Disability Insurance & The Definition of 'Disabled'

John Martens, CLU |
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For early-career physicians starting their research on Disability Insurance, the process can seem overwhelming. With several carriers and policy options, looking at the definition of disability being used is a great place to start in determining which policy is right for you. Below we will cover some of the different disability definitions, and you can find more information on the different policy types, including group or employer plans, AMA policies, and private coverage in our other blog posts here.

If doing the research yourself doesn’t fit into your busy schedule, you can always request a free, no-obligation disability insurance comparison summary and an insurance specialist can help walk you through the process.

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WHY THE DEFINITION OF DISABILITY MATTERS

Not all disability insurance is created equal. One of the biggest differences between policies is the way it defines what it means to be ‘disabled’. This is arguably one of the most important factors to consider because whether you meet your policy’s definition of disability determines if you are eligible to receive benefits. Picking up disability before entering practice is required for physicians, so you might as well make sure you’re getting the most out of your premium and policy if/when you need it.


WHICH DEFINITION PROTECTS ME THE MOST?

There are several disability insurance options with varying definitions of ‘disabled’ including True Own-Occupation, Own-Occupation, Modified Own-Occupation, and transitional. Specific definitions for each of these can be found here.

For physicians, we recommend focusing on coverage that uses the True Double Dip Own-Occupation definition and can be specialty-specific. These are private policies that offer coverage specific to your occupation and usually have the most detailed definition of what it means to be disabled.

The definition used for “True Double Dip Own-Occupation” coverage is usually “the inability to perform the material and substantial duties of your occupation at the time of disability, regardless of if you can work in a broader specialty, teach, or work in another occupation altogether”. This is explained in even more detail in our blog post about Group vs. Private Coverage.

The specific mentioning of duties at the time of disability and coverage regardless of the ability to work in another occupation is why this definition is the most specific and provides physicians with the most coverage.

“DUTIES AT THE TIME OF DISABILITY”

The inclusion of “material and substantial duties of YOUR occupation” is one of the reasons True Double Dip Own-Occupation has the most specific definitions of disability. Your daily duties now are likely not the same daily duties you will have later in your career, so the coverage grows with you and protects you based on your current position. Even within the same specialty, the daily tasks of a PGY1 are likely different than that of an attending, and you want to be protected for your specific situation. There can also be differences depending on where you are working, be it a large hospital system, small group, rural town, etc.

We also often get questions about the impact of picking up coverage while in one specialty during residency, but then practicing in a different or more specific specialty after a fellowship. The good news is this type of policy STILL covers you because of the daily duties verbiage.

WHAT DOES “OWN OCCUPATION” MEAN?

Own-Occupation means the definition of disability is defined by your inability to perform duties specific to your specialty/training. Again, this is a major factor when determining if you’re eligible for benefit because with some policies receiving your benefit can be affected by your ability to work in another occupation.

WHAT DOES DOUBLE DIP MEAN?

The Double Dip element of True Own Occupation DI coverage allows you to earn an income while still collecting disability benefits.

For example, let’s use an interventional cardiologist who developed tremors and can no longer perform invasive procedures. Under true double dip own occupation disability coverage, he is likely eligible to receive benefit because of the inability to perform the procedures – a duty of his occupation at the time of disability. He may, however, still have the ability to teach or work in a broader specialty, and it is able to do so while receiving benefit with the double dip element of his policy. With other coverage types, the ability to earn income (even in another specialty or occupation) generally offsets your benefit amount.


NEED DISABILITY INSURANCE OR HAVE QUESTIONS?

One of our Twin Oak Insurance Specialists is happy to run a comparison of all 6 carriers and walk you through the process as we have for thousands of residents and fellows across the country. And as a reminder, there is still time to get the in-training benefits for final-year residents and fellows who pick up coverage now!

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