If you’re a physician, lawyer, dentist, or other high-income professional working in a complex field, you shouldn’t go without robust long-term disability insurance coverage. You’ve dedicated countless hours to mastering your craft and worked hard to build a certain standard of life for yourself and your family. Without a comprehensive disability insurance policy, however, a single unexpected illness or accident could mean losing it all.
But not all disability insurance policies are created equal—and the worst time to find out that your insurance policy isn’t good enough is when you’re filing for disability benefits. You may think your “own occupation” disability policy is the best you can get, but that’s not necessarily true. For some professionals, it’s worth considering whether specialty-specific coverage is a better choice.
RELATED POST: Do Doctors Need Disability Insurance? – Bryant Legal Group (bryantlg.com)
What Are the Main Definitions of Disability?
Most long-term disability plans use one of two different definitions of disability:
- Any occupation disability insurance will only pay benefits if you are totally disabled from any gainful employment, even if it’s much lower paying or outside your industry.
- Own occupation disability insurance will pay benefits if you are unable to perform the material duties of your own occupation.
Almost all disability insurance for professionals, like physicians and lawyers, will at minimum use an own occupation definition of disability. And for good reason. These professions require highly developed cognitive and emotional skills, physical stamina and precise motor skills. Conditions that might not be considered disabling in other professions can end a career in law or medicine.
However, the question that professionals need to ask themselves is this:
How does my insurance company determine what my occupation’s “material duties” are?
This is an especially relevant question for attorneys, doctors, and other professions that have an extremely broad range of niches and sub-specialties. Just because you can still work as a “doctor” doesn’t mean you can still practice your medical specialty.
This is where specialty-specific policies, offered by a few disability insurance companies, may be a wise choice.
What Is Specialty-Specific Disability Insurance?
Specialty-specific disability insurance is a form of true own-occupation disability insurance that offers stronger protection and greater flexibility for professionals working in a lucrative field.
Let’s consider some basic examples.
On the medical side, say you’re a highly trained surgeon working in a lucrative medical specialty. You need extremely steady hands, and you need to be mentally sharp to do your job. However, you develop essential tremors.
You probably can’t work as a surgeon anymore, but you could still do non-clinical work or other medical duties that don’t require precise use of your hands. If you have a specialty-specific insurance plan, you’d probably be eligible for full disability benefits even if you choose to keep working as a doctor outside your original specialty. If you only have an “own occupation” plan, that may not be the case.
How does this work for attorneys?
According to plan documents for one major insurance company that offers specialty-specific coverage, an attorney who has been practicing for at least two years will have their “own occupation” defined specifically according to their legal subject matter area or the type of legal practice that they specialize in.
For example, say you are a trial lawyer, and you make your money by personally preparing for, appearing and participating in legal proceedings (like depositions and trials). If your disability insurance company sold you specialty-specific coverage, you could get disability insurance benefits if your disability prevents you from physically participating in those legal proceedings, even if you can (and choose to) do behind-the-scenes (albeit less lucrative) legal work.
Should You Get Specialty-Specific Coverage?
Whether or not you should buy specialty-specific attorney or physician disability insurance will depend on your circumstances.
In general, these disability insurance policies are good choices for professionals who work in a niche subfield. If you have more specialized skills and make a significantly higher income than a “generalist” in your occupation, the best disability insurance policy for you will probably be one that defines your “own occupation” as narrowly as possible.
However, more robust coverage also means more expensive insurance premiums. If you already have enough saved for a comfortable retirement, or your specialty isn’t as lucrative (and you wouldn’t mind switching to less demanding work), a more basic own occupation plan may be sufficient. If you have questions, don’t hesitate to talk with a trusted financial planner, or pick up the phone and call our long-term disability insurance lawyers.
Exploring a Few Common Challenges and Pitfalls
Even if, in theory, you have an excellent individual disability insurance policy, that doesn’t mean your long-term disability claim will be a simple affair. Insurance companies are motivated to save money, not pay out benefits. We see legitimate claims denied all the time.
Here are a few things to watch out for:
- “Invisible” disabilities. Highly educated professionals and business owners depend on sharp cognitive and emotional skills to do their work. However, most disability insurance companies still tend to be focused on physical disabilities and limitations when making disability determinations. They may even have exclusions or limitations for mental illness or other conditions that rely on self-reported symptoms (rather than “objective medical evidence”) for diagnosis. If you have a disability that primarily affects your cognition, understand that your disability claim may require a substantial amount of supporting evidence.
- Insurers not understanding the nature of your occupational duties. Specialty-specific coverage can help here, but that doesn’t guarantee that your insurance company will fully understand what the material and substantial duties of your occupation are—particularly if you have a unique role or niche specialty.
- Changing your occupational duties before you file for benefits. Many disabilities develop gradually over time, with professionals choosing to work as long as possible before filing. However, this can hurt you, particularly if you reduce your hours or change your occupational duties to lower-paying, less specialized work prior to filing for long-term disability benefits. In this scenario, the insurance company may consider your reduced or altered role to be your “own occupation,” rather than your original specialty. If they do so, your claim could be denied, or your monthly benefit could reflect your reduced, post-adjustment income. A better solution for professionals with a residual disability rider in their insurance policy is to file before making any occupational changes. Then, should you choose to continue working in a different or reduced role, your residual disability insurance benefits might cover a portion of the difference between your old and new salary.
Additionally, if you’re planning to purchase new or additional coverage, keep in mind that the definition of disability (and how your “own occupation” is defined) is just one part of a robust long-term disability insurance policy.
In addition to considering factors such as exclusions, length of elimination period, benefit period, and whether a policy is non-cancelable, professionals may also consider buying riders such as cost of living adjustment (COLA) or future increase option (FIO) to provide more flexible coverage and better financial security.
RELATED POST: A Doctor’s Guide to “Own Occupation” Disability Insurance Policies – Bryant Legal Group (bryantlg.com)
Need Help? Talk to Bryant Legal Group
Our Chicago long-term disability attorneys have extensive experience working with doctors, lawyers, business owners, and other highly paid professionals with specialized skills and unique roles.
If you’re considering filing a long-term disability claim or have recently had a claim denied by your insurance company, we strongly recommend working with an experienced disability lawyer. As we said, insurance companies reject valid claims all the time. And depending on your policy, you may only have one chance (and a very limited time window) to appeal a denied claim. We also help professionals evaluate their current coverage and determine the best coverage for their needs.
To request a consultation with our legal team, call (312) 561-3010 or complete our simple online contact form today.
The content provided here is for informational purposes only and should not be construed as legal advice on any subject.