation when you are on a claim. If a doctor purchases a policy with a $5,000 benefit in 2018, and then goes on claim in 2035, they will still start with a benefit amount of $5,000 regardless of inflation. However, if the doctor remains on claim for another five years, the COLA rider will increase with the cost-of-living.
Most COLA riders do not even go into effect until the policyholder has been on claim for at least 12 months, and these provisions are most beneficial in the event of a long-term disability. If you are on claim for several decades, a $5,000 benefit will have significantly less purchasing power after 20 or 30 years, and a COLA rider could provide tens of thousands of additional dollars in benefits.
Thus, a COLA rider can be a tremendous help in the event of a serious disability, however it will not impact the majority of policyholders who go on disability claims for a few years or less.
A COLA rider is not considered a necessity for all physicians. However if you can afford to add it and you are going to practice medicine for at least 10 more years, a COLA rider can guarantee the continued value of your disability benefit regardless of inflation in the event of a long-term claim.
The Cost of Living Adjustment feature ensures your benefits keep pace with inflation if you are receiving compensation from a disability claim.
Available Options
- 4-year Delayed 3% Simple Interest
- 3% Simple Interest
- 0-6% Compound Interest
- 3% Compound Interest
- 2-6% Compound Interest
- 3-6% Compound Interest
- 6% Compound Interest
A typical long-term disability policy will only replace about 60% of a physician’s lost income. However, with a catastrophic disability rider, you can automatically receive a higher benefit amount (up to 100% in some cases) for lost salary in the event that you suffer a catastrophic disability. Usually, a catastrophic disability is defined as a condition that prevents you from completing at least two activities of daily living (ADLs). ADLs include bathing, dressing, feeding yourself, using the restroom, seeing, or hearing.
Depending on your financial resources, a catastrophic rider can help you secure additional protection in the event of a worst case scenario. Some physicians prefer to put their available insurance premium budget towards purchasing a higher basic monthly benefit rather than purchasing a catastrophic disability rider.
Available Options
- Up to: $8,000
- Up to : $10,000
- Up to: $12,000
*Note: You can adjust the benefit period and elimination period in addition to the benefit amount up to the limits specified.
Mental health conditions and substance abuse disorders are common causes for disability claims for physicians. In fact, 10-15% of physicians will struggle with substance or alcohol abuse at some point in their lives. Different policies vary in their coverage of claims related to mental illness, nervous conditions, or substance disorders, however many carriers allow physicians to purchase Mental Illness or Substance Disorder specific riders to enhance their coverage.
As you consider any riders related to mental illness, nervous or substance disorders, pay close attention to limitations in the benefit period. Many of these riders will still only pay benefits for a maximum of one or two years for mental health or substance abuse related claims. For this reason, some physicians decide the additional cost of the rider is not worth the limited payout period. However, for other physicians, this rider can be tremendously valuable. In the event that a physician suffers debilitating depression that prevents them from working for a year, or wants to go on claim to seek rehabilitation treatment, this rider can provide critical income protection while they get back on their feet. Carefully consider your age, savings, and family history as you decide whether this rider is right for your policy.
Available Options
- 24 months
- 60 months
- Unlimited
*Note: Unlimited mental health coverage would match the policies benefit period.
These special benefits are the base benefits that come with the insurance policies at no additional cost to you. Note that these features differ by each insurance provider.
- Non-disabling Injury
- Good Health
- COBRA Continuation
- Death Benefit
- Capital Sum
- Supplemental Health
- Compassionate Care
- Unemployment Waiver of Premium
- Serious Illness
- Hospice Care
- Dividends
On average, physicians graduate with over $200,000 of student debt. With some carriers, the policyholder has the option to purchase a Student Loan Rider which will directly reimburse your student loan holder for the amount of any monthly repayments while on a claim. Oftentimes, this coverage is only available for the first 10-15 years of the policy’s effective date.
While it is important for physicians to budget for the cost of their student loan repayment when considering their disability coverage needs, specific student loan riders are not always necessary. Some physicians choose to put their budget towards a larger monthly benefit instead of the rider. Additionally, physicians may be able to defer their loans during a partial disability or apply for a discharge in the event of a permanent disability.
