Disability insurance

[anbuitachi]

Seems like all attendings have anesthesia specific disability insurance. I know it is highly recommended to get one. But I dont know anyone who had to use it, or what conditions qualify activation of disability insurance. Does anyone know of anyone who had to use it and what was their situation?

It is extremely costly, and i imagine insurance companies will try everything they can to deny you the money since it will be a lot of money for the insurance company since anesthesiologists make over 100k. Some scenarios i can think of is hemiparesis from a stroke, complete blindness.. or severe dementia.. but if it has to come to that for me to get disability payments, it almost doesn't seem worth it spending thousands per year on it. And also is it worth it to get anesthesia specific disability insurance? It seems like most of those things would rule you out for all the medical fields (eg if you are blind), leaving you able to only do low paying jobs.

Eg there are insurances specific for Pain management, so if you are disabled for pain, youd receive payments even if you can still do anesthesiology, but i cant think of a single scenario that would be disabling for pain management but not anesthesiology..

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[Man o War]

Seems like all attendings have anesthesia specific disability insurance. I know it is highly recommended to get one. But I dont know anyone who had to use it, or what conditions qualify activation of disability insurance. Does anyone know of anyone who had to use it and what was their situation?

It is extremely costly, and i imagine insurance companies will try everything they can to deny you the money since it will be a lot of money for the insurance company since anesthesiologists make over 100k. Some scenarios i can think of is hemiparesis from a stroke, complete blindness.. or severe dementia.. but if it has to come to that for me to get disability payments, it almost doesn't seem worth it spending thousands per year on it. And also is it worth it to get anesthesia specific disability insurance? It seems like most of those things would rule you out for all the medical fields (eg if you are blind), leaving you able to only do low paying jobs.

Eg there are insurances specific for Pain management, so if you are disabled for pain, youd receive payments even if you can still do anesthesiology, but i cant think of a single scenario that would be disabling for pain management but not anesthesiology..

SPEND THE MONEY!
First and foremost you must have "own occupation" disability policy. If you can't work as an anesthesiologist, they pay you. Other policies are fairly worthless IMO.
I now know 2 anesthesiologists who are on disability and thankfully had good own occ policies. One injured his left arm/hand and the other got a head injury skiing and has cognitive impairments. It happens. Don't make the mistake of thinking it won't happen to you.
As for me, I have an excellent policy through Principal, own occ with all the bells and whistles. I pay about $700/month for it to replace about 2/3 of my income.

 

[Man o War]

To answer the other question, both guys had to go through extensive, rigorous testing to get paid. It took a long time. Most of these polices have elimination periods anyway...I chose 6 months to lower the premium. So you should have a nice healthy slush fund to live off of while it's all getting sorted out.

 

[anbuitachi]

To answer the other question, both guys had to go through extensive, rigorous testing to get paid. It took a long time. Most of these polices have elimination periods anyway...I chose 6 months to lower the premium. So you should have a nice healthy slush fund to live off of while it's all getting sorted out.

Wow he actually got them to pay for a left hand injury? He must be paralyzed..

 

[Man o War]

Wow he actually got them to pay for a left hand injury? He must be paralyzed..

Yes, he's been on it for several years. He's not paralyzed but his his left hand is useless- he has a hard time gripping a glass to drink from. Awful.

 

[anonperson]

Seems like all attendings have anesthesia specific disability insurance. I know it is highly recommended to get one. But I dont know anyone who had to use it, or what conditions qualify activation of disability insurance. Does anyone know of anyone who had to use it and what was their situation?

It is extremely costly, and i imagine insurance companies will try everything they can to deny you the money since it will be a lot of money for the insurance company since anesthesiologists make over 100k. Some scenarios i can think of is hemiparesis from a stroke, complete blindness.. or severe dementia.. but if it has to come to that for me to get disability payments, it almost doesn't seem worth it spending thousands per year on it. And also is it worth it to get anesthesia specific disability insurance? It seems like most of those things would rule you out for all the medical fields (eg if you are blind), leaving you able to only do low paying jobs.

Eg there are insurances specific for Pain management, so if you are disabled for pain, youd receive payments even if you can still do anesthesiology, but i cant think of a single scenario that would be disabling for pain management but not anesthesiology..

