Long term disability insurance

[heavyluva]

As rad oncs, are you guys purchasing long term disability insurance or electing for it as a benefit?
I have the option to get it for around $120/pay period. It’s capped at $10,000/month as the pay out. Obviously, it would have to be a pretty major injury to prevent me from being able to do my job as a rad onc (although I guess not being able to use my hand would interfere with contouring). Trying to decide if it’s wise to purchase this or not. Interested in what others are doing.. thanks in advance

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[w00tz]

I think it is wise to have a LTD policy, however, I am not sure about which definition of disability is the best one to get. I think blogs like White Coat Investor, usually recommend "true own occupation" definition of disability and that's what I went with. "True own occupation" LTD policy has the lowest threshold to qualify as disabled and also the most expensive policy to get. I question the need for such an expensive policy, because I am also thinking one would have to be quite disabled to not work in radiation oncology. I know of several paraplegic rad oncs and I'm pretty sure one my attendings in residency had early dementia. The ideal policy and definition of disability is probably specialty and person specific. I'm sure I could get different policy with a stricter definition of disability with a lower premium, but haven't figured out which definition is the most ideal for me. Until I figure that out, I'm just going with true own occupation to be on the safe side.

 

[scarbrtj]

I know of several paraplegic rad oncs

Really? That is actually quite neat. I wish I knew them. I wish rad onc as a whole knew them more widely.

 

[udrag14]

I have my own personal disability policy. It costs around $144/month for $5,000 a month policy.

I think it is a must, especially if you are not financially independent. Disability insurance through your job can be a dual edged sword. It is pretty easy to obtain; however, if you switch jobs, then you may not have equal disability coverage. Also, you have to look into the policy and make sure it doesn't have exclusion/exemption clauses.

 

[Ray D. Ayshun]

120/mo, or 240, for 10k is pretty reasonable. Im in the 100/no for 5k own occupation but looking to increase it in the next little bit. I'd happily cut off my dominant index finger for 240k/ year until 65.

 

[RadOncDoc21]

120/mo, or 240, for 10k is pretty reasonable. Im in the 100/no for 5k own occupation but looking to increase it in the next little bit. I'd happily cut off my dominant index finger for 240k/ year until 65.

Then how would you be able to accurately stage prostate cancer despite the use of advanced imaging?

 

[heavyluva]

Then how would you be able to accurately stage prostate cancer despite the use of advanced imaging?

Thanks for the responses! I will have to look into the specifics of the policy. It is around $240/month for 10k but not sure about specifics with respect to coverage.

 

[Ray D. Ayshun]

Then how would you be able to accurately stage prostate cancer despite the use of advanced imaging?

It's contouring I'm worried about. Cutting off my index finger wouldn't hinder me from putting my hands on a patient's shoulders during a prostate exam.

 

[RadOncDoc21]

It's contouring I'm worried about. Cutting off my index finger wouldn't hinder me from putting my hands on a patient's shoulders during a prostate exam.

Contouring is overrated, just get a fellow to do it!

 

[seper]

I also pay for privately obtained LTD. Hospital-provided policy sounds like benefits are terminated once "approved disability leave" is over.

 

[Radonc90]

1+ to what @seper said.

This is a complex issue. I know a "little bit" about this...

Believe it or not, death is easier bc you are in a better place...LOL. But if you have spouse/kids, then you want
high amount of Life Ins (different topic) such as $1M or $2M or $3M etc. etc. to help your spouse/kids get
through life.

Disability is way more frequent than death, so buying Disability Insurance is crucial if:

1- You are between let's say 32 yo (fresh from residency) and 60 yo.
At 60 yo, you should have accumulated some savings and may not need to pay Disability Premium any longer.
Or you can say that it is important between 30-55 yo.
Pick whatever age range you want to buy insurance.
I believe the Ins Co also stops paying at a certain age, usually at 65 yo bc that is the age when Social
Securities/Medicare kick in.

2- You can be single with no spouse/kids and even so, you want disability insurance bc let's say you have
Multiple Sclerosis and are in long-term care, who pays for it?

3- With spouse/kids, it is even worse, you need to worry about not only paying for your long-term care for the MS,
but also for spouse/kids education etc. etc.


