Plan ahead: Disability insurance can be a lifesaver
Lloyd W. Kitchens Jr., FACP, had always been a firm believer in planning for the future, but a recent turn of events showed him just how unpredictable the future—and how important good planning—can be.
Since he was 19, Dr. Kitchens, a Texas oncologist who is a Regent of the College, has lived with Crohn's disease. To protect his personal finances, he has purchased disability insurance for as long as he can remember.
Just over two years ago, Dr. Kitchens needed that protection when gastrointestinal surgery put him out of work for nearly nine months. To make matters worse, physicians discovered that he also had chronic hepatitis C, probably from a transfusion some 25 years earlier, and needed interferon therapy. The disability payments helped Dr. Kitchens keep his finances in order until he had regained his health and returned to practice full time.
Just a few months after returning to work, Dr. Kitchens developed toxic shock syndrome. He went into multisystem organ failure and spent months recuperating. His physician recommended that he never return to work.
While Dr. Kitchens had always suspected he would need to rely on disability payments for a time, he never dreamed he would have to permanently retire at age 49. Today, his three disability policies pay 100% of his after-tax salary, and will continue to do so until age 65. Dr. Kitchens said that knowing that his finances were sound was one of the few bright spots in an otherwise bleak time of his life. "If I had had the stress of not being able to go back to work combined with wondering how I was going to make my house payments, it would have really been terrible," he said. "Having that insurance in place was a real blessing."
Unlike Dr. Kitchens, most internists don't think seriously about disability insurance. "The problem is that doctors believe they're indestructible," said James J. Bergin, FACP, an ACP Regent and chair of the Member Insurance and Benefits Subcommittee. "It's hard to see people on a daily basis who are dying, so there is a system of denial that's built into the profession."
But as physicians know, illness can strike at any time. For example, when ACP Regent Sandra Adamson Fryhofer, FACP, was pregnant with twins almost eight years ago, she developed complications that forced her to be on bed rest for the last three months of her pregnancy. For the two months prior to that, she could be on her feet for only six hours a day.
The disability insurance Dr. Fryhofer had purchased through ACP kept her practice afloat while she was out on disability. "I was in solo practice, so I still had to pay rent and the phone bill, and I even had to pay a doctor to come into the office," she explained. "The money helped make ends meet until I was able to resume working."
Dr. Fryhofer said her experience shows why even internists who are young and healthy but without financial stability should buy disability insurance. "When you have a young family, something like that can be devastating," she said.
And because all internists are vulnerable to the health problems that they see every day, Dr. Kitchens said that it is smart to buy disability coverage sooner rather than later. "My advice to people is to purchase any disability insurance that you're eligible for," he said, "because you never know when you might need it."
What's in a good disability insurance policy?
Here are some definitions from Group Insurance Administrators, ACP's disability insurance administrator.
- Total disability. You are totally disabled if, as a result of an accident or sickness, you are unable to perform the substantial duties of your occupation as they exist when your disability begins, and you are not engaged in any other occupation.
- Partial and residual disability. If you are recovering from a total disability and return to work, partial disability benefits will compensate you for lost earnings. Even if you are not totally disabled but still losing income because of disability—for example, a cardiologist who can no longer perform invasive cardiology but chooses to perform general medicine and suffers a loss of income—you would be protected by residual disability provisions.
- Elimination periods. Disability policies typically require that you be continuously disabled for 30, 60, 90 or 180 days before paying benefits. If you are young and have little savings or high debt, consider a shorter waiting period. As income and savings rise in later years, most people choose longer waiting periods.
- Cost-of-living option. This feature adjusts benefits to inflation.
- Waiver-of-premium provision. This feature pays your disability premiums when you are disabled.
- Guaranteed insurance. Your plan should allow you to increase coverage commensurate with increases in your salary without any additional health exams or screenings. This feature helps individuals who develop a health condition and want to increase their coverage.
For more information on disability insurance and specific policies available to ACP members, contact Group Insurance Administrators at 800-442-7526.
Internist Archives Quick Links
Reviews of the World's Top Medical Journals—FREE to ACP Members!
ACP JournalWiseSM is mobile optimized with optional email alerts! Get access to reviews from over 120 of the world’s top medical journals alerting you to the highest quality, most clinically relevant new articles based on your preferred areas of specialty. ACP Members register your FREE account now!
New CME Option: Internal Medicine 2014 Recordings
New CME Package
Includes 75 of the most popular sessions in internal medicine and the subspecialties. Stream the sessions, answer brief quizzes and earn CME credit. See details.