I'm in OB GYN. I heard of a colleague who had a chronic shoulder injury after a patient accidentally kicked her during labor. One of my co residents badly injured their wrist (required surgery) when helping transfer an obese patient from the OR table to the gurney after a c section.

Also, doesn't have to be as extreme as your examples. Mental illness, visual disturbances, accidents causing life altering injuries etc. Life happens.

Own occupation is a must.

Insurance companies will always make it challenging to collect payments but if you have a life changing disability you need this as a back up. A physician career is worth too much.

In addition, I have a clause that will cover if I have to take extended time off to care for a disabled spouse or child. Nice to have that peace of mind.

The premiums are painful but it comes with the territory of generation a reasonably high income.

 

[pgg]

I knew an anesthesiologist in residency who needed his policy.

Although I have some degreee of disability coverage by virtue of the military's medical retirement system, I still got my own policy. Most companies won't insure active duty military, but I ended up with a small own occ policy through the AMA, and a better own occ policy through Mass Mutual.

Just accept the fact that insurance will be either your #1 or #2 expense in life (behind housing, maybe). Car, home, rental property, umbrella, malpractice, disability ... it's a lot of money but being caught without just adds a second life changing crisis to whatever illness or accident just changed your life.

 

[anbuitachi]

I'm in OB GYN. I heard of a colleague who had a chronic shoulder injury after a patient accidentally kicked her during labor. One of my co residents badly injured their wrist (required surgery) when helping transfer an obese patient from the OR table to the gurney after a c section.

Also, doesn't have to be as extreme as your examples. Mental illness, visual disturbances, accidents causing life altering injuries etc. Life happens.

Own occupation is a must.

Insurance companies will always make it challenging to collect payments but if you have a life changing disability you need this as a back up. A physician career is worth too much.

In addition, I have a clause that will cover if I have to take extended time off to care for a disabled spouse or child. Nice to have that peace of mind.

The premiums are painful but it comes with the territory of generation a reasonably high income.

But the disability wont be paying for those right? Chronic shoulder injury can probably get better after total shoulder replacement. and Im guessing the wrist improved as well?

 

[IlDestriero]

You don't need a catastrophic injury to collect as an anesthesiologist, or as a surgeon. I don't know any anesthesiologist that has used it outside of one with stage 4 cancer, but I know a few surgeons that had a derailed career from accidents. You have to be able to use both hands effectively, have depth perception, be mobile, highly functioning cognitively, etc. That's why own occupation is so important. They're not going to deny your claim and suggest you just work in the preop clinic when your nerve injury leaves your hand 90% useless. **** happens. Lightning strikes. Be prepared.
I hate that bill, it's real kick in the nuts, but I pay it with a smile on time, knowing my family and I need that coverage.
At some point I won't need it anymore, and I'll throw a little party as I burn the bill in the fireplace, but I'm not there yet. You're all invited, but it's probably 10 years off.


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Il Destriero

 

[deleted126335]

The unlikely is not impossible. Don't confuse strategy and outcome.

I have had a disability policy for over 25 years and never collected. I don't consider the premiums wasted. I bought life insurance when my wife got pregnant. I don't consider those premiums wasted either. . Also auto and homeowners and excess liability and umbrella that I have never collected on.

Unless you have a working crystal ball, just bite the bullet. If you are young or mid career, your single most valuable asset is your ability to earn an income. You worked real hard and invested a lot to attain it. You need to insure it. You will probably get away with not needing the insurance. But then again you will probably get away with never having buckled a seatbelt either.

 

[sleepallday]

Totally agree with the other comments, especially being the primary bread winner in the family. just not worth the risk. On a side note, I was able significantly reduce my premiums with a couple of modifications. First, it's an own occupation policy but if I am able to work in another career or side business, the policy will only cover the difference in income (if there is one). Second, the inability to practice due to mental health issues or addiction I have capped at two years. According to my agent, the second is the most common claim and capping it is saving me a lot.

 

[acidbase1]

I'm a new grad, got the full meal deal. As bad as it stings, imagine going through all this work and having nothing to show for it. 700$ is worth the piece of mind imo.

