WCI #427: Dealing with a Disability Claim with Attorney Ben Glass

Summary

White Coat Investor Podcast #427: Dealing with a Disability Claim with Attorney Ben Glass

Host and Guest Introduction

In episode #427 of the White Coat Investor Podcast, Dr. Jim Dahle welcomes Ben Glass, a seasoned disability insurance attorney, to discuss the intricacies of disability claims—a topic crucial for high-income professionals in the medical field. Ben Glass brings extensive experience in assisting doctors and other professionals navigate the often-complex landscape of disability insurance claims, making this episode an invaluable resource for listeners seeking to understand and optimize their disability coverage.

The Importance of Disability Insurance for Medical Professionals

Dr. Dahle emphasizes the significance of disability insurance, especially for physicians who invest substantial time and resources into their education and careers. He shares a personal anecdote about becoming temporarily disabled after a mountain accident, highlighting the unpredictability of disabilities and the essential role of having robust insurance coverage.

Notable Quote:
Ben Glass underscores the reality of disability rates, stating, "...the statistics on Americans in general is that one out of four people is going to deal with a disability before age 65." (09:16)

Common Mistakes in Disability Insurance Claims

Ben Glass identifies several common pitfalls that medical professionals encounter when filing disability claims:

1. Insufficient Coverage: Many doctors rely solely on group policies provided by employers, which often offer limited protection compared to individual policies tailored to their specific needs.

2. Misunderstanding Policy Terms: The definition of "own occupation" is pivotal. A quality policy should cover professionals based on their specific roles and duties, not just their general job titles.

3. Premature Claims: Filing claims too early without adequate medical documentation or persisting in treatment can jeopardize the legitimacy and success of the claim.

4. Overstating Limitations: Exaggerating the extent of one's disability, whether intentionally or unintentionally, can lead to claim denials, especially if contradicted by evidence or surveillance.

Notable Quote:
Ben Glass advises, "...the quality of the definition of own occupation... is really where it can make a significant difference, financial difference to you and your family." (43:31)

The Disability Claims Process Explained

Ben Glass provides a step-by-step overview of the disability claims process:

1. Initiation: For group policies, the claimant contacts their HR department to obtain claim forms. For individual policies, contacting a broker is the standard route.

2. Documentation: Completing claim forms requires detailed information about one's medical condition and how it impairs their ability to perform occupational duties.

3. Submission and Review: The insurance company reviews the claim, often requesting comprehensive medical records and possibly conducting interviews to assess the legitimacy of the disability.

4. Decision and Appeals: If denied, the claimant has the option to appeal within a specified timeframe (typically 180 days for group policies), often necessitating legal assistance to strengthen the appeal.

Notable Quote:
Ben Glass emphasizes the importance of preparation, saying, "...the more information you have, the more records you have, the more maybe narrative statement from your own healthcare team... the easier it's going to be." (19:58)

Handling Gray Area Claims: Back Pain, Migraines, and More

Claims involving subjective or less visible conditions, such as chronic back pain or migraines, present unique challenges:

1. Objective Evidence: Insurance companies require solid medical documentation to substantiate claims for these conditions. This includes specialist consultations, treatment records, and evidence of how the condition impairs occupational duties.

2. Policy Limitations: Some policies may have exclusions or time limits on benefits for certain conditions, necessitating a careful review of policy terms and possibly seeking specialized legal assistance.

3. Consistency Between Claims and Reality: Surveillance, including social media activity, can uncover discrepancies between claimed limitations and actual activities, potentially undermining the credibility of the claim.

Notable Quote:
Ben Glass warns, "...you have to be brutally honest in describing your condition and your limitations to the insurance company. Because one way or another, if you're not being honest, they will find it." (31:13)

The Role and Fees of Legal Assistance

Hiring a disability attorney like Ben Glass can be instrumental in navigating denied claims:

1. Contingency Fees: Most disability attorneys work on a contingency basis, taking a percentage (typically one-third) of the benefits won if the claim is successful.

2. Consultation Costs: Initial consultations may involve flat fees (e.g., $2,200) for comprehensive case evaluations, including policy reviews and strategy development.

3. Value-Added Services: Attorneys provide not only legal expertise but also emotional support and strategic planning to help claimants rebuild their lives post-disability.

Notable Quote:
Ben Glass explains his fee structure, "...they're going to pay me a third of their benefits if I'm able to win their benefits." (38:56)

Final Advice and Recommendations

Both Dr. Dahle and Ben Glass advocate for proactive measures:

• Early Acquisition of Policies: Purchasing disability insurance while young and healthy ensures better rates and more comprehensive coverage.

• Understanding Policy Details: Professionals should thoroughly understand their policy terms, especially definitions like "own occupation," to ensure adequate protection.

• Consulting Experts: Engaging with experienced brokers and legal advisors can significantly enhance the chances of a successful claim.

Notable Quote:
Ben Glass concludes, "...most people are going to have some coverage under the group policy from their employer. This is just look at the picture of your family on your desk and say, what happens if my stream of income goes completely away?"* (43:31)

Conclusion

Episode #427 of the White Coat Investor Podcast offers an in-depth exploration of disability insurance claims, underscoring the importance of comprehensive coverage and informed decision-making for medical professionals. Through Ben Glass's expert insights, listeners gain a clearer understanding of the claims process, common challenges, and strategies to enhance their financial security in the face of unexpected disabilities.

Transcript

[Jim Dahle]

This is the White Coat Investor Podcast.

