Chiropractic Economics: Know the essentials of an individual disability insurance policy
by Frank N. Darras; contributed to and originally published in Chiropractic Economics.
November 30, 2017
The irony is seldom lost on chiropractors: You spend years bending, lifting, repositioning, and manipulating patients to ease their pain.
But in turn, these activities can wreak havoc on your own body and mind, which can ultimately lead to a disability.
Unfortunately, the high risk of disability due to sickness or accident in the chiropractic profession has led to a historically high volume of claims, and chiropractors are a difficult underwriting risk for insurance companies. But that doesn’t mean you have to settle for a subpar private disability insurance policy. Here are five features you should shop for when you’re comparing disability insurance policies.
1. Seek occupation-specific coverage.
In today’s market, you should not settle for anything less than occupation-specific coverage that specifically protects the education, medical training, and physicality it took to become a licensed chiropractor. The ideal policy should have its own occupation clause that considers you disabled if you cannot perform the material and substantial duties of your occupation.
Pay attention to the language surrounding your “own occupation” versus “any occupation” provisions. Some policies may only provide bene- fits under their own occupation clause for up to 24 months, five years, or 10 years. After that amount of time, the occupation clause kicks in. Many policies provide total disability coverage, but only if you are not working in any other gainful occupation for pay or profit.
The “any occupation” language states that although you cannot perform the specific duties of your chiropractic profession, your disability does not prevent you from working in another occupation for which you are trained, educated, or suited.
This misleading language adds insult to injury by denying you further payment of benefits and forcing you to seek other employment for significantly less pay.
You should also pay close attention to how—and when—the policy defines disability and occupational duties. Insurance companies should be determining your occupation when you become disabled by evaluating how you do the important duties of your profession in time spent or money earned. Your material and substantial duties are likely to change throughout your career.
Insurance carriers often incorrectly frame chiropractors as business owners—because they supervise staff and dispense supplements—instead of focusing on hands-on manipulation, which is their most important duty.
2. Do not forget total and partial disability coverage.
Most people think of total disability when shopping for disability insurance, but chiropractors should also have coverage for partial disability. Statistics show that you are more likely to become partially rather than totally disabled. If you are still able to perform some of the material and substantial duties of your occupation, it will be extremely difficult to collect total disability benefits.
Therefore, look for a policy with a residual disability benefit. Without it, your policy becomes all-or-nothing, and if your carrier suggests you can return to work, even with limited hours or duties, you will not be eligible for any benefits.
Total disability coverage pays if you cannot perform the primary duties of your occupation, but the residual disability benefit will compensate you for loss of income (usually 20 percent) following the partial loss of your duties or the increased time it takes to complete duties due to impairment.
This provision allows you to collect benefits while you work your way back into the practice. For example, if you suffer a heart attack and have to work reduced hours, the residual disability benefit will provide benefits while you continue to work your way back to full-time status.
Some policies may also have a recovery benefit that will continue to pay disability benefits if you return to work full time, helping while you rebuild your practice due to lost patients and referral sources. If you are no longer sick or injured but still have a loss of income, this generous provision can help speed up your financial recovery until the loss of income disappears and your financial picture has recovered.
3. Insist upon the future increase option.
The future increase rider is a great policy feature for younger chiropractors. This rider guarantees your right to purchase additional disability coverage in the future in exchange for an increased premium.
The premium is determined by your age at the time you purchase additional coverage.
The guaranteed insurability rider allows you to add more disability protection without requiring you to undergo additional medical underwriting. If you are under 45 years old and foresee income growth in your future, this rider is an excellent way to ensure your coverage increases even if your health declines.
Note that additional coverage is usually limited to half the original monthly benefit amount. You must also prove that your earned income meets the insurer’s issue limits for additional coverage at the time you exercise the options.
4. Minimize mental health, substance abuse, and self-reported condition limitations
The mental health and substance abuse limitations are among the most restrictive clauses in any given disability insurance policy. Insurers do not like to pay extended benefits for these “soft” conditions.
Your ideal disability insurance policy would not have these types of limitations and would not have a self-reported condition cap. However, many insurers no longer offer such unrestricted coverage; if they do, it usually comes at a steep price.
If you cannot eliminate these limitations, ensure your policy’s mental/nervous and substance abuse limitations are not less than 24 months. Chiropractors should also pay special attention to the self- reported condition limitation, which restricts payment of benefits for certain subjective physical disabilities that are not supported by objective medical testing.
Conditions like fibromyalgia, chronic fatigue, and even headaches rely on subjective reporting of symptoms, and the payment of benefits may be limited to a maximum of nine to 24 months. Look for an individual disability policy with no self-reported or other limited condition clause.
4. Ask about the waiver of premium clause.
Consider purchasing a waiver of premium option for your life insurance policy. Many chiropractors with a substantial income have life insurance policies, but they often do not add the disability waiver of premium to it. Under this provision, if your disability prevents you from working, your obligation to pay future premiums on your life insurance policy is waived. This is an inexpensive way to protect life insurance coverage from the financial uncertainty often caused by permanent disability.
Do not let poor insurance coverage threaten your financial livelihood. If you identify the best features to insure your professional needs, you can find an disability insurance policy that protects your career.
Frank Darras, Esq., is the founding partner of DarrasLaw, a disability insurance litigation firm that assists highly skilled medical and chiropractic professionals in selecting, applying for, and claiming individual disability insurance benefits. DarrasLaw has recovered nearly $800 million in wrongfully denied insurance benefits and offers free policy analysis and claim help to chiropractic professionals across the nation. He can be contacted through frankdarras.com.