Now in 10 years after you have accumulated a couple million in assets, then cancelling the policy is an option.

But now, with virtually no net worth and student loans it's an absolute must, esp if you have a family

 

[sethco]

Another thing to keep in mind is disability insurance, like life insurance, is not necessarily permanent. Once you hit financial independence, you can evaluate whether you want to keep paying premiums on disability and life policies

 

[BLADEMDA]

Another thing to keep in mind is disability insurance, like life insurance, is not necessarily permanent. Once you hit financial independence, you can evaluate whether you want to keep paying premiums on disability and life policies

I bought two disability policies. I've cancelled one and kept the other. If I get disabled it pays about 40% of my current income. This allows me a reasonable monthly payment for the remainder of my career.

I recommend you plan ahead and think about your needs in 10-20 years as well as your current situation.

 

[deleted162650]

Keep in mind that you can deduct your disability premiums. There are some quirks as to how you have to do it, and it does come with some caveats so talk to your CPA about it to see if it's something you care to do. We've talked about this here in the past.

 

[pjl]

Keep in mind that you can deduct your disability premiums. There are some quirks as to how you have to do it, and it does come with some caveats so talk to your CPA about it to see if it's something you care to do. We've talked about this here in the past.

Not sure this is a good idea, post tax dollars now = not taxed benefits.


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[deleted162650]

Not sure this is a good idea, post tax dollars now = not taxed benefits.


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It's not that simple. If you time your deduction right , you can make it appear that you paid with pre-tax dollars for the current year.

Like I originally said, consulting with a CPA about this a good idea before you decide to do it.

 

[Robotic Wis-Hipple]

Well, and if your policy pays 2/3 of your income, and that falls in a lower tax bracket your actual effective tax rate on those benefits may be lower. In addition to that, if you get a deduction every year for 20 years for insurance the vast majority will never receive longterm payment of that's a good deal.

I need a business.....

 

[epidural man]

I went to get some disability insurance after a discussion on this forum.

I was getting out of the military and so wanted to document everything before I left. I was working in the pain clinic and asked my buddy to open up an encounter for me under our electronic system. I documented that I had back pain - that's it. No treatment...no sequela , no lost work, no nothing. Just a documented complaint of back pain.

Because of this, the underwriters would only give me the insurance with a musculoskeletal rider so I couldn't collect if I had a musculoskeletal injury.

Well since about 40% of insurance pay-outs are for musculoskeletal complaints - I said I would accept the rider if they gave me a 30-40% discount on premiums - since that would make ALL THE SENSE IN THE WORLD.

Yet, it didn't make any sense to greedy underwriters. NO discount provided.

So basically, if I get injured - I'll be very poor. Oh well. I'm a little uncomfortable with no disability insurance, but I'm also very uncomfortable paying for everyone else's insurance payouts without the ability to be treated fairly in that field. Plus, there is so much fraud in the disability world, I'm a little glad I'm not part of it.

 

[anbuitachi]

I went to get some disability insurance after a discussion on this forum.

I was getting out of the military and so wanted to document everything before I left. I was working in the pain clinic and asked my buddy to open up an encounter for me under our electronic system. I documented that I had back pain - that's it. No treatment...no sequela , no lost work, no nothing. Just a documented complaint of back pain.

Because of this, the underwriters would only give me the insurance with a musculoskeletal rider so I couldn't collect if I had a musculoskeletal injury.

Well since about 40% of insurance pay-outs are for musculoskeletal complaints - I said I would accept the rider if they gave me a 30-40% discount on premiums - since that would make ALL THE SENSE IN THE WORLD.

Yet, it didn't make any sense to greedy underwriters. NO discount provided.

So basically, if I get injured - I'll be very poor. Oh well. I'm a little uncomfortable with no disability insurance, but I'm also very uncomfortable paying for everyone else's insurance payouts without the ability to be treated fairly in that field. Plus, there is so much fraud in the disability world, I'm a little glad I'm not part of it.

That's one of my worries. I should speak to some insurance peeps. I have documented back pain , knee pain, shoulder pain, and other joints w imaging to back it up lol... And bunch of other medical issues on my chart.. .

