Disability Insurance Definitions​ & FAQs

Understand your disability insurance policy and the optional features before you buy.

Monthly Benefit

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.

Benefit Period

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

Ohio National

Maximum Benefit Period 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. The Maximum Benefit Period is shown in the Policy Specifications.

Mass Mutual

The maximum length of time we will pay monthly benefits for a disability. The maximum benefit period is shown in the policy specifications. We will not pay monthly benefits for a disability for longer than the maximum benefit period because of a change in the type of coverage being paid. The maximum benefit period is 24 months for each period of disability caused or contributed to by a mental disorder.

Standard

The maximum period of time we will pay disability benefits for any one disability. This period is shown on the policy data page. It begins on the commencement date. Once the maximum benefit period ends, you will not be eligible for a new maximum benefit period unless:

  1. You have been working for at least 30 hours per week for at least [6] [12] consecutive months; and
  2. The policy remains in force; and
  3. You have satisfied all other terms of the policy.

 

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. This period is shown on the schedule.

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 maximum benefit period for this policy is shown on the data page.

Elimination Period

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

Ohio National

Elimination Period is the period of time you must be totally disabled before base monthly benefits begin. The elimination period is shown in the policy specifications. But, for a total disability that results from normal pregnancy or childbirth, the elimination period is the longer of:

  1. The number of days shown in the policy specifications; or
  2. 90 days.

Mass Mutual

The Waiting Period is 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 intermittent basis subject to the Recurring Disability provision.

Standard

The Benefit Waiting Period means a period, measured from the first day of your Disability throughout which you must be disabled before benefits become payable.

Guardian

The Elimination Period is the number of days you must be disabled before benefits begin to accrue and starts on the first day that you are disabled. The days within this period need not be consecutive, but they must occur within the Accumulation Period. Benefits will not accrue or be payable during the Elimination Period.

Ameritas

The Elimination Period 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. This period is shown on the schedule.

Principal

The Elimination Period is the number of days of disability from the start of a continuous disability for which no benefits will be paid. 

Own Occupation 

This is arguably the most important feature for physicians to include in a disability insurance policy.  The own occupation definition of disability allows you to be covered for exactly what you are doing in your employment position.  If for some reason you are unable to perform your job at full capacity but are still able to work part-time, you will receive compensation for lost wages due to the injury or illness even if you are making up that lost income by picking up another job.

Ohio National

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

The Own Occupation rider provides a monthly benefit when the insured is totally disabled as defined by this rider. Total disability or totally disabled — The occurrence of a condition caused by a sickness or injury in which the Insured: cannot perform the main duties of his/her occupation; is working in another occupation; must be under a doctor’s care; and the disability must begin while this rider is in force.

Standard

This Own Occupation rider changes the definition of total disability/totally disabiled in the policy’s benefit for total disability section to read as follows:

Total Disability/Totally Disabled means that due to your injury or sickness:

  1. You are unable to perform the substantial and material duties of our regular occupation; and 
  2. You are receiving regular medical care from one or more physician(s) appropriate for your injury or sickness. This regular medical care requirement will be waived when we receive written proof, satisfactory to us, that further care would be of no benefit to you. 

 

Guardian

Any occupation means any occupation for which you are or become reasonable suited by your education, training or experience.

Ameritas

The Elimination Period 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. This period is shown on the schedule.

Ameritas

The Own Occupation rider provides a monthly benefit when the insured is totally disabled as defined by this rider. It also modifies, if in force, the partial disability benefits provision of the extended partial disability benefits rider equal to the monthly benefit for this own occupation rider shown in the policy specifications. It is made part of the policy. It is issued in consideration of the application and premium payments for this rider and for the policy to which it is attached. All definitions and provisions in the policy apply to this rider, unless otherwise specified in this rider.

Principal

The contract includes an own occupation definition, which means, you will be considered totally disabled if, due to sickness or injury, you are not able to perform the material and substantial duties of your regular occupation as (type of physician), and you satisfy the regular care of a physician provision of the policy.

By this definition, you are able to work in another capacity other than your regular occupation, which is defined as the occupation in which you are regularly engaged at the date of disability

Partial Disability Insurance

Partial Disability Insurance (also called residual disability insurance) is used in the case you become unable to perform your job at full physical capacity but are able to work part-time. You will receive compensation for lost wages due to the injury or illness keeping you from working full-time.  This is not an editable item but some insurance companies have a lower threshold than others. The lower the threshold the more beneficial this rider to you, because you have to lose less income before you start to see it being replaced.

Available Options
15% Loss of Income
20% Loss of Income

Standard

Residual Disability/Residually Disabled means you are not totally disabled, and you are working in your regular occupation, but due to your injury or sickness:

  1. You are unable to perform one or more of the substantial and material duties of your regular occupation; or you are performing all of the substantial and material duties of your regular occupation but for not more than 50% of the time that you did immediately prior to your injury or sickness; and 
  2. You have a loss of income; and 
  3. You are receiving regular medical care from one or more physician(s) appropriate for your injury or sickness. This regular medical care requirement will be waived when we receive written proof, satisfactory to us, that further care would be of no benefit to you.

