Disability Insurance for Psychiatrists?

[MDhasbeen]

With graduation approaching in a little over a year, I'm investigating options for disability insurance. Does the APA offer a plan specific to psychiatrists? It seems many buy their liability insurance through them. I probably should've bought disability insurance even as a resident, but my mind was wound up in calls and living on a tight budget. Wondering now if I should buy a plan during my last year and continue that plan through the rest of my career. I'm also reading from the other specialty forums here that it seems some work environments provide disability insurance along with the work contract. How common is this in psych?

All thoughts/input appreciated.

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[OldPsychDoc]

Personally, I wouldn't be without it. You never know what can happen! Whether it comes with the job contract depends on whether you're an independent contractor (and responsible for your own health, disability, malpractice, retirement, etc) or an employee (with benefit packages including all of the above). Another one of those big decisions...

 

[MDhasbeen]

Personally, I wouldn't be without it. You never know what can happen! Whether it comes with the job contract depends on whether you're an independent contractor (and responsible for your own health, disability, malpractice, retirement, etc) or an employee (with benefit packages including all of the above). Another one of those big decisions...

Don't have a lick of business sense in me so I'll probably be salaried. Read that employee benefits can be cut rather abruptly. Got me concerned, especially with the crappy economy today. Thought I should perhaps supplement what I get through a contract with personal insurances, especially disability, as well. Good or bad idea?

 

[Regnvejr]

Both places I have been employed have both short- and longterm disability insurance. Always a good idea. You have a lot of money sitting in loans and startup, so be sure to be covered. Most physicians will be fine, but you don't want to be the one caught without the insurance.

Remember that if you die, the loans "go away." But with disability, they're not going anywhere and put a burden on you and your family.

 

[notdeadyet]

Remember that if you die, the loans "go away." But with disability, they're not going anywhere and put a burden on you and your family.

Just to specify: any federal education loans go away. Not true if you take out supplemental private loans (which a surprising number of medical students apparently do nowdays).

Probably a no brainer, but just wanted to toss that out there.

 

[ProfessorPeanut]

Hi,
I'd like to re-open this thread to get some advice. I'm a female PGY-2 who is single and without children. I recently met a DI salesperson who works with a lot of doctors and is convincing me that I need to get DI, and now. Perhaps I'm just skeptical because of the "salesperson" part, but I'm thinking (and I've seen in another thread) that it would likely take a TBI or the equivalent to fully take a psychiatrist out of commission (not that that can't happen). That being the case, and also considering that most jobs will offer some version of short and/or long term DI (I have it now as housestaff), should I go ahead and get it? If so, do I need it NOW? Do most psychiatrists get additional DI? (I tried a Google search and got tons of hits about psychiatrists filling out paperwork for others to get disability - haha, not helpful!)

The only thing that made me reconsider my first opinion was reading the last two posts about loans, which I didn't consider, and no one in my family would be able to cover those in the case of me having a TBI (heck, I can hardly cover them now).

Thanks in advance!

 

[st2205]

What are the ballpark rates? I remember my peds attending saying that one that would provide half salary was something like $13/mo which surprised me.

 

[TexasPhysician]

What about crippling PTSD? A select few DI policies are really good and include psych conditions equivalent to other illnesses. Check out Guardian and MetLife in my opinion. I have it and recommend it!

 

[Igor4sugry]

With graduation approaching in a little over a year, I'm investigating options for disability insurance. Does the APA offer a plan specific to psychiatrists? It seems many buy their liability insurance through them. I probably should've bought disability insurance even as a resident, but my mind was wound up in calls and living on a tight budget.

All thoughts/input appreciated.

From my research I came to conclusion that Individual Disability policy that is specialty specific (own-occupation) is a must before you graduate residency. We have all seen or heard stories of relatively young doctors having some illness/injury that prevents them from working. You don't want a crappy group policy that will force you to work for an insurance company reviewing charts all day since you technically "can work". With a own-occupation policy that won't happen and you are free to pursue any other endeavor while getting the money.

