Definition of Total Disability

There are many features of a disability insurance policy, but the definition of total disability is the most important one for physicians and dentists.

Should you become totally disabled and submit a claim to your insurance company, they will apply their definition of “total disability” to your situation. If your disability does not meet the terms of their definition, you will not qualify to receive payments.

How can you protect yourself? Insist on true “Own Occupation” disability insurance for your protection.

Below are a few terms to consider and understand regarding the importance of Own Occupation / Specialty coverage:

Own Occupation / Specialty

The preferred definition of total disability is Own Occupation / Specialty. With Own Occupation / Specialty protection, you are considered totally disabled if your injury or sickness prevents you from working in your occupation or specialty, even if you are able to work in another occupation or specialty.

For example, if you are a surgeon and you become totally disabled as a surgeon, you could work in another occupation or even another medical specialty, and continue to receive full monthly benefits from your policy.

Own Occupation / Specialty is the gold standard of disability protection and you should insist upon it, making sure you have it in your policy.

Modified Own Occupation

Many insurance policies offer policies with a much less desirable definition of total disability called Modified Own Occupation. At first glance, it looks like Own Occupation, but then adds restrictive language that would reduce your policy’s monthly benefit if you were able to work in another occupation.

Under this definition, the above surgeon would receive a reduced benefit if, while totally disabled as a surgeon, he or she chose to work in another occupation or specialty.

Own Occupation / Specialty and Modified Own Occupation are so similarly written, they can easily be confused as the same thing, leading many physicians and dentist to believe they have Own Occupation / Specialty when they really don’t.

Any Occupation

Worse yet is Any Occupation definition of total disability. This one should be avoided at all costs, if possible. The only way to qualify for a disability payment with this type of policy is to prove that you are unable to perform ANY OCCUPATION OR ANY REASONABLE OCCUPATION.

Any Occupation policies take control of your income out of your hands at claim time and put it in the hands of the insurance company. Some medical and dental association disability policies offer some variation of Any Occupation policies, as do many employer-provided group disability policies.

I Can Help

As you can see, any additional language at the end of the Own Occupation / Specialty definition of total disability has the effect of limiting your benefit and could cost you at claim time. That is why it is imperative that you have a knowledgeable professional working for you to decipher language and the intricacies of policy options.