4 Questions Physicians Should Ask About a Disability Insurance Definition

Dr. Kris Vanderkooy is a member of the medical team at Northwestern Mutual. In his role, Dr. Vanderkooy helps set the underwriting practices for Northwestern Mutual’s insurance products. Dr. Vanderkooy was in clinical practice for several years before joining Northwestern Mutual. 

Disability insurance is an important part of any financial plan. But for physicians, it’s even more critical. That’s because as a doctor or dentist, you’ve made a significant investment in your career and your ability to generate income. Disability insurance for doctors and dentists protects a portion of that income. 

If you’re a physician evaluating disability insurance policies, key considerations should include not only your cost and coverage, but also how the policy you choose defines total disability and partial disability. Your policy’s disability insurance definitions of total and partial disability will dictate how the policy will work if you ever make a claim — and ultimately whether you can collect some or all your benefit. 

For this article, we’re focusing on the questions doctors and dentists should ask about the partial or total disability insurance definitions, so you can make an informed decision about the right policy for you. 

1. WHAT HAPPENS IF I CAN’T DO MY JOB AS A MEDICAL PROFESSIONAL BUT COULD STILL WORK IN ANOTHER FIELD?

   In many cases, a total disability insurance definition is based on your ability to perform all the substantial and material duties of your regular occupation, but that’s not always the case. In some instances, you won’t be considered totally disabled if you can work in any job, even if a health issue prevents you from working in the medical field. If you’re a doctor or dentist, it’s a good idea to make sure that the total disability definition in any policy you consider is based on your regular occupation. These policies are frequently referred to as “own occupation” disability insurance.
    

2. HOW MANY OPTIONS ARE THERE TO QUALIFY FOR TOTAL DISABILITY?

   Some own occupation disability insurance policies have a single pathway to qualify for total disability. Typically to be considered totally disabled, you must be unable to perform all of the substantial and material duties of your occupation at the time you become disabled. Be wary of anyone who may try to convince you that most physicians only have one duty.

   However, some disability insurance policies for physicians and dentists have a second option. These policies have a definition that very clearly gives you an additional pathway to qualify as totally disabled, even if you can still perform some of the substantial and material duties of your occupation.
    

3. WHAT HAPPENS IF I CAN DO SOME OF MY DUTIES BUT NOT ALL OF THEM?

   This situation is not uncommon, particularly in the medical field where something like a tremor could prevent you from performing procedures but not your other substantial and material duties, like seeing and treating patients in a clinical setting.

   In this situation, if you have a policy that has a single definition for total disability, you may qualify as partially disabled, but only if you continue to work. In the case of a doctor or dentist with a tremor, continuing to see patients in the office and getting a partial benefit may be exactly what you want. But that may not always be feasible, particularly if you’re in a practice where your partners need someone who can perform procedures.

   Ask if the policy you’re considering has another pathway to qualify for total disability. Does it offer the option to stop working and receive your full benefit, or continue working — including in another profession — and be eligible to receive a partial benefit to make up for earned income you’ve lost?
    

4. WHAT ARE MY OPTIONS IF I’M TOTALLY UNABLE TO PERFORM THE SUBSTANTIAL AND MATERIAL DUTIES OF MY REGULAR OCCUPATION?

   In this case you will typically stop working and collect your total disability benefit. However, in the unlikely situation where you are unable to work in the medical profession but could still work in a less physically demanding occupation, this is another case where policy definitions can differ. Some policies will allow you to collect your full benefit while working in a different profession. Others will pay a portion of your benefit or the entire benefit to make up for a salary shortfall between your new profession and your old medical job.

   Ultimately, it's a good idea to think through as many scenarios as possible and test them against the definition of a policy you are considering. What would happen? Will you have clear choices based on the definitions? 

If you’d like to talk to a financial professional about disability insurance, he or she can help you answer these questions and show you how your policy works into the bigger picture of your financial plan. 

Disability income insurance policies contain some contractual features and optional benefits that may not available in all states. The ability to perform the substantial and material duties of your occupation is only one of the factors that determine eligibility for disability benefits. Policies contain exclusions, limitations and reduction-of-benefit provisions. Eligibility for disability income insurance, additional policy benefits and qualification for benefits is determined on a case-by-case basis. 

To be used with form ICC16.TT.DI.IIB.(0916), ICC16.TT.DI.FIB.(0916), ICC16.TT.DI.CAT.(0916), ICC16.TT.NCDI.(0916), ICC16.TT.GRDI.(0916), ICC16.TT.DI.PDB.(0916), ICC16.TT.DI.PDBO.(0916) ICC16.TT.DI.TRU.(0916), ICC16.TT.DI.MED.(0916), ICC16.TT.DI.TRA.(0916), ICC16.TT.DI.PDBO.(0916) or state equivalent. Not all contracts and optional benefits are available in all states. Disability insurance policies contain some features and benefits that may not be available in all states. The ability to perform the substantial and material duties of your occupation is only one of the factors that determine eligibility for disability benefits. These policies also contain exclusions, limitations and reduction-of-benefits provisions. Eligibility for disability income insurance, additional policy benefits, and qualification for benefits, is determined on a case-by-case basis. For costs and complete details of coverage, contact your Northwestern Mutual Financial Representative.  

Northwestern Mutual is the marketing name for The Northwestern Mutual Life Insurance Company, Milwaukee, WI (NM) (life insurance, disability insurance, annuities, and life insurance with long-term care benefits) 

90-2714-86 (05/21)