Majority of information that is very well written is on whitecoatinvestor.com website.
Scroll down to "Disability Insurance Series"
http://whitecoatinvestor.com/personal-finance/insurance-more-than-just-malpractice-protection/

Basic points:

1. Disability insurance needs to be specialty specific, guaranteed renewable at least.
The above guide by whitecoatinvestor describes what riders you should get.
2. Policies that come through employer are weak:
a. Once you leave the job they are no longer effective b. they are a group policy that is weaker than individual policy
3. Buying in residency is cheapest
-if you go with employer and say leave at 40yo to another job and then need to buy individual policy it will be quite expensive. Getting it in residency is relatively cheap.
4. Buy policy from insurance broker that will offer quotes from multiple companies.
I avoid buying from individual medical societies and from insurance agents from specific companies.
I found that this guy was quite good and gave me good discounts on multiple policies:
http://www.physicianfinancialservices.com/
You should never be pressured into buying a policy. I found multiple agents e-mailed them and they sent me back a pdf with prices for multiple companies. It turned out that prices did vary based on agent as some gave much better rates than others.
5. Amount to get
I was quoted with policy for $2500 income along with all riders that whitecoatinverstor recommends. Costs ranged from $42/mo to $84/mo.
Most policies cover mental health disability for only 2 yrs, but there are some (such as Standard) was without any mental health restriction.

-So I would definitely get an individual disability policy while in residency and then upgrade it as you advance in practice to as much as you can afford.

 

[Igor4sugry]

Currently good discussion on disability insurance for residents on BogleHeads forum:
http://www.bogleheads.org/forum/viewtopic.php?f=2&t=115902

 

[Leo Aquarius]

I personally think disability insurance is silly for psychiatrists. Think about it, how disabled do you have to be to not practice psychiatry? You basically have to be rendered unable to speak. That's called brain death, which is as likely as you winning the lottery. The other reason is death, which is covered by life insurance.

The categories that generate the largest number of disability claims are lower back injuries and depression. Lower back injuries will not be a credible reason to stop practicing psychiatry, and probably won't be accepted. Depression, now you may get a case there. But if one of these conditions is pre-existing, the underwriter may deny coverage.

But if you are so inclined to get disability insurance, then you should also conduct the same type of examination of the health of the insurance company: the healthier the company, the better the chances your claim will be honored without the hassle that drives so many people to curse insurance companies. Just because you get approved for insurance, doesn't mean your claim will be honored when you want it to be.

I personally won't waste money on disability insurance. When I'm 80 I will still practice psychiatry. Now surgeons, one bad ski trip and there goes a finger or hand.

 

[TexasPhysician]

I personally think disability insurance is silly for psychiatrists. Think about it, how disabled do you have to be to not practice psychiatry? You basically have to be rendered unable to speak. That's called brain death, which is as likely as you winning the lottery. The other reason is death, which is covered by life insurance.

The categories that generate the largest number of disability claims are lower back injuries and depression. Lower back injuries will not be a credible reason to stop practicing psychiatry, and probably won't be accepted. Depression, now you may get a case there. But if one of these conditions is pre-existing, the underwriter may deny coverage.

But if you are so inclined to get disability insurance, then you should also conduct the same type of examination of the health of the insurance company: the healthier the company, the better the chances your claim will be honored without the hassle that drives so many people to curse insurance companies. Just because you get approved for insurance, doesn't mean your claim will be honored when you want it to be.

I personally won't waste money on disability insurance. When I'm 80 I will still practice psychiatry. Now surgeons, one bad ski trip and there goes a finger or hand.

Incorrect. Severe back injuries and any major pain could easily disable you in any field. Add early Alzheimer's, brain trauma, psych conditions, retina detachments, many Neuro conditions, spine trauma, cancers - especially those affecting your voice, etc. Quite a long list actually.

Guardian also covers partial disability for me. Say I get MS or myasthenia or cancer or need dialysis that limits my hours but doesn't completely disable me, I'm covered under partial disability.

Any injury that keeps me out 60 days or more is considered a temporary full disability and the plan kicks in.

If I get disabled with cancer for a year, the plan also covers me until I get my pp up to 80% again. Being gone for a year, your patients will go elsewhere. I'll need to find or recapture cash or good insurance patients and this will take time. Guardian continues to pay until my practice is back to 80% of what it was at my peak - which may be forever.

All of this guaranteed until I hit 65 isn't bad for only $160/month for currently $5k/month coverage as a resident in my opinion.

This is a broad disability plan and is quite important in my opinion. Straight full disability plans that are non- occupation specific probably are a waste of money.

 

[Leo Aquarius]

Alzheimers, cancer, neuro diseases before the age of 65? Hey, I want to get in on this business of selling disability insurance.