[Ben Glass]

Where we help those who wear the white coat get a fair shake on Wall Street. We've been helping doctors and other high income professionals stop doing dumb things with.

[Jim Dahle]

Their money since 2011. This is White Coat Investor podcast number 427 dealing with a disability insurance claim. This episode is brought to you by Laurel Road for Doctors. Laurel Road is committed to helping residents and physicians take control of their finances. That's why they've designed a personal loan for doctors with special repayment terms during training. Get help consolidating high interest credit card debt or fund the unexpected with one low monthly payment. Check your rate in minutes plus white code. Investors also get an additional rate discount when they apply through LaurelRoad.com WCI for terms and conditions, please visit www.l LaurelRoad.com WCI that's www.l LaurelRoad.com WCI Laurel Road is Brand KeyBank NA Member FDIC all right, welcome back to the podcast. It's been a week since we chatted and I hope you have had a wonderful week. I love summertime. I look forward to it all winter, even though in the winter I go out and play and in summer I go out and play. In the winter I get annoyed by the cold and in the summer I get annoyed by the heat. But for whatever reason, I love the extra daylight you get during summer. And it just reminds me of my upbringing in Alaska, right, where we'd go out at 10 o' clock at night and go rock climbing because the sun was still up in the summer. And then in the winter you sat around in front of your lights trying not to get depressed. But there's something special about summertime, so I hope you're having a good one. Our quote of the day today comes from my friend Bill Bernstein who said if you find yourself stimulated in any way by by your portfolio performance, then you are probably doing something very wrong. A superior portfolio strategy should be intrinsically boring. I love that quote. A lot of truth there. There's a lot of people that talk about fun money, right? They use 2% of their portfolio or 5% of their portfolio for fun. You know, it's probably true that most white coat investors can light 2 to 5% of their portfolio on fire and still be perfectly fine. So anything you invest in with 2 to 5% of your portfolio is probably fine. That said, is that really the most fun you can think of spending 2 to 5% of your portfolio on? When I think of fun money, I think of traveling. I think of going Rafting. Those are the sorts of things I think about with fun money. If your fun money is really gambling in the stock market, I wonder if maybe you need to pick your head up, look around, see if you can find something that's a little bit more fun than that. All right, thanks everybody out there for what you do. You do important work. We're going to talk about some of that work you do today as part of our interview. But it's not easy work. There's a reason you are a high income earner. You spent a long time learning to do this, and what you do is not always appreciated and often has significant legal consequences. And so we just want you to know that as a society, we appreciate what you're doing out there. Okay. Some of you sometimes contact us asking about buying books. You want to distribute them to your students or residents or friends or whatever. We do offer discounts. I mean, you can order one book or two books or three books or whatever. You can order that from Amazon. You can order it from the White Coat Investor store. But if you actually want to buy a bunch of these, if you want to buy 25 plus of them, we thank you for your commitment to spreading financial literacy among medical students, residents, your colleagues, et cetera. So we offer bulk book pricing for orders of 25 + on any of the White Coat Investor books. The orders include the shipping costs and take about two weeks because we don't print them until you order them. So it takes about two weeks to get them. But including shipping, the cost for doctor's guide is 15.99. A book. For financial boot camp, it's $16.99. For the guide for students, it's $1,799. For asset protection, it's $18.99. Okay, if you buy 25 plus. If you want to buy 100 plus, we'll give you an additional discount on those books. All you have to do for this is email booksitecoatinvestor.com to order them. And don't forget, if you're getting these books for first year medical or dental students, you don't even have to pay for them. All you have to do is find someone in the class to be a volunteer champion. We try to send this book, the Guide for Students, to every first year medical and dental student. Every year we get it to about 70% of them. We'd like to do better than that. So if it's for that book and that group of students, you may not even have to pay anything at all. All you gotta do is find a champion for that class. But if you Wanna get somebody 25 plus books, we'll give you a discount. Email booksitecodeinvestor.com we'll get it set up. Okay. Our subject today is near and dear to our hearts. Megan's our podcast producer. I'll mention in the interview that Megan is married to Tyler, who has hosted this podcast before. And some of you heard episode 365 where we had Tyler on the podcast talking about his disability experience, his disability claims. He had a group policy. He had an individual policy. He got the denied with the group policy. He made a claim successfully on the individual policy. And part of the reason they were successful at that is they spoke with our guest today before putting in the claim and learned some things that make any sort of a claim go a lot smoother and be a lot more likely to work. So I want you to pay attention to this. Even if you're not disabled, I want you to think about your disability insurance coverage, what you have and what you might do if you ever actually have to use your disability insurance. It's not that hard to get disabled. I fell off a mountain last summer, got myself disabled somewhat. At this point, I'm only disabled from being able to climb 5, 10 and harder, but still, I got to experience a little bit of what sudden disability feels like. It's not that fun. Trust me when I say you don't want to be dealing with a bunch of craziness, trying to make a claim when you're disabled and trying to take care of yourself and rehab your injury or whatever at the same time. So let's get attorney Ben Glass on the podcast. We're going to do a great interview and I'll chat a little bit more afterward. Our guest today on the White Coat Investor podcast is Ben Glass. He's a long term disability attorney. Disability insurance attorney. But what you should really know about Ben we just got done talking about is that he is still at, you know, an older age refereeing soccer up through the high school level. In fact, he says he has been refereeing longer than most of the parents yelling at him have been alive. He's also the father of nine and has worked with a lot of you out there, a lot of White Coat investors that have had issues with disability insurance claims. So we thought we would get him on the podcast and talk with him about some of these issues and what you can do in advance and after you get disabled and when you're having issues and those sorts of concerns. You should be aware Ben is also a sponsor of the White Coat Investor. Right. He's on our recommended list for legal services. If you go there looking for help with, you know, disability insurance claims, he's there. So he does pay us money every year. You should be aware of that conflict of interest. But that's not exactly the reason we brought him on the podcast. The reason why is actually we thought this was a really important discussion to have. And the funny part about it, you'll recall Megan, our podcast producer, is married to somebody who has guest hosted this podcast before. You recall Tyler Scott, who has actually had some issues with the disability insurance claim. And so when Megan was lining this up, she was pleased to remember and recall and be reminded that, hey, we worked with Ben Glass when we were having issues with our claim. So it was a very personal connection today. Ben, welcome to the podcast. Thanks for being here.

