What Do Doctors Need To Know About Long-Term Disability Insurance and Claims?

Disability is an unfortunate fact of life for many.  Whether you are seriously injured, diagnosed with a severe medical condition, or are dealing with a chronic medical condition – statistics show that up to 25% of individuals will become disabled before retirement! And, depending on the specifics of your life, that percentage can increase significantly.

What doctors need to know about long-term disability insurance and claims As a doctor, you treat disabled people every day.  But, you are different! You will not have to deal with the problems your patients deal with in their lives.  Right? Because statistics do not apply to you!

You have spent your life thinking strategically and analytically – and leaving the emotion out of it.  And, yet unfortunately, many doctors, think emotionally when it comes to their own disability possibilities. Do NOT be like those doctors!

As a Long-Term Disability lawyer, I have a few strategic and analytical tips to help you think about and plan for the possibility of disability:

  1. Purchase a Private Long-Term Disability Policy
    • Do not rely on your employer’s long-term disability policy – employer-provided policies are not customizable, are subject to different and insurer favorable laws, and may require you to perform work other than as a physician!
    • These plans may be more expensive in the short-term but their long-term worth cannot be understated.
    • Private Long-Term Disability policies may not offset Social Security Disability Income.
    • With certain private long-term disability policies, you may be able to perform other work and still recover the benefits you paid for!
    • These plans may provide you with more of your pre-disability income, for a longer period of time, and are subject to more favorable state laws in the claims handling process.
  2. Do NOT Rely Solely on Social Security Disability
    • Social Security has a maximum wage base of $127,200 in 2017 and the maximum disability insurance payment under SSDI for a single individual is only about $2,700.
    • Social Security disability approval rates have fallen about 30% over the past 5 years and it is expected approvals will remain low.
    • With SSDI, you have to prove inability to do any type of work (not just your specialty or as a doctor) and potential income/salary is not a consideration.
  3. At A Minimum, Enroll In Employer’s LTD Plan
    • Cheaper up front option than private insurance and easy enrollment.
    • Definition of disability likely more restrictive than private LTD insurance.
    • Will likely require consideration of ability to do other occupations after a period of time (usually 2 years).
    • May include an income qualifier, but may not.
    • Usually, pays only 60% or 66-2/3% of pre-disability base income.
    • Will likely offset receipt of any SSDI, worker’s compensation or other private disability benefits received.
    • Shorter maximum benefit period than private insurance but usually at least until retirement age.
    • Probably governed by federal law (exception is public/religious employers) which heavily favors insurance company and makes denials easier to support.
  4. Read Your Policy and/or Know What You Have To Prove Before You Start
    • Disability is not about a diagnosis.
    • Prove your limitations – that is what you cannot do.
    • Relate limitations to diagnosis.
    • Relate limitations to material and substantial job duties.
    • Consider non-exertional limitations.
    • Make sure your limitations are not related to an excluded diagnosis under your LTD policy – often mental conditions, non-objectively defined conditions, and/or self-induced conditions are not covered.
    • Get started getting your medical records in order and helpful to your claim months before you actually apply – if possible.
  5. Know What You Are Up Against
    • Anything that can be used against you, will!
    • Prepare for a long period of time without income as any disability process will likely take months and can take years.
    • Consistency, consistency, consistency – be brutally honest on your application, to your doctors, and to the insurance company.  There is an art to this.
    • Don’t use superlatives – never, always, constantly – they are easy to disprove
    • For private and employer-provided disability insurance claims – your financial team will need to be engaged – so get started now
    • Don’t fight alone!
    • Don’t miss deadlines!
    • Keep copies of everything and follow-up to ensure receipt!

8 Specific Actions To Take Before Filing Your Long-Term Disability Claim Report If you're preparing to file for long-term disability, we've created a checklist of "8 Specific Actions to Take Before Filing Your Long-Term Disability Claim."  All we need is your name and email address, and we'll send you the checklist right away.  Don't make a costly mistake before you've even applied! Just click here to receive your copy of "8 Specific Actions to Take Before Filing Your Long-Term Disability Claim."

If you are a doctor with a long-term disability claim, or just want to be prepared when you file your claim, give your team at Louisiana Disability Law a call today at 985-240-9773 or simply fill out our contact form.

Loyd J. Bourgeois
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Disability and Personal Injury Attorney
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