 

[Leo Aquarius]

I was crunching some numbers. Assuming the average psychiatrists earns $150,000, and insurance pays 80%, that's about $10,000 per month for each claimant. If each insurance holder pays $160/month, then you need 62.5 enrolees to cover each claimant ($10,000 per month).

Thus, if less than 1 out of 63 people develop a serious disability (Alzheimers, cancer, severe head trauma, stroke in the young, etc) by age 65, then it's worth becoming a disability insurance company. I say YES! I'm sure the odds are more on the order of 1 out of 500 or 1000. These companies should be making great margins.

Maybe I just found my second stream of income as I build a side career 🙂

 

[vistaril]

Alzheimers, cancer, neuro diseases before the age of 65? Hey, I want to get in on this business of selling disability insurance.

ummm maybe not AD, but of course cancer and neuro diseases are common before age 65....in fact the median age of onset of many cancers is before 65. What do you anticipate average life span is in this country? 90 or something?

 

[Scorcher31]

I'm with Leo on this one. Heck If I was paralyzed from the neck down I could still do home psychiatry in my office. If I'm more gone than that, I personally have no interest sticking around anyways. Then again its personal preference. I also have a spouse that makes good money and could also get her health insurance to cover us. Same reason I'm not terribly concerned about life insurance. With that said we have and most likely always will have a conservative lifestyle.

 

[vistaril]

I'm with Leo on this one. Heck If I was paralyzed from the neck down I could still do home psychiatry in my office. .

no....you probably couldn't. People paralyzed from the neck down don't function in such a capacity.

 

[michaelrack]

no....you probably couldn't. People paralyzed from the neck down don't function in such a capacity.

Agree with Vistaril. Maybe one in 10,000 psychiatrists could pull something like that off.

To use an example from another field, it's not realistic for a college physics professor to expect to be able to continue to work with advance ALS just because Stephen Hawking is able to work.

 

[Scorcher31]

Agree with Vistaril. Maybe one in 10,000 psychiatrists could pull something like that off.

To use an example from another field, it's not realistic for a college physics professor to expect to be able to continue to work with advance ALS just because Stephen Hawking is able to work.

Of course it was an over exaggeration, but if it's what you love to do I'm sure you can find a way with even a major disability to see patients. We are simply at lower risk of becoming disabled compared to almost any other type of physician. We don't really need our hands. We don't need to do procedures. We can see people at home for cash. We can dictate everything, etc. If I'm not mistaken, a couple of years ago and that one of the major factors that contributes to disability is whether someone actually liked their job.

 

[TexasPhysician]

Alzheimers, cancer, neuro diseases before the age of 65? Hey, I want to get in on this business of selling disability insurance.

Close family friend got early Alzheimer's that began around age 48.

I don't buy disability insurance expecting to use it. I do it for peace of mind. In the odd chance something bad happens to me, I want to still be able to have a decent lifestyle and pay for my childrens' education. My wife is not a physician with high income potential.

Of course disability insurance companies make a profit. If not, they wouldn't exist.

With a family that depends on me earning an income, comprehensive disability insurance and term life insurance is a must in my opinion.

 

[OldPsychDoc]

I'm having a hard enough time seeing patients in this damn shoulder immobilizer, and typing one handed into EPIC... 🙁

 

[michaelrack]

Of course it was an over exaggeration, but if it's what you love to do I'm sure you can find a way with even a major disability to see patients. We are simply at lower risk of becoming disabled compared to almost any other type of physician. We don't really need our hands. We don't need to do procedures. We can see people at home for cash. We can dictate everything, etc. If I'm not mistaken, a couple of years ago and that one of the major factors that contributes to disability is whether someone actually liked their job.

that is true to some extent.. However even a well-motivated psychiatrist who works in a private clinic (as a non-partner employee) who accidentally has both hands cut off is going to have major difficulties earning a living as a psychiatrist for a while. But I agree that a psychiatrist with a major disability will have an easier time earning a living than docs in other specialties.

 

[Scorcher31]

No disagreement here Michael. Hope your shoulder gets better OPD.

 

[MrJiggles]

So is the general consensus to get "own occupation" disability insurance?

 

[michaelrack]

So is the general consensus to get "own occupation" disability insurance?

if you do get it , it should be "own occupation", and if possible "own specialty"