[Ben Glass]

Thanks, Jim. You should know that your brand is huge because as I said before the call, I talked to a lot of White Coat Investor tribe members, your fans. And the thing that I see across these discussions are they usually have bought good levels of insurance. So I just want to let you know that they are listening to you. They are reading your stuff. They are listening to your other sponsors who sell disability insurance to doctors. And so they come. Obviously, these are smart people. They usually come with some pretty good policies, and we can talk about that today.

[Jim Dahle]

Yeah, well, there's a little bit of a selection bias. Right. If they don't have any policy at all, they're probably not calling you. And in my experience, that's actually the biggest issue with doctors and disability is people aren't just. Just aren't buying policies. They don't have the coverage even though they need it. Yeah. So maybe we can sprinkle throughout this discussion, you know, people can realize, hey, these are real people we're talking about. They're like you. They thought they were invincible. They didn't think they'd ever be disabled. But the statistics on Americans in general is that one out of four people is going to deal with a disability before age 65. It's a pretty high percentage. And I think maybe that's why these policies cost so much, because they actually get used well.

[Ben Glass]

So there's a couple of things there, and one we'll talk about is that and doctors. So a lot of the discussion I had with doctors is if you are a surgeon, if you are a dentist, if you work with your hands, that there's a lot of things that wouldn't quote, unquote disable someone who, like me, who sits at the desk and thinks all day long. Right. But it, when they buy the correct policy and it protects them in their own occupation, they may not be able to do what they were born to do. And they bought a policy that will pay them for their loss of income because of that. So the other reason people don't buy disability policies is that most employers are providing some form of group policies. What folks need to know is that group policies, because they're sold to everybody, are almost never as good as an individual policy. Individual policy is more expensive, of course, but. But the coverage is better. And so most everyone who's working for an organization is probably covered at some level, Jim, by group policy. But again, most of the folks who come to me from White Coat Investor have purchased individual policies.

[Jim Dahle]

But I'll bet most of the work you do is actually with people with group policies, isn't it?

[Ben Glass]

It is. So most of my work across the country is for people who, people of, not just doctors, but anyone who has made application for benefits and been denied. So that's where I make most of my money. You've been denied benefits. I'm going to restore you to claim and I'm going to get paid if I'm successful in doing that. In the Dr. World, the space that I'm occupying is really as pre claim advisor. And our goal when we talk to a doctor who has been diagnosed typically with some sort of progressive disease process and maybe today they can still work, but they have questions about malpractice and ability to do the job, is we'll have a discussion. And our goal on those discussions, Jim, is that you'll never need a lawyer because I'm going to give you a good strategy. Either your claim is valid and here's the 17 steps you need to walk through. But they're pretty easy once I tell them to you or maybe call me in six or 12 or 18 months. But right now you probably don't have a claim. And so these are important conversations because the last thing you want to do is like quit your job, not have an income, but not have a valid claim. So it's fun talking to doctors because they have complicated lives, they are achievers. These are family discussions often because the spouse is often on the call as well. They may be business owners. So there's a complication there like what do we count as income and how can I make money? And many of them, Jim, can, even with their whatever the illness is that's causing their inability to say, operate, they can go and do other things. And so now, depending on their policy, what are the other things they can go and do and still make money without messing up their primary disability claim? So that's where I get involved. And guys and gals like me, if we get involved early, we can give you a plan and hopefully you never need us after that.

[Jim Dahle]

Yeah, that's good advice. All right, before we get into, you know, all this talk about, you know, trying to get your claim paid and, and all these strategies, let's talk for a minute. Let's say somebody walks up to you, it's a doc in your neighborhood, just started residency, thinking about buying disability insurance. What would you tell them as far as disability insurance you ought to go buy?

[Ben Glass]

So, yes, good idea. By individual coverage. The most important thing in a disability policy for me is the definition of disability. And typically, Jim, we talk about the definition of own occupation, and there's different sort of levels of policies. The best policy will pay you if you can no longer do what you were born to do. So again, the surgeon example is fairly easy because people can understand if I've got a vision issue or a tremor issue, I can't operate. The best policies will allow you to then change. Maybe I can teach something, maybe I can work for big pharma, but I can earn money in a different occupation and still get paid my full disability benefit if I've bought the right policy. So my advice would be you find a broker who's used to. To selling, who has experience in selling to doctors and understands what it means to be a specialist, understands what it means to work in a practice, and understand that, you know, you can oftentimes switch out of your main occupation to something else. And that broker, and I don't sell any of this stuff, so no bias here, but that broker will have access to a lot of different policies. Typically, I tell young professionals of all type, go and buy the policy because it's going to be the cheapest when you're healthy and young, and over time, you'll be able to increase the amount of coverage you're buying. And that's good. But if you wait until you have a diagnosis or you have some wonky blood test, then you either become uninsurable or it becomes a lot more expensive. So when you're healthy and when I was a young lawyer, it's kind of expensive when you're young and maybe not making as much money and you've got some debt.