Ohio National

The definition of Residual Disability or Residually Disabled in the Definitions section of an Enhanced Residual Disability Rider that is a part of the policy is deleted and replaced with the following:

For the first six months of Disability, you have a Residual Disability or you are Residually Disabled if due to Sickness or Injury:
(1) you are not Totally Disabled as defined in the policy; and
(2) you are working in Your Regular Occupation; and
(3) you are able to perform one or more, but not all, of the Material and Substantial Duties of Your Regular Occupation or you are able to work in Your Regular Occupation no more than 80% of the time you formerly spent working before your current Disability started; and
(4) you satisfy the Regular Care of a Physician provision in the policy.

Mass Mutual

For the first 6 months of Partial Disability, whether during the Waiting Period or after, the Insured is Partially Disabled if due to Sickness or Injury he/she:
(1) is working at his/her Occupation or another occupation;
(2) is not Totally Disabled;
(3) is under a Doctor’s Care.

Guardian

Partial Disability means you are gainfully employed and you are not totally disabiled under the policy but solely due to injury or sickness, your loss of income is at least 15% of your prior income.

Ameritas

Residually Disability means that due to sickness or injury:
(1) your loss of monthly earnings is at least 15% of your prior monthly earnings; and
(2) your loss of monthly earnings is the result, directly and apart from any other cause, of an injury or sickness as defined in the policy; and
(3) 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 work in your occupation for 80% or more of the time as was usual prior to the start of your disability.

Future Increase Option

Future Increase Options allow you to increase your monthly insurance coverage as your income increases without going through additional medical underwriting.  This feature is probably the second most important when making a decision on coverage.

More Flexible: These paid options allow you to specify the amount of increase you put on the policy and are able to use it in the future.  Specifying this benefit amount means you are eligible to increase coverage any year of your policy (some exceptions apply). Additionally, there is no mandatory paperwork and it requires less work to uphold this feature as a part of your policy. Some examples are Future Increase Option and GPI. 

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)

 

Mass Mutual

Additional Coverage(s) purchased under this Rider will increase the Total Disability Monthly Benefit under Your Policy shown in the Policy Specifications, and will increase the Coverage(s) provided by the following riders if In Force on the Policy: Cost of Living Adjustment Rider Extended Partial Disability Benefits Rider Own Occupation Rider.

Ameritas

This rider gives you the qualified right to purchase additional base monthly benefit based on financial insurability only.

Cost of Living Adjustment

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
 

Ohio National

This rider provides for an annual increase in the Base Monthly Benefit and Additional Monthly Benefit, as defined below, during a period of Disability. The benefit provided by this rider does not apply to a Residual Disability unless a Residual Disability Rider is a part of the policy. The benefit provided by this rider does not apply to any Additional Monthly Benefit unless an Annual Renewable Disability Income Rider is a part of the policy. .

Mass Mutual

Eligibility For RetireGuard COLA Benefit RetireGuard COLA Benefit increases will be paid if: † the Insured has paid premium for the RetireGuard COLA Benefit; and † the RetireGuard COLA Benefit is In Force at the start of Total Disability; and † the Insured is Totally Disabled for 365 days. Only Monthly Benefits under this Rider, up to the RetireGuard COLA Monthly Benefit amount shown in the Policy Specifications, will be eligible for increases

Standard

This rider provides a Cost of Living Adjustment to the Basic Monthly Benefit, compounded each year for a Disability continuing more than one year.

Guardian

Means that due to injury or sickness, you are: 

  • Unable to perform two or more of the activities of daily living without human standby assistance; or
  • cognitively impairment
  • Irrecoverably disabled

Ameritas

This rider provides for a yearly compound interest cost of living adjustment in certain monthly income benefits during disability.

Principal

This rider may provide for a cost of living adjustment to Your Maximum Monthly Benefit during the period of Your Continuous Disability. On the first Change Date We will adjust the Maximum Monthly Benefit(s) shown on the Data Page in effect at the start of Your Continuous Disability, by multiplying by the COLA Factor. On subsequent Change Dates, the new Adjusted Maximum Monthly Benefit will be determined by multiplying the previous year’s Adjusted Maximum Monthly Benefit by the current year’s COLA Factor. These Adjusted Maximum Monthly Benefits will then be used to calculate Your monthly benefits.

Catastrophic Coverage

Catastrophic Coverage gives you an additional monthly income if you are unable to perform 2 of the 6 activities of daily living (eating, bathing, getting dressed, toileting, transferring, and continence). This additional income helps you afford assistance that isn’t covered by your health insurance while also providing your income replacement.

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.

