What Is A Physician's Long Term Disability Insurance Policy?

J.P. Gonzalez-Sirgo
Founder of J.P. Gonzalez-Sirgo, P.A.

What is a Physician's Long Term Disability Insurance Policy?

Your ability to earn a living may be your greatest asset. A long-term disability insurance policy is a contractual arrangement that serves to protect the insured against loss of income that may arise from a total disability, as defined by the terms of your policy. Long-term disability benefits cover about 60% of income that is lost as a result of a disability, but may cover more depending on your policy. Long-term disability benefits are generally paid on a monthly basis. Additionally, there is usually a waiting period of 180 days before the insurer will begin paying out these benefits. Long-term disability benefits terminate upon a stated condition in your policy. Typically this will be at the time that the disability terminates, or at the time of your retirement age.

In contrast, short-term disability benefits have a much shorter waiting period before the insurer will begin to pay these benefits. Thus, short-term disability benefits cover the gap in lost income between the time when the disability arose and the time when long-term disability benefits kick in. Disability benefits should also be distinguished from worker’s compensation benefits. Worker’s compensation benefits only cover injuries that arise from work-related events.

Why do you need long term disability insurance?

According to the most recent census report, approximately 1 in 5 people in the U.S. are living with some form of a disability. The Social Security Administration projects that 1 out of every 4 twenty year olds will develop a disability before they retire. Furthermore, the CDC estimates that the most common form of disability in the U.S. is some form of a mobility limitation. Additionally, research shows that the highest percentages of persons living with disabilities are generally in southern states, including Florida. A physician suffering from limited mobility may find it very difficult to carry out essential functions of their occupation. Thus, disability insurance is an attractive option to safeguard against the risk of losing your income earning ability.

For physicians, long-term disability premiums can be significanr since the potential loss of income can be great. For the insurance company, charging expensive premiums can be very profitable. However, when it comes time to pay out on these policies the cost can be exorbitant. In 2016, the Bureau of Labor and Statistics estimated that in Florida, physicians and surgeons earn about $219,000 a year on average. Thus, it is very common for insurance companies to look for ways to deny these claims. If you have been denied disability benefits, it is in your best interest to contact an attorney to assist you with the appeals process. An experienced long term disability insurance claims lawyer will be familiar with the techniques insurance companies use to deny disability benefits, even when the insured has met all the terms of the policy required to receive these benefits.

How do you know if you are entitled to receive long-term disability insurance benefits?

Whether you are entitled to long-term disability benefits depends on the terms of your policy. Some policies are more physician-friendly. These policies characterize a disability as one that prevents the physician from practicing in a particular specialty. Thus, if a physician cannot practice in a particular area of his or her occupation then benefits will be paid. Other policies tend to favor the insurer. These policies may require the disability to prevent the physician from practicing medicine in general. Thus, benefits would only be provided if the disability is so severe as to prevent the physician from practicing at all.

If you’ve recognized the risk of becoming disabled during the course of your employment, and you’ve taken proactive measures to protect yourself and your family from the potential loss of income that can result from a disability, the last thing you want to receive is a letter from your insurer denying your claim. Understandably this can be a very stressful moment. The good news is that you don’t have to do it alone. Find assistance from an experienced long term disability insurance claims lawyer.

What happens if you have been denied long term disability insurance benefits?

If you have been denied your right to receive disability insurance benefits it is crucial that you contact an attorney immediately. This is because the appeals process can often be determinative of the outcome of your claim. Whether you carry individual disability insurance coverage or group disability insurance coverage is important because it will determine which sets of laws will govern your case. If you carry individual insurance coverage then your claim will be governed by Florida law. If your disability insurance coverage is provided by your employer then chances are it is subject to a complicated federal law known as ERISA. ERISA has strict procedural requirements for appealing claim denials by your insurer. The record produced and the events that occur during the appeals process can often determine whether or not you will be eligible to receive disability insurance benefits. If you have been denied your right to receive benefits, it cannot be stressed enough how important it is to contact an experienced attorney as soon as possible.

Don’t take a chance and risk losing these benefits because you didn’t consult with an experienced attorney when it matters the most. The insurance company may be operating in bad faith, or may simply be in breach of contract. In either event, you’re going to need a seasoned attorney that will fight for your rights and get you the benefits that you have contracted for.

You can reach Miami Long Term Disability Insurance Claims Lawyer J.P. Gonzalez-Sirgo by dialing his direct number at (786) 272-5841, calling the main office at (305) 461-1095, or Toll Free at 1 (866) 71-CLAIM or email Attorney Gonzalez-Sirgo directly at [email protected].

Sources

https://www.census.gov/newsroom/releases/archives/miscellaneous/cb12-134.html

https://www.cdc.gov/media/releases/2015/p0730-us-disability.html

https://www.ssa.gov/disabilityfacts/articles.html

https://www.bls.gov/oes/current/oes291069.htm

29 U.S. Code Chapter 18 - EMPLOYEE RETIREMENT INCOME SECURITY PROGRAM