[Jim Dahle]

Yeah, for sure. And it's interesting to look at the Overall statistics in the country. If you look at people applying for disability, and this is everybody, this isn't just people that were going through white coat investor approved agents who are particularly adept at getting doctor's coverage. But something like 1 out of 5 is declined. And more than that, 1 out of 4, 1 out of 3 gets some sort of rating or exclusion on their policy. And so it's actually pretty common that people have trouble getting, you know, ideal coverage. It definitely is easier the younger you are and the fewer problems you have. And the interesting thing about it, it's fascinating, right? This thing's only going to pay you till you're 65 or 67 most of the time. So it actually, you're buying the possibility of more benefits when you're buying it younger. It's a better deal at age 30 than it is at age 50. And so I find it fascinating that it costs so much more at age 55 when they're only gonna have to pay you for 10 years. But that's the way they're priced. The older you get, the more expensive this stuff is.

[Ben Glass]

Well, exactly right. And then you get to. When I talk to guys, so I'm 67. You said older earlier. So I'm 67. And I had my policies from about, you know, 22 or 23 on. And recently, because I've built financial wealth and I've got a business that I own, I could cancel my disability policies because it would only pay. If I get hit by a bus tomorrow, they would only pay me a max of two years. So those are the types of discussions that I have with people all the time. Everything from should I buy to talking to group administrators too, Jim, like what kind of policy will protect a group of eye doctors or a group of interventional radiologists? And I have an interesting story there, if you'd like to hear it at some point. And so it helps HR or whoever's making the decision buy the protection that they think that they need. Again, I refer them to the guys and gals selling the policies who are experienced with doctors. But I'm often surprised at how little the group administrator who's making the decision, how little thought they actually give to what policy to buy. They're relying on a broker.

[Jim Dahle]

You just see what they do when they pick retirement plans. It's even worse, I'm sure.

[Ben Glass]

Yes, yes, I'm sure. And look, they have to wear a lot of hats and they have to be good. But that's why there's uber specialists in every little financial niche we can think of, yeah, for sure.

[Jim Dahle]

All right, well, let's, let's talk a little bit about claims now. What makes for a strong claim?

[Ben Glass]

What the insurance company is looking for, first of all, Jim, is what do you do? And it's not just necessarily the label on what you call yourself. Right, I'm an md. Okay, that's very general. But no, I'm a cardiac surgeon. And because most of these policies, at least for the first two years of coverage, are shaped around can you do the duties of the occupation? Not to get too deep, but it's not necessarily how your job is actually performed at this particular practice, but how does the occupation perform? And so then, so we shape the parameters there. What are the occupational duties? And then we look and say, well, what's the diagnosis? Although the diagnosis doesn't tell us a lot about whether a claim will be paid or not claimed. You could have a very dire diagnosis and still work. So people with stage 4 cancer who are radiologists could still do their job.

[Jim Dahle]

Right.

[Ben Glass]

But what we're looking for in the medical records is as much objective scientific evidence as we can that whatever the disease or the injury process is, is preventing you from doing the policies, say one or more of these occupational duties on a full time basis. So that's the framework. And typically an insurance company will ask, what do you do? Send us your billing records. We want to make sure if you say you're a surgeon, you actually are operating on people, things like that. And this is why. So one of the mistakes doctors make is they talk to their doctor friends about disability. And disability is a big broad word and hardly everyone, hardly anyone can explain that. No, it's disability through the framework of what were you actually doing in your occupation or as your occupation at the time you developed your condition. That's the first step. The second is as much objective medical evidence as you possibly can, can get, and then financial records. So particularly if you're a sole practitioner or you're working in a small group, like your book's gotta be clean, especially if you're the practice owner. So there's investigations there. And again, talking to someone experienced at the beginning can help a doctor shape their claims so that they're not just chasing everything, financial records, billing records, at a time when they're stressed out and trying to get treatment for whatever their condition is.

[Jim Dahle]

So, I mean, somebody comes in there, maybe we first, let's step back and just generally walk us through the process of making a claim. Yeah, what happens, you decide, you know what? I think I'm disabled. I got this disability insurance policy. What's the process over the next few weeks and months and what happens?

[Ben Glass]