 

[IlDestriero]

That's one of my worries. I should speak to some insurance peeps. I have documented back pain , knee pain, shoulder pain, and other joints w imaging to back it up lol... And bunch of other medical issues on my chart.. .

That's going to be a problem. You might qualify for some group policy though.


--
Il Destriero

 

[teeva]

I got disability insurance as a resident prior to my 31st birthday based on the recommendation of other residents. I had not and still have not seen a doctor since around age 16.

Guardian offers 10% discount for residents, and there's another 10% discount for anesthesiologists because it doesn't cover psych or drug addiction for more than 2y.

Currently my monthly premium is 2.2% of my net monthly income, and if ever needed will cover 52% of my net monthly income....enough to pay the mortgage and live comfortably, or make other plans. The premium isn't insignificant and I do wonder why I need it in the first place, being single with no kids, and only mortgage debt.

 

[Man o War]

I went to get some disability insurance after a discussion on this forum.

I was getting out of the military and so wanted to document everything before I left. I was working in the pain clinic and asked my buddy to open up an encounter for me under our electronic system. I documented that I had back pain - that's it. No treatment...no sequela , no lost work, no nothing. Just a documented complaint of back pain.

Because of this, the underwriters would only give me the insurance with a musculoskeletal rider so I couldn't collect if I had a musculoskeletal injury.

Well since about 40% of insurance pay-outs are for musculoskeletal complaints - I said I would accept the rider if they gave me a 30-40% discount on premiums - since that would make ALL THE SENSE IN THE WORLD.

Yet, it didn't make any sense to greedy underwriters. NO discount provided.

So basically, if I get injured - I'll be very poor. Oh well. I'm a little uncomfortable with no disability insurance, but I'm also very uncomfortable paying for everyone else's insurance payouts without the ability to be treated fairly in that field. Plus, there is so much fraud in the disability world, I'm a little glad I'm not part of it.

Try another company. I have significant documented shoulder issues and they covered me with only a 2 year exclusion for shoulder problems (I am with Principal).

 

[Arch Guillotti]

It's not that simple. If you time your deduction right , you can make it appear that you paid with pre-tax dollars for the current year.

Like I originally said, consulting with a CPA about this a good idea before you decide to do it.

How do you time the deduction and why would you want to? Are you trying to game the system or not?

 

[AdmiralChz]

That's one of my worries. I should speak to some insurance peeps. I have documented back pain , knee pain, shoulder pain, and other joints w imaging to back it up lol... And bunch of other medical issues on my chart.. .

Like Il D said there are group discounts out there that don't require medical record review, I am sure they have some stipulations (unable to file a claim within 12-24 months, etc...) and will cost more than someone who underwent underwriting but might be worth investigating. AMA offers one, I believe.

Interestingly Anesthesiology is the most expensive specialty to insure with the highest premiums - more than NSG, gen surg or CT. I asked my financial guy who helped me land a reasonable policy why - apparently Anesthesiologists far and away actually USE their policies much more on average than other specialties.

 

[anbuitachi]

Like Il D said there are group discounts out there that don't require medical record review, I am sure they have some stipulations (unable to file a claim within 12-24 months, etc...) and will cost more than someone who underwent underwriting but might be worth investigating. AMA offers one, I believe.

Interestingly Anesthesiology is the most expensive specialty to insure with the highest premiums - more than NSG, gen surg or CT. I asked my financial guy who helped me land a reasonable policy why - apparently Anesthesiologists far and away actually USE their policies much more on average than other specialties.

Maybe all the addictions? Isn't that the most common reason for use?

 

[Simba1711]

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[deleted162650]

How do you time the deduction and why would you want to? Are you trying to game the system or not?

I'd say it's not so much "gaming the system" as it is exploiting a loophole.

 

[caligas]

I'd say it's not so much "gaming the system" as it is exploiting a loophole.

Do you have any links that describe this loophole? I like the idea but I can't find anything specific.

 

[Consigliere]

I was under the impression that disability insurance didn't cover addiction. I could be wrong though.

 

[ZzzPlz]

I was under the impression that disability insurance didn't cover addiction. I could be wrong though.

I believe most plans it's an extra insurance rider for which you pay out the ass in our line of work. I decided to keep the money

 

[MD Financial Services Scott]

I knew an anesthesiologist in residency who needed his policy.