 

Ohio National

You have a Catastrophic Disability or are Catastrophically Disabled if due to an Injury or Sickness: (1) you are unable to perform two or more Activities of Daily Living without Stand-By Assistance due to loss of functional capacity; or (2) you require Substantial Supervision due to Severe Cognitive Impairment. 

The monthly benefit amount provided by this rider and payable to you if you are Catastrophically Disabled. The Catastrophic Disability Monthly Benefit amount is shown in the Policy Specifications. In order to be eligible for each Catastrophic Disability Monthly Benefit, you must satisfy the Regular Care of a Physician requirement as stated in the Benefit section of the policy.

Mass Mutual

Definition of Catastrophic Disability or Catastrophically Disabled — The Insured’s condition has met either (1) or (2) where: (1) The definition of “Presumptive Disability” as defined in Your Policy, which includes: complete loss of speech; complete loss of hearing in both ears; complete loss of sight in both eyes; or complete loss of use of both hands, or both feet, or one hand and one foot. (2) The definition of “Total Disability” as defined in Your Policy, and (a) or (b) where: (a) The inability to perform two (2) of six (6) Activities of Daily Living (ADLs), as defined below, without assistance. 

Standard

Catastrophic Disability / Catastrophically Disabled means that due to your Injury or Sickness:  you are unable to safely and completely perform two or more Activities Of Daily Living without Hands-On Assistance or Standby Assistance due to loss of functional capacity;  you require Substantial Supervision for your health or safety due to Severe Cognitive Impairment; or  you are Presumptively Disabled.

Guardian

Means that due to injury or sickness, you are: 

  • Unable to perform two or more of the activities of daily living without human standby assistance; or
  • cognitively impairment
  • Irrecoverably disabled

Ameritas

This rider provides for a yearly compound interest cost of living adjustment in certain monthly income benefits during disability.

Principal

Due to a sickness or injury: (1) you are unable to perform two or more activities of daily living without stand-by assistance due to loss of functional capacity; or (2) you require substantial supervision due to severe cognitive impairment

Total Disability

Ohio National

You have a Total Disability or you are Totally Disabled if due to a Sickness or Injury, in and of itself, (1) you are not able to perform the Material and Substantial Duties of Your Regular Occupation; and (2) you are not working in any other occupation for wages, compensation or profit; and (3) you satisfy the Regular Care of a Physician provision. 

Mass Mutual

The insured is considered to have a presumptive total disability even if he/she is able to work if certain conditions exist. These conditions are any of those listed below that begin while this policy is in force and are caused by sickness or injury. 

  1. Complete loss of speech;
  2. Complete loss of hearing in both ears;
  3. Complete loss of sight in both eyes; or 
  4. Complete loss of use of both hands, or both feet, or one hand and one foot.

Standard

Total Disability means that due to your injury or sickness

  1. You are unable to perform the substantial and material duties of your regular occupation and 
  2. You are not engaged in any other job or occupation for wage or profit; and 
  3. You are receiving regular medical care from one or more physician(s) appropriate for your injury or sickness. The regular medical care requirement will be waived when we receive written proof, satisfactory to us, that further care would be of no benefit to you.

Guardian

Until We have paid benefits for two years in the same claim: The policy will contain one definition of total disability. This version provides two years of “own occupation” coverage – You can receive total disability benefits as long as you are not working. After two years, the definition becomes “any occupation” coverage. 

Ameritas 

For the length of the benefit period, the inability to work in your own occupation, even if you are working in another occupation. Specialty own occupation language is included for physicians and dentists. 

For the length of the benefit period, the inability to work in your own occupation and you are not working in any other occupation for wage or profit. Specialty own occupation language is included for physicians. 

For the first 60 months, the inability to work in your own occupation, even if you are working in another occupation; followed by the inability to work in your own occupation and you are not working in any other occupation for wage or profit. Specialty own occupation language is included for physicians and dentists.

Mental Health Coverage

Mental Health Coverage specifies the benefit period for disability claims due to mental health-related illnesses such as anxiety, stress, or depression.  If for some reason you are hospitalized due to a mental health-related illness, this definition does not apply but instead, your base policy definition applies and your coverage will be paid out.  For mental health-related illnesses that do not put you in a hospital but still keep you from working, you can expect to see benefits paid out for these designated time frames.

Available Options
24 months
60 months
Unlimited

*Note: Unlimited mental health coverage would match the policies benefit period.

Special Benefits

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

Other Definitions

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.

Presumptive Total Disability 

The insured is considered to have a presumptive total disability even if he/she is able to work if certain conditions exist. These conditions are any of those listed below that begin while this policy is in force and are caused by sickness or injury. 

  1. Complete loss of speech;
  2. Complete loss of hearing in both ears;
  3. Complete loss of sight in both eyes; or 
  4. Complete loss of use of both hands, or both feet, or one hand and one foot

 

Disability Insurance Frequently Asked Questions

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.

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.

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.

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 the cost associated with it to help you evaluate the value and build unique, cost-effective coverage tailored to your situation.