Sure. Exactly right. So if it's a group policy, you go to HR and you ask them for the claim forms, and they'll often refer you to a website for, you know, for Unum or New York Life or whoever the carrier is. Same thing. If you have a broker, you call your broker, say, I think I'm going to have to tap into this policy. Can you help me get the claim forms. You fill out claim forms that tell your story. Give authorization to the insurance company to get your medical records. Give authorization to the insurance company to talk to your employer if you are employed so they can get the financial records. And you send that in you. Our advice typically is you should have looked at all of your medical records first. It would be a mistake to not do that to make sure your records say what you think they say. But whether you do or you don't, the insurance company is going to send out the authorizations, going to get their records. They're going to do an interview, much like the interview I do of doctors, to find out your story. What do you do? How many hours do you work? Where do you work things? What's going on in your life? Why can't you work things like that? And then depending on the nature of the condition. So unfortunately, I talked to a fair number of guys and gals who are relatively young with early onset Parkinson's. You know, I don't know if I'm just attracting them or what, and they have a tremor and they are in one of the medical areas where they have to work with their hands. I talked to an emergency room physician just two days ago. 35 years old, early onset Parkinson's tremor can still do a lot of things, but has to be careful. And so sometimes if it's, quote, obvious like that the claim is just going to be approved and going to be paid. Other times, if the diagnosis is kind of a mystery and you got to go to 2 and 3 and 4 and 5 specialists to kind of nail it down, that can make it more challenging for the insurance adjuster to understand what's going on. What we're trying to do, what a doctor who's making a claim is trying to do, is to make this claim an easy call for the insurance adjuster. So the more information you have, the more records you have, the more maybe narrative statement from your own healthcare team about why you can't, you know, operate or why you can't do Whatever your medical specialty is, the easier it's going to be because that claims adjuster has got 100 files on her desk, let's say, and you want to make yours easy. That's a process. If they pay the claim, then you start to get checks. You will typically have a follow up. Again, depending on the nature of the diagnosis, you may have monthly follow up reports from your doctors, which can be kind of a pain in the butt for your doctor, right? Or no, maybe if you've got a progressive disease and it's very clear we're just going to check in with you every year. And if the claim is denied, Jim, whether it's a group policy or an individual policy, typically. Well, if it's a group policy for sure you'll have an appeal time, typically 180 days to answer the objections of the insurance company. That's another time when it's good to have an experienced attorney do this because the appeal becomes the whole case and there's virtually no rules on what you can put into an appeal. So we put a lot of stuff into our appeals and individual policies, although it's not required by any federal rule, individual policies typically will give you an appeal time, a time for you and your doctors or your legal team, if you have a lawyer, to answer the objections, to have a look at the claim file and see, all right, what's missing? Why didn't they pay my claim? Is there a way that I can make this more clear and obvious to the adjuster?

[Jim Dahle]

Now, are the typical medical records just coming from your primary doc and maybe a specialist related to the condition, a neurologist or an orthopedist? Or do you often need to see a doc that kind of specializes in evaluating you for disability, so you don't.

[Ben Glass]

Necessarily need to see a specialist? And again, it's so much of this depends on the nature of the disease process. However, most of my doctor clients have seen a specialist because that's your world and they have access to most frequently the right name, the right phone number and can get in to see specialists. So the more, again, we're looking at the evidence, right? We want to make this really clear and obvious to an insurance adjuster. So I would say the more that you have specialists that are appropriate for the condition you have, and these specialists, support specialists don't have to say you are disabled because again, that's defined by the policy. Specialist says, and Jim, who's an emergency department physician, cannot do these types of procedures. And gee, this is risky not just to Jim, but to his patient in the middle of the night in an er. So that's the kind of information the adjuster is looking for.

[Jim Dahle]

Yeah, but you don't need to find a doc that's doing half their practices is evaluating people for disability. You don't need that sort of a doctor.

[Ben Glass]

No, in fact, I rarely see or have a client who is seeing that type of doctor because again, these are folks, my clients are folks with legitimate claims who have already, by the time they've talked to me, they usually have worked their way up the chain of specialists for their condition.

[Jim Dahle]

Yeah, okay, you mentioned legitimate claims. I presume there's a fair number of people out there in the world that really don't have legitimate claims and are trying to get paid from their employers or their individual disability insurance policy. I mean, that's why they go through all this is they don't want to have to pay, you know, people that are faking it, for lack of a better term. What, what's your sense of how much of that is out there?

[Ben Glass]

So I don't think it's so much. It's people that are faking it. I think it's, I think it's more, it's more, it falls here. Someone is working in a bad, toxic work environment and they may have something going on, but the work environment makes the whole thing untenable. They get pissed off and want to quit and they want to tap into their policy. But these policies don't insure against a bad work environment. So that's why we really look at your occupation. So if you're an emergency department physician, you work for a crappy group in a crappy hospital and everybody's mean to you, that's not going to help. If you could just move across town and work for a better group. The people that you know, are there people that have claims? Yes. Most of the people that approach us, we look and we go. The records just aren't there. They don't understand. Their friends may have said you should talk to an attorney or you should apply for disability. But we know based on our experience that the claim's not going to be paid and a judge isn't going to overrule the claims person. So I think most people are not genuinely out to try to cheat an insurance company. They just don't know. Because Jim, nobody knows what's in their insurance policy until they have a claim and someone explains it to them. And so, you know, I'm there to help people ignore the well meaning advice of friends who don't do this work and to give them real clarity on this is valid go or you don't have a claim, you should go back to work or you should try to find a different way to make money.

[Jim Dahle]

Ben, there are a lot of claims out there that for lack of a better term are in a bit of a gray area. You know, it's a medical condition where there's not great objective evidence that there's something going on. The classic example is probably back pain. Lots of surgeons have back pain that keep them from operating more than an hour at a time. Many dentists have back pain later in their career and yet they go get an MRI and all they see is one or two little tiny herniated discs. And of course there's lots of people out there with small herniated discs that don't have any back pain at all. Can you walk us through the process of these claims and how you look at them and what happens when you have a claim like this?