From what I gather from Paul Revere Ins Company over the years...


- For "specialty-specific" disability, the Premium = ~ $4K/year for $10K/month = $120K/yr.
The reason for high premium is bc it is "specialty-specific".
* Let's say you are a Plastic Surgeon and developed a stroke with your RH disabled, now let's say you
stop practising Plastic and decide to do Primary Care (let's say making $200K/yr), Paul Revere Ins pays
you $10K/month simply bc you cannot practise your chosen specialty of Plastic Surg. Your total income
will be $200K (Primary Care) + $120K (Paul Revere Ins).
* If you decide to retire bc your RH is disabled, then all you get is $120K/yr from let's say Paul Revere Ins.

- Radonc contouring: if you have a stroke affecting your dominant hand such as RH, then you may not be
able to contour GTV/CTV/ITV/PTV...You may have to contour with your LH or use AI = artificial intelligence
(just kidding, still under development). Or ask a dosimetrist to help you, but hospital or academics may
not want you any longer bc:
1. You maybe a liability (sloppy LH contouring for example) and...
2. There are some 200 PGY-5 graduates waiting to take your job...

- I think Paul Revere still offers "specialty-specific" disability, but premium is high.

Also, how do we define "burned out", is it a "disability"?

- So now, Paul Revere Ins has "career-specific" disability, i.e., if you cannot practise Plastic Surg, then you should
do let's say Primary Care etc. In that situation, they have different equation: they have a formula to subtract the
income from PCP work and calculate a ____ % to pay you their portion. Pay attention to the fine print! OK, let's say
Plastic Surg is $200K (I just made it up), then you do PCP (making $120K), Paul Revere will pay you $80K/yr to make it whole for you.

- Now let's say you are Kaput, quit and work for EVILCore, Paul Revere Ins can still calculate ___% bc you still make money as an MD.

- Only when you completely leave medicine and open a Pizza restaurant, then Paul Revere Ins pays you the whole amount of $10K/month, until a certain age. Income from your Pizza resto does not count bc you have completely left medicine.

Remember that Paul Revere Ins (or similar companies) exists to make money and not to protect you.

Also, don't count on private hospital or University (for those in academic) disability insurance policy, they are terrible for us (the amount is low and the coverage is gone when you leave the job)...

The most important lesson is: for Life and Disability Ins, go with private 3rd party company.

Hope this helps...

 

[elementaryschooleconomics]

1+ to what @seper said.

This is a complex issue. I know a "little bit" about this...

Believe it or not, death is easier bc you are in a better place...LOL. But if you have spouse/kids, then you want high amount of Life Ins (different topic) such as $1M or $2M or $3M etc. etc. to help your spouse/kids get through life.

Disability is way more frequent than death, so buying Disability Insurance is crucial if:

1- You are between let's say 32 yo (fresh from residency) and 60 yo.
At 60 yo, you should have accumulated some savings and may not need to pay Disability Premium any longer.
Or you can say that it is important between 30-55 yo or whatever the age range is for you.
Pick whatever age range you want to buy insurance.
I believe the Ins Co also stops paying at a certain age, usually at 65 yo bc that is the age when Social
Securities/Medicare kick in.

2- You can be single with no spouse/kids and even so, you want disability insurance bc let's say you have
Multiple Sclerosis and are in long-term care, who pays for it?

3- With spouse/kids, it is even worse, you need to worry about not only paying for your long-term care for the MS,
but also for spouse/kids education etc. etc.


From what I gather from Paul Revere Ins Company over the years...


- For "specialty-specific" disability, the Premium = ~ $4K/year for $10K/month = $120K/yr.
The reason for high premium is bc it is "specialty-specific".
* Let's say you are a Plastic Surgeon and developed a stroke with your RH disabled, now let's say you
stop practising Plastic and decide to do Primary Care (let's say making $200K/yr), Paul Revere Ins pays
you $10K/month simply bc you cannot practise your chosen specialty of Plastic Surg. Your total income
will be $200K (Primary Care) + $120K (Paul Revere Ins).
* If you decide to retire bc your RH is disabled, then all you get is $120K/yr from let's say Paul Revere Ins.