Although I have some degreee of disability coverage by virtue of the military's medical retirement system, I still got my own policy. Most companies won't insure active duty military, but I ended up with a small own occ policy through the AMA, and a better own occ policy through Mass Mutual.

Just accept the fact that insurance will be either your #1 or #2 expense in life (behind housing, maybe). Car, home, rental property, umbrella, malpractice, disability ... it's a lot of money but being caught without just adds a second life changing crisis to whatever illness or accident just changed your life.

You might read the technical wording of your elimination period in your AMA policy, it has a phrase of Total and Continuous in there, very difficult to have that level of a disability since if you can do something then you are not totally disabled..... The Mass policy has a loss of income of 20% to trigger benefits, very different than 100%.

 

[MD Financial Services Scott]

Try another company. I have significant documented shoulder issues and they covered me with only a 2 year exclusion for shoulder problems (I am with Principal).

One should always check around with the different carriers since you never know what the outcome might be.

 

[MD Financial Services Scott]

I was under the impression that disability insurance didn't cover addiction. I could be wrong though.

They do cover addiction, some for only 24 months, other carriers to age 65, just depends on what you want and what you want to pay for.

 

[MD Financial Services Scott]

Totally agree with the other comments, especially being the primary bread winner in the family. just not worth the risk. On a side note, I was able significantly reduce my premiums with a couple of modifications. First, it's an own occupation policy but if I am able to work in another career or side business, the policy will only cover the difference in income (if there is one). Second, the inability to practice due to mental health issues or addiction I have capped at two years. According to my agent, the second is the most common claim and capping it is saving me a lot.

You can always push the waiting period to 180 days rather than 90, that usually has another 10-17 % savings, depending on the company.

 

[MD Financial Services Scott]

That's one of my worries. I should speak to some insurance peeps. I have documented back pain , knee pain, shoulder pain, and other joints w imaging to back it up lol... And bunch of other medical issues on my chart.. .

If still in training you should ask about any GSI plan offerings, that might be a good solution.

 

[pgg]

You might read the technical wording of your elimination period in your AMA policy, it has a phrase of Total and Continuous in there, very difficult to have that level of a disability since if you can do something then you are not totally disabled..... The Mass policy has a loss of income of 20% to trigger benefits, very different than 100%.

Yes - it's very limited. And it's a short term payout (max 5 years I think). And I have a 1-year elimination period. But the premium is incredibly cheap. And at the time it was the only disability policy I could get while on active duty. I was relieved when I found out Mass Mutual would underwrite a real policy for me. It costs a whole lot more but it's a far better policy.

 

[anbuitachi]

How does it usually work? I hear company sends people and remove blood and urine and sees entire history. If i were to consider multiple companies, do i have to do that with every company, see what they offer me and then decide??

 

[Man o War]

How does it usually work? I hear company sends people and remove blood and urine and sees entire history. If i were to consider multiple companies, do i have to do that with every company, see what they offer me and then decide??

Yep. Some of them have hard cutoffs for BMI too. I had to lose 10 lbs to get my policy. I wasn't obese by any means, I remember being surprised by the weight requirement for my height. Don't recall the exact number though.
For me, because of my shoulder issues I was DQd automatically from most companies except Principal, so I didn't have to talk to other companies.

 

[anbuitachi]

Yep. Some of them have hard cutoffs for BMI too. I had to lose 10 lbs to get my policy. I wasn't obese by any means, I remember being surprised by the weight requirement for my height. Don't recall the exact number though.
For me, because of my shoulder issues I was DQd automatically from most companies except Principal, so I didn't have to talk to other companies.

I hope they dont have a height cutoff

 

[deleted162650]

How does it usually work? I hear company sends people and remove blood and urine and sees entire history. If i were to consider multiple companies, do i have to do that with every company, see what they offer me and then decide??

I locked in my policy with Standard while still a resident. No labs or medical exam required with ability increase coverage amount after becoming an attending also with no exam. This offer was only good for current residents.

 

[dku_di4mds]

I would like to step in and clear up some confusion.

How does it usually work? I hear company sends people and remove blood and urine and sees entire history. If i were to consider multiple companies, do i have to do that with every company, see what they offer me and then decide??