[Ben Glass]

Yeah, sure. So Jim, migraines would fall into that category as well. So first let's accept these are more challenging claims. But now we're looking at the sort of the secondary evidence. So is the claimant seeing quality specialists? Do those specialists records reflect that they believe that their assessment of the patient's pain is true? So do they believe in the patient? Are we trying standardized therapies, including legit standardized medications without success. So we've been successful. Migraine is impossible to see, to quote see a migraine. But someone who's seeing again moving up the food chain of specialists and seeing uber specialists and trying to get better, trying as many treatments without success, that all becomes evidence that the insurance company is supposed to take into account the entire picture. Now that having been said, insurance company doctors will say what you just said, no radiologic evidence. Sometimes they'll have surveillance and if you're survey, if the surveillance they get on you contradicts what you say about your abilities, that's hard. But you know, if you're, if you're a high performing dentist and you've got a track record of X hours or X number of procedures in a week and that's also diminishing in conjunction with the medical records. That's all evidence that we are trying to tie together to say yes, this is very legitimate. Even if we don't have radiologic evidence that having all been said. The thing that your listeners need to know is some policies will limit that. They'll say like we'll accept the claim, but if you don't have A proven radiculopathy. We're only going to pay the claim for two years. And they may have a list of conditions such as fibromyalgia, migraine headache, chronic pain, that they'll say, we accept that this is real, but we're not going to pay it for more than two years. What people need to know is that these types of policies exist. That's mainly a group policy that we see. And so again, the higher up the food chain you go in terms of buying a quality policy, the less likely, in my experience it is that you are going to get big pushback. I think by and large these insurance companies try to treat high wage earning professionals the right way.

[Jim Dahle]

It's interesting, you get what you pay for a lot with disability insurance, don't you?

[Ben Glass]

I think that's true, absolutely.

[Jim Dahle]

Now you mentioned something, you mentioned surveillance. How often is an insurance company hiring a spy, hiring a private investigator to follow you around to figure out if you're really disabled? Is this common? I mean, how often does this happen?

[Ben Glass]

So that part happens. I see less and less frequently.

[Jim Dahle]

But why?

[Ben Glass]

They don't have to. They go, just go on social media, they go and look at your posts or you think your social media is private, but your friends are posting, oh, here's Jim at our ski trip, right, and tagging you in it. So that's where the problem is. And again, we're not saying, I'm not saying you need to close down your entire life and secure it, but I think you have to be very accurate when you're saying to an insurance company, these are activities I cannot do or I cannot do more than an hour. You have to be honest about that because they will find you that one time. And I'll tell you a trick that they use. They'll find you that one time you're out doing something for three hours that you said you could only do for one. Here's how they get you. Jim, when's your next visit with your surgeon? Oh, it's July 7th at 11:00am okay. Some likelihood, if you have that type of claim, that there's going to be a guy waiting down the street who's going to follow you, going to see what you do before you visit the surgeon, what you do after you visit the surgeon. Do you stop at the grocery store and you say you can't carry a certain weight and you're doing grocery shopping. So you've helped them by telling them when you will be outside of the house again. I don't want people to be paranoid about living their lives. But the main strategy is you have to be brutally honest in describing your condition and your limitations to the insurance company. Because one way or another, if you're not being honest, they will find it.

[Jim Dahle]

You know, when people hear stories like this, they hear that, you know, your specialty exists to help people get their claims that you're actually needed. Sometimes I suspect the hassle factor of knowing they may have to fight to get their benefits in some situations may cause them to wonder if they should bother buying the insurance at all. Should that potential hassle affect their approach to the initial decision to buy disability insurance any differently? I mean, should.

[Ben Glass]

I mean, I don't think so. Look. Yeah, look, I bought my product for myself at 22 or so. I paid it and never had to make a claim, thank Goodness, right. For 40 years. But I had that security as I was growing my family and growing my business. So here's what I tell people, Jim, you get run over by a truck, you don't need me. That's easy. They're going to pay the claim. And if you're driving to work, there's a decent risk there that something will happen that may put you out. Maybe it doesn't put you out permanently, but maybe it puts you out for six months or a year. So I think it's worth it. Again, I don't sell the policies I recommend to my young lawyers who work for me and young professionals that I get to hang out with from time to time. I think it's one of the insurance policies that's worth it. Again, most people are going to have some coverage under the group policy from their employer. This is just look at the picture of your family on your desk and say, what happens if my stream of income goes completely away? That's the risk you're protecting. The insurance companies will tell you that most claims are paid. That's true, but most claims are not for a long period of time. I broke my ankle, I can't operate for six months. I'm pregnant, and I can't be around for six or nine or 12 months. So they pay the claims. That goes into their stats. I'm a proponent of, of in America, insurance is relatively inexpensive, and most people just don't realize how important it is. Auto, homeowners, malpractice, it's just one of the things we live with.

[Jim Dahle]

Yeah. Now, you've alluded to a few mistakes that doctors make when they're dealing with the claims process. You know, lying, for example, or not, you know, not seeing, you know, multiple Specialists that are actually documenting what you can't do or putting things on social media that contradict what you're saying you can't do, telling the insurance company where you're going to be. You know, what other mistakes do you see people make with the claims process in general? Where are they screwing up?

[Ben Glass]