- Radonc contouring: if you have a stroke affecting your dominant hand such as RH, then you may not be
able to contour GTV/CTV/ITV/PTV...You may have to contour with your LH or use AI (just kidding, still under development). Or ask a dosimetrist to help you, but hospital or academics may not want you any longer bc:
1. You maybe a liability (sloppy LH contouring for example) and...
2. There are some 200 PGY-5 graduates waiting to take your job...

- I think Paul Revere still offers "specialty-specific" disability, but premium is high.

Also, how do we define "burned out", is it a "disability"?

- So now, Paul Revere Ins has "career-specific" disability, i.e., if you cannot practise Plastic Surg, then you should
do let's say Primary Care etc. In that situation, they have different equation: they have a formula to subtract the
income from PCP work and calculate a ____ % to pay you their portion. Pay attention to the fine print! OK, let's say
Plastic Surg is $200K (I just made it up), then you do PCP (making $120K), Paul Revere will pay you $80K/yr to make it whole for you.

- Now let's say you are Kaput, quit and work for EVILCore, Paul Revere Ins can still calculate ___% bc you still make money as an MD.

- Only when you completely leave medicine and open a Pizza restaurant, then Paul Revere Ins pays you the whole amount of $10K/month, until a certain age. Income from your Pizza resto does not count bc you have completely left medicine.

Remember that Paul Revere Ins (or similar companies) exists to make money and not to protect you.

Also, don't count on private hospital or University (for those in academic) disability insurance policy, they are terrible for us (the amount is low and the coverage is gone when you leave the job)...

The most important lesson is: for Life and Disability Ins, go with private 3rd party company.

Hope this helps...

You know a "little bit"? This is more comprehensive than the predatory insurance dudes who want to have coffee with me once a month! This was very helpful.

 

[thecarbonionangle]

Don’t forget to lock down before graduating residency (30 pct discount). Include a cost of living adjustment rider, increase coverage rider, etc. start out with like 5k a month coverage and increase to about 12k-15k a momth when you can before your increase rider expires. This is an absolute must. Highly recommend specialty specific coverage. Money is tax free.

 

[Ray D. Ayshun]

the tax free thing is important. My understanding is that if you pay the premium out of your own pocket, no taxes. However, if your work pays the premium, your disability payout will be subject to income taxes.

 

[Mandelin Rain]

the tax free thing is important. My understanding is that if you pay the premium out of your own pocket, no taxes. However, if your work pays the premium, your disability payout will be subject to income taxes.

This depends.

If you (or your company) pay premiums with post-tax dollars, the benefit is tax-free.
If you (or your company) pay the premium with pre-tax dollars, the benefit is taxed.

For many docs here, they ARE the company, so they can choose. But, the government is always going to get their taste.

 

[Mandelin Rain]

Disability insurance is VERY important. Probably even more so than life insurance.

1. You are much more likely to become disabled than die during your working years.
2. If you become disabled (vs. die) you may become an ongoing financial burden for your family depending on severity of disability, and thus have even an increased need for income

Secure this early, and in large amounts.

 

[evilbooyaa]

I pay about ~250 a month for 7.5k in disability. It's more expensive b/c it's own occupation and doesn't have an expiration limit. Strongly encourage graduating residents to get a personal disability (and life insurance policy) that can be used in addition to whatever institutional policies one is eligible for.

 

[MD Financial Services Scott]

As rad oncs, are you guys purchasing long term disability insurance or electing for it as a benefit?
I have the option to get it for around $120/pay period. It’s capped at $10,000/month as the pay out. Obviously, it would have to be a pretty major injury to prevent me from being able to do my job as a rad onc (although I guess not being able to use my hand would interfere with contouring). Trying to decide if it’s wise to purchase this or not. Interested in what others are doing.. thanks in advance

If is it an employer offered policy be sure to read the terms of the elimination period, not just the days, look for the words 'totally or continuously'. Read the definition of disability make sure it does not have any terms about 'after a period of time you will have to do any occupation based on education, training, OR experience'. Finally check to see what income benefit offset provisions, these are essentially benefit reductions in the policy.