Depending on your age, state of residence, company, monthly benefit amount, a blood/urine sample may be required. A prescription drug history check will be completed and you will sign a form granting the company a right to request medical records if an underwriter wants them. If you have no health history other than annual physicals the company may not request any medical records. One insurance exam is good for all the companies. You do not have to do an exam for each application/company. If you end up applying to more than 1 company, you will have to sign another set of forms. Each company has its own underwriting process and they don't share medical records. This means that each company will request its own copy of any medical records. Once the company evaluates your morbidity risk, they will either issue you a policy "as applied for", issue a policy "other than as applied" which means coverage exclusions, premium surcharges, etc, or decline you for coverage. After that step, you decide how to proceed by either paying for the policy or not.

 

[anbuitachi]

I would like to step in and clear up some confusion.



Depending on your age, state of residence, company, monthly benefit amount, a blood/urine sample may be required. A prescription drug history check will be completed and you will sign a form granting the company a right to request medical records if an underwriter wants them. If you have no health history other than annual physicals the company may not request any medical records. One insurance exam is good for all the companies. You do not have to do an exam for each application/company. If you end up applying to more than 1 company, you will have to sign another set of forms. Each company has its own underwriting process and they don't share medical records. This means that each company will request its own copy of any medical records. Once the company evaluates your morbidity risk, they will either issue you a policy "as applied for", issue a policy "other than as applied" which means coverage exclusions, premium surcharges, etc, or decline you for coverage. After that step, you decide how to proceed by either paying for the policy or not.

How long would the insurance exam last? If i get it in pgy1 year, can i decide in pgy5 or will i have to go thru another insurance exam. man i am so screwed. I have so many prescription meds

 

[MD Financial Services Scott]

Yes - it's very limited. And it's a short term payout (max 5 years I think). And I have a 1-year elimination period. But the premium is incredibly cheap. And at the time it was the only disability policy I could get while on active duty. I was relieved when I found out Mass Mutual would underwrite a real policy for me. It costs a whole lot more but it's a far better policy.

How does it usually work? I hear company sends people and remove blood and urine and sees entire history. If i were to consider multiple companies, do i have to do that with every company, see what they offer me and then decide??

The insurance broker you use would take the blood profile results and just share it with each carrier, no need to have a blood draw for each of them.

 

[turnupthegas]

I'm in the process of getting mine now. I'm a brand new attending. my group gives 10k, so I was thinking of adding 6500 now and more later as I get settled into making more than 55K a year. LOL. The other option is to max it out now and then again later if i make more. 700 bucks a month is a lot fork over. I also haven't received my first paycheck yet.

 

[MD Financial Services Scott]

I'm in the process of getting mine now. I'm a brand new attending. my group gives 10k, so I was thinking of adding 6500 now and more later as I get settled into making more than 55K a year. LOL. The other option is to max it out now and then again later if i make more. 700 bucks a month is a lot fork over. I also haven't received my first paycheck yet.

Double check it because if you are typical age of finishing residency/fellowship $6500 monthly benefit should not cost but maybe $120-$200 depending on design...

 

[turnupthegas]

240 for 6500 for Berkshire is high? Could this be negotiated or is this just what the company spits out.

 

[MD Financial Services Scott]

240 for 6500 for Berkshire is high? Could this be negotiated or is this just what the company spits out.

You can always ask the rep if there is any way to shave the cost down but usually it is just a matter of each carrier kind of has specialties and or states that they excel at which creates great deals from those carriers for those people. As an example, as of today there are some surgical specialties that are 25% under market price with Ohio National, no reason for that other than that is the pricing they are getting at the moment. Ask if they can reduce cost or look around through another rep would be my suggestion.

 

[MD Financial Services Scott]

But the disability wont be paying for those right? Chronic shoulder injury can probably get better after total shoulder replacement. and Im guessing the wrist improved as well?

Yes the carriers will pay for those, it is called a partial or residual claim capacity.

 

[MD Financial Services Scott]

240 for 6500 for Berkshire is high? Could this be negotiated or is this just what the company spits out.

Maybe kind of high but that does depend on your age, gender, state of residency and medical specialty.