Many physicians only purchase enough disability benefit to cover the cost of their most essential living expenses in the event of a disability. However, a long-term disability can have long-lasting impacts on your financial stability if it prevents you from investing money in your retirement savings.
A retirement protection rider supplements any missed payments to retirement accounts when the policyholder is on claim. For example, if a physician is unable to contribute to an IRA, 401(k), or similar plan due to a disability, the retirement protection rider will fund equivalent payments into an irrevocable trust during the disability claim. The policyholder may invest the benefits paid to the trust as they wish, similar to IRA contributions. When the policyholder reaches retirement age, the money in the trust is paid out to the policyholder.
Depending on your age, state, and retirement portfolio, it might make more sense to forgo the retirement protection rider, and instead purchase a larger monthly benefit amount which will allow you to continue to contribute to their retirement investments even while on a disability claim. Read more about retirement riders here and talk with your financial advisor to determine the best way approach to safeguard your retirement in the event of a disability.
Non-Cancellable
As long as the premiums are paid on time, we will continue coverage through the day prior to the policy anniversary on or next following the insured’s 65th birthday.
Pre-Existing Condition
A condition for which symptoms existed that would cause an ordinarily prudent person to seek diagnosis, care or treatment within a 12-month period immediately prior to the coverage date(s), or for which medical advice or treatment was recommended by a doctor or received from a doctor within a 24-month period prior to the coverage date(s).
Waiting Period
The period immediately following the start of disability during which benefits do not accrue. Disability must continue to the end of the waiting period, shown in the policy specifications, before any benefits may be payable. The waiting period may be completed on an intermitted basis subject to the recurring disability provision.
Frequently Asked Questions
Let us get answers for you!
Why do you need disability and life insurance?
Life happens. We cannot predict the future, but we can be prepared for it. That is the purpose of insurance – to protect and provide for yourself and your loved ones if the unfortunate happens. Your life and disability insurance choices may make the difference in your family’s lifestyle after a tragedy strikes by paying the bills, financing children’s educations, and protecting your spouse’s retirement.
When is the best time to purchase a disability insurance policy?
Premium and policy eligibility are based on age and current health status. Therefore, the best time to purchase a disability insurance policy is when you are young and healthy and while discounts are still available with residency or fellowship status. Additionally, many insurance carriers will restrict the amount of coverage you are eligible for if you have an employer-sponsored plan.
Which disability insurance carriers to do you work with?
Physicians Thrive only offers what we view as the strongest and most comprehensive physician-specific plans from the leading disability insurance carriers. We work with Ameritas, Guardian, Metlife, Principal, MassMutual and The Standard.
What is the Comdex Ranking?
The Comdex is not a rating, but a composite of all ratings. It ranks companies on a scale of 1 to 100, showing you at a glance, where a company is ranked among all rated companies. The Comdex Ranking is not equated to a grading system such as 90% equals an A or 80% equals a B grade.
The Comdex Ranking is a relative number based on the following factors:
- If a company’s ratings from one of the ratings services AM Best, Standard and Poor’s, Moody’s or Fitch changes
- If one or more companies are added or removed from the list of insurers rated by the above rating services
- If another company with similar ratings, experiences a rating change, the percentiles or Comdex Ranking will adjust
For example, if 1000 companies are rated, a company that is rated in the top one hundred of these companies, and meet the criteria for Comdex, will have a Comdex Ranking of approximately 90 or above.
– Jillian Halper
The Physicians Thrive team was phenomenal – organized, professional, personable, and able to answer all of my questions!
– Brendan Calhoun
Very friendly, professional and comprehensive contract review. Well worth it for peace of mind.
Get Free Disability Insurance Quotes
When you receive your quote comparison, our experienced advisor will review the quotes, explain all your options and the verbiage in each policy in detail to help you create a customized plan that meets your needs and your budget. We will review each element of the plan and its associated cost to help you evaluate the value and build unique, cost-effective coverage tailored to your situation.