So I talked to a OBGYN a few years back and he had progressive neurological condition which took him out of the labor and delivery and out of the operating room. And he became an office based physician and his income diminished by half. His friends told him, you don't have a disability claim, you make too much money. So he took advice from non lawyer friends where actually he did have a claim. He had a claim for partial disability or what they call residual disability and he was entitled to benefits at that time, but he didn't claim it. So he left money on the table. Now the problem became as his condition progressed, now his occupation is not GYN surgeon in the L and D, right, It's office based. And so now his claim becomes harder. So a mistake, and I see this, a well meaning treating physician will begin to describe what disability is or isn't to his patient. They're not trained in this. The other thing that doctors do, which I find if I can say to you hilarious, is they go to their friends for treatment, they don't charge each other and they don't make records. Sometimes that makes my job a lot harder. All right, so when you have something go, you can go to your friend but make sure you're paying them and they're keeping records. You know, the other thing I see, the story I tell, which is kind of scary is I represented an interventional radiologist at a major university medical center. And this guy is one of the godfathers of, he's more my age cohort, godfathers of interventional radiology. And Jim, he was getting some wonky blood results from being in the IR suite and exposed to radiation for 20, 25 plus years. And his doctor said you gotta get out or else you may develop a cancer. And that's a legitimate claim. Problem was his practice had bought a policy that defined own occupation as whatever your certification is. And if you have no certification, it's md. There were certifications in interventional radiology but he didn't have one because he got his training before the certification came into existence. And he actually today trained the fellows to become certified. And so the insurance company said your board certification is general radiologist. You can still read X rays. We're not paying the claim and we litigated that case and we lost the case. So the mistake there was not what the claimant did, but what HR did in buying a policy for a group of interventional radiologists and not understanding the policy and not thinking through, oh, you know, we have some guys on the staff who don't have this newer certification, and we're buying a policy that only protects the newer doctors if something happens and they can't do ir. So those are the things I see. The other is making a claim, honestly paying me, somebody like me, to look over your shoulder while you make the claim and to say, jim, I'm not sure that you check the right box here, or I'm not sure your medical records really add up. Like, let's not do this thing now. So they're making a claim too soon or without the right evidence, where if they stayed in treatment for six more months and, you know, saw the right specialist, their claim would be much better. So there's a couple things that I see. You know, the biggest one is just, and I don't see this from doctors so much, but over, just over dramatizing what their limitations are. And it's not backed up by the medical records and often contradicted by surveillance.

[Jim Dahle]

Okay, so what does it involve to hire an attorney like you? I mean, what's the range of what, you know, the clients you've had in the last year have paid in legal fees. You know, I assume a few people, a fair number of people, you probably don't pay you anything because it's just a very quick discussion. But if they get an hour consultation with you, that's probably a relatively small amount. Other people are going to need you to do a lot. What's that kind of range of what they end up paying in legal fees to?

[Ben Glass]

Most people don't need us to do a lot. Like, again, if their claim has been denied, denied, and they're coming to me, they're going to pay me a contingent. They're only going to pay me if we win, and they're going to pay me a third of their benefits if I'm able to win their benefits. No matter if I get you back on claim now or if I litigate your case and take it to the court of appeals. So we're going to evaluate that case. Obviously, we're only going to take cases that we believe that we can add value because that's the only way we're going to get paid. We offer a flat fee consultation in Advance. It's about $2,200. But what that involves is work with my team. We're going to collect all your policies because typically guys who are white guys and gals who are white coat investor tribe members have multiple policies. That's good. We're going to understand the policies. You're going to go and get your medical records and get them to us. We're going to look at those medical records before we get on a call. And then my call with you is to set a strategy. And one of the half the time I spend on that call gym is, is a life coaching call. It's like, what are we going to do next? Because I can solve your legal problem. I can get you paid benefits if your claim is legit. But now let's, I'm an entrepreneur. Like, let's figure out how we're going to go make money out in the world and then for what they have paid, like we stand behind them. So as they prepare their own claim forms and collect their records and communicate with the insurance companies, we're saying, and I mean, some lawyers will stay involved and charge every, you know, six minutes or something. We don't do that. Like we will look over your shoulder is what we call it. And, and bless your claim forms. And as you have small little questions, it's all included in what we do. And then Jim, what I tell the doctors is if it gets to a point where I need to charge you, there'll never be a surprise. I'll always say, hey, you sent over another big batch of medical records. It's going to take me some time to look through it. Here's what it's going to cost. So we're very transparent. Again, I make money in the denied claims and the contingent fee denied claims work and we're able because the regulations to do this work all over the country. And I've got a great team that does that. The consults though, with physicians are the interesting part of what I'm doing in my career now because I get to meet people who have achieved great things in their life. They've got this challenge and I'm a good guy to talk to about. Okay, challenge, yes. Can't do anything about that. But now I can help motivate and inspire you. What's next in your life. And I provide some level of assurance. Typically the spouse, whether it's husband or wife or whatever spouse is there and they are worried as well, what are we going to do? And so having the spouse on the call and being able to me to go look, everything's Going to be. Okay, here's the steps. We're going to be good at the steps. It's not going to cost an arm and a leg because I want this to be the main call we ever have. And I want you to not have a problem with the claim. I just find that interesting work. And now I'm getting invited to these medical conferences to be able to talk about this to doctors and to practice administrators and just helping them. I like doing that work a lot. I've been blessed. I'm 42 years into my career. I'm doing, Jim, some of the most interesting work I've ever done. And it's cool to be. It's cool to be a leader in this space of helping shape the law for consumers, including doctors, CEOs, entrepreneurs.

[Jim Dahle]

Yeah. So, I mean, potentially, if there's a denied claim and they gotta hire somebody like you and they end up paying a third of their benefits, I mean, I assume that's all the benefits they get from now until the policy stops paying. If that's the case, should they be getting a larger policy than they otherwise would, knowing that they might have to pay a third of it out to an attorney?

[Ben Glass]

Insurance companies aren't going to sell you policy more than about 60% of your income. Right. They don't want to incentivize you. So there is a limit to how much disability insurance you can buy. But by and large, yes, I would not be cheap on how much of a monthly benefit I'm buying. Again, you'll find that insurance is a very competitive space, I think. But the more important question goes back to what we talked about at the beginning of the podcast, which is the quality of the definition of own occupation. That's really where it can make a significant difference, financial difference to you and your family. The one last thing is, and you probably know this is if you're paying the premium, the benefit is tax free.

