Navigating disability insurance for ophthalmologists: Lessons learned

(Image Credit: AdobeStock/MohamadFaizal)

Disability insurance is a crucial aspect of financial planning for ophthalmologists, ensuring financial security if an event occurs resulting in disability. However, it can often be overlooked or misunderstood.

Stephanie Pearson, MD, FACOG, an obstetrician-gynecologist (ob-gyn) by training, sustained a career-ending injury during a difficult delivery with a patient in 2013 after being kicked in the shoulder twice. She sustained a torn labrum and ended up with a frozen shoulder, or adhesive capsulitis. After being told it would heal, Pearson ultimately required surgery. Before surgery, Pearson says, she was told she would be back to work as an ob-gyn in 12 weeks. It has now been 10 years since her injury, and Pearson is still not cleared to do obstetrics or perform surgery.

Pearson is the cofounder and CEO of PearsonRavitz, an insurance advisory firm helping physicians learn what sort of coverage they should have and empowering them at all stages in their career to make confident and educated decisions regarding their insurance coverage.

It was only after she sustained an injury that Pearson learned her hospital group benefit did not cover work-related injuries. Being flatly denied coverage, Pearson says, she was told she “would have been better off if [she] had fallen off [her] bike” instead of being injured while working. On top of her group policy, the private policies Pearson had ended up “not [being] exactly what [she] had thought [she] purchased or what [she] really should have had.”

Since then, Pearson has become an advocate for physician disability insurance education because of the challenges she faced while going through her recovery.

Advice to ophthalmologists

When it comes to knowing more about their coverage, Pearson suggests that ophthalmologists request a master copy of their policies so they can see where there may be shortcomings in the coverage. Policy language is the single most important part of coverage that not only ophthalmologists but all physicians should be paying attention to, according to Pearson.

“You want to make sure that you are covered for what you’re doing day in and day out, and that you’re not getting held against a room full of other ophthalmologists who may not be practicing in the same way,” Pearson said.

However, when it comes to insurance, it is not one-size-fits-all, according to Pearson. This misconception can lead to not being covered properly and fully. “It’s really important that you’re being properly educated and properly advocated for by someone who’s going to treat you as an individual and not a cookie-cutter [case],” said Pearson.

Pearson also stressed group policies often may define own occupation and total disability in ways that can greatly affect your coverage. She said she has seen more group policies not covering work-related injuries and illnesses post COVID-19 and described this as a “slippery slope.”

One of the biggest pieces of advice Pearson offers results from one of the mistakes she made herself: Maintain coverage to keep pace with your income. As income increases, so should coverage, Pearson points out.

Knowing the shortcomings of group policies is also something that can save you in the long run.

“With employer-paid policies, you don’t have any control. It is what it is. They create it, they control it; most of the time, they keep it,” Pearson said, adding that had she been aware of the shortcomings of her group policy, she would have been able to correct it in her individual policies.

While the group policies are something
you don’t have control over, that doesn’t mean the burden falls solely on the employer, said Pearson.

“[While there is] a responsibility of ownership to take care of employees…I find it hard to think that any employer would be able to fully insure properly their employees. So I think it is a shared responsibility,” she said.

Pearson’s experience serves as a powerful reminder of the critical importance of disability insurance for physicians. Her advocacy for proper education and tailored coverage highlights the need for physicians to take an active role in their financial planning. By understanding the nuances of disability insurance, ophthalmologists can safeguard their livelihoods and secure their financial future.

Stephanie Pearson, MD, FACOG

P: 610-658-3251

Pearson is a cofounder of PearsonRavitz, a personal insurance brokerage specializing in disability and life insurance for physicians.