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Thursday, February 9th, 2023 | by Adam Bratland

Five Things Every Dentist Should Know About Disability Insurance

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The odds of a dentist experiencing disability is a lot higher than most people would guess.  In fact, the odds of a dentist becoming disabled for at least one year during their practicing life (starting at the age of 20) is 25%.  The disability will most likely be attributed to musculoskeletal issues involving the neck, shoulders, back, and/or wrists.  Cardiovascular disease and mental health disorders are also factors that prevent dentists from practicing dentistry.

In short, dentistry is a tough occupation that can come with a lot of physical wear and tear on your body from twisting and turning and sitting in odd positions for hours on end.  Furthermore, dentistry comes with a lot of mental stress.

Not only are most dental graduates hundreds of thousands of dollars in debt, but they also may choose to purchase a practice, which often results in owing one million dollars plus in dental related expenses.
Young dentist performing a dental check-up on a patient.
Dentists want what all American workers want …. a nice house, a new car, family vacations, etc.  If carrying a high debt level isn’t stressful enough, dentists also have to treat patients daily with high anxiety, low pain thresholds, unrealistic expectations, and a need to tell you how much they hate dentists.

For those dentists that make the decision to become practice owners, they receive the extra frustrations associated with managing staff, paying all the expenses, dealing with insurance companies, etc.  It’s no wonder that approximately 20% of dentist disability claims are filed due to mental disorders and cardiovascular disease.

The premise of this article assumes that the reader understands the importance of dental disability insurance and either currently has a policy or is actively looking for disability coverage.

Notify a medical professional as soon as possible.

If you are currently concerned about the possibility that you may need to file a claim, you need to make an appointment with your medical doctor and explain your concerns as early as possible.

For example, if you are experiencing carpel tunnel pain, you may express that to your MD along with your concerns about patient safety.  It can be as simple as stating, “My wrists hurt so bad that it’s sometimes hard for me to hold a drill and I’m worried that the drill might slip out of my hands and harm the patient.”

This appointment and all your other medical records will be introduced to your insurance company when you file your claim – or shortly after at trial – if your claim is denied).

 

What is the definition of “Disability” on the insurance policy?

There are two main types of disability insurance for dentists.  “Own Occupation” vs “Any Occupation.”

“Own Occupation” Disability Insurance

Generally speaking, own occupation is a more generous definition and essentially affords you the designation of being “Disabled.”

“Own Occupation” disability insurance will pay you based on the income lost from not working as a practicing dentist, and cannot perform occupational functions covered by your disability policy.

“Any Occupation” Insurance

“Any occupation” may state that you cannot receive benefits if you are able to perform another occupation that you may be reasonably suited for.

For example, if you have an “any occupation” policy, your claim may be denied if it is determined that your physical or mental ailment doesn’t prevent you from being an instructor, consultant, or dental supply rep.

Don’t write off your disability payments as a business expense.

If you pay for your disability insurance through your business and write it off, the benefits are subject federal income tax.

Before signing a policy, you should discuss the policy with your accountant and financial planner.  They confirm your tax consequences and help you decide on a benefits coverage amount to cover your liabilities and living expenses if you have to file a claim. Dental professional holding a mouth mirror and dental probe.

Know the limitations and exclusions in the policy.

Some policies don’t have any benefits or very limited benefits for mental health, substance abuse, or self-inflicted injuries. You may also receive exclusions for some medical conditions or prior injuries, which are often part of your medical history.

Private plans vs. employer-sponsored plans.

Private Disability Insurance Plans

There a pros and cons to purchasing a disability insurance policy from the ADA or from an insurance company.

Pro

Generally speaking, state laws allow you to file a lawsuit quicker and petition for a jury trial.

Con

You may be governed by your state laws vs federal laws.

Employer-Sponsored Disability Insurance Plans

There are benefits and potential pitfalls to having an employer-sponsored disability insurance plan.

Pro

Employer coverage helps offset time and money.

Cons

You will likely have a stringent set of procedures to comply with as you file your claim. An employer-sponsored policy typically takes longer to prove a disability and to receive benefits.

Your Summary Plan Description will provide details regarding the plan and the process of filing a claim.

 

Insurance Companies Profit Off of You

It’s also important to remember that insurance companies are in business to make a profit.

Although you may love and trust your insurance agent, they ultimately don’t decide whether your claim is denied or approved.  Their job is to describe all aspects of the policy so that you understand exactly what you are paying for and under what conditions you would receive benefits.

What Should You Do if Your Insurance Company Doesn’t Pay Out Your Benefits

Most insurance companies design contracts and construct time consuming protocols in order to avoid paying benefits so if you do have to file a claim, you need to be patient and thorough.

I would highly recommend seeking legal help from an attorney with experience fighting for dental disability claims.

A final recommendation would be that if you are in the beginning stages of finding a disability policy, you should request a quote from the American Dental Association and use it as a comparison against other quotes you receive.

 

Adam Bratland is a proud member of Consani Associates, Ltd. 


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