[Jim Dahle]

Yeah, for sure. Which definitely helps when it's only 60% of what you were making before. But if you were paying 40% of what you were making before in taxes, it's exactly the same. But I do tell people, get a big enough policy that it will pay for your living expenses as well as to continue to save for retirement. Because as we know, these things typically don't pay longer than, you know, whichever one's longer, two years or until you get to age 65 or 67. So you still need some retirement savings or you're going to be all on Social Security when you.

[Ben Glass]

Exactly. And if they, if they Bought the right policy with the correct own occupation. Remember, they may be able to collect that full benefit, but find something else to do. Like, all you guys are smart, right? So maybe there's consulting or, you know, expert witness work or something over here that you can still do even with whatever is keeping you out of medicine per se or patient care per se. And so that's why I say it's the quality of the definition of disability and a policy, which I think is just as or more important than how many dollars are actually being paid as a benefit.

[Jim Dahle]

Yeah. Awesome. All right, well, our time's getting short. Ben, what have we not talked about today that you feel like doctors ought to know about the disability claims process or getting disability insurance or et cetera?

[Ben Glass]

I just think that if. And my offer is this. If anybody who's listening to this would like me to look at their policy and just give them a general overview, I'm happy to do that. I wrote a book for doctors that tells some of these stories. If you want to reach out to me, I'm happy to send them a copy of the book. It may be hard to believe hearing this come from a lawyer, but I really want people to have a seamless experience, not need a claims denied lawyer, because honestly, like, there's enough of that work out there for sure. And I like building relationships. So, you know, these doctors are all treating potentially my future patients, my future clients as well. And then the last thing I'll say about that is if you're. If you're insured under group policy and you're not sure what it actually covers for you, I'm happy to look at that group policy too, because then you may want to go running to one of the white coat investor brokers and have a discussion about can I affordably buy individual coverage now? And again, you said this before, the younger and healthier you are, the smarter that decision becomes.

[Jim Dahle]

Awesome. Well, Ben, thank you for the work you do. Thank you for refn high school soccer. We thought attorneys were underappreciated. Referees certainly are underappreciated.

[Ben Glass]

It's a weird hobby. It's a weird.

[Jim Dahle]

Appreciate coming on the podcast and educating us on these topics.

[Ben Glass]

Yes, sir. Thank you.

[Jim Dahle]

Okay. I hope you enjoyed that interview. You know, there's this idea out there, especially among doctors, the lawyers are the evil other side. Right. Because we're always thinking about, you know, malpractice prosecution attorneys. There's actually lots of attorneys out there that help you a lot. Right. We've got a list of. Of two you know, multiple kinds of attorneys on the website, people we refer you to, whether it's estate planning kind of stuff, more likely contract review stuff. That's what most of you use attorneys we recommend to you for disability insurance claim lawyers, these sorts of people that can really help you get malpractice insurance, these sorts of things. So be aware that those exist on a recommended tab. They're not the most popular pages under our recommended tab, but they do get used by white coat investors from time to time. Let them know that you're coming from us so they know where their business is coming from. So they continue to support the white coat investor, but really they're there to help you. The reason we keep these lists, we maintain these lists, is yes, to help support the white coat investor, but also just because we get asked for these things by you, we know there are a certain percentage of white coat investors that need help with this sort of illegal task. So we keep that going. This episode was brought to you by Laurel Road for Doctors. Laurel Road is committed to helping residents and physicians take control of their finances. That's why they've designed a personal loan for doctors with special repayment terms during training. Get help consolidating high interest credit card debt or fund the unexpected with one low monthly payment. Check your rate in minutes. Plus white coat investors also get an additional rate discount when they apply through LaurelRoad.com WCI for terms and conditions, visit that same website, LaurelRoad.com WCI that's www.l LaurelRoad.com WCI LaurelRoad is a brand of KeyBank NA Member FDIC. Don't forget if you want to buy bulk books, email booksitecodeinvestor.com and we will get those copies out to you. It takes about two weeks, but it's a lot cheaper than buying large numbers of books off Amazon or directly out of the White Coat Investor Store. Thanks for those of you leaving 5 star reviews telling your friends about the podcast, a recent one came in from rural Main Dock said Help me get on track. This podcast has a practical and pragmatic approach for high income professionals to become financially literate and achieve the financial goals they may not have even known they had. I appreciate that so much of what is discussed here is good sense for everyone to live below your means to make a plan for the future. The variety of people at many different stages of career brings a depth of perspective. I appreciate growing my financial literacy while feeling connected to a larger community. Thanks for all you do. 5 stars it's true it is a larger community. There are literally hundreds of thousands of White Coat investors out there. They want to help you. We have online communities. You may not know this. We have a forum [e-mail] we have a subreddit White Coat Investors Subreddit if you're into Reddit. We have a Facebook group. If you like Facebook. Right? White Coat Investors Facebook group. We also have a financially empowered women's group. A few. They have periodic events as well as have a smaller Facebook group where they discuss issues that are unique to women. So check those out. Be connected. We are a community. We're here to help you keep your head up and your shoulders back and know that you're not alone in your financial jury. Thanks so much for what you do. See you next time on the podcast.

[Ben Glass]

The hosts of the White Coat Investor are not licensed accountants, attorneys or financial advisors. This podcast is for your entertainment and information only. It should not be considered professional or personalized financial advice. You should consult the appropriate professional for specific advice relating to your situation.