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.