Toby Lason

Partner, Disability Insurance Agency. I help high-earning professionals understand what their disability contracts actually say. Carrier-neutral advice.

[Toby Lason @tobylason]

Most disability insurance policies don't actually protect your ability to do your specific job. They protect your ability to do any job.

That's the difference between own-occupation and any-occupation coverage, and why it's by far the single most important aspect of the coverage.

With an any-occ policy, if you're a surgeon who can no longer operate but could teach or consult, the carrier can deny your claim. This results in a very high claim denial rate. The ten years of training and career you've built around a specific skill set are not protected.

Own-occupation means the policy pays if you can't perform the duties of your specific occupation, even if you're earning income doing something else. Massive distinction.

I've worked with thousands of physicians, CRNAs and dentists, and the most common problem I see is that they don't know their group coverage converts to any-occupation after 2 years.

If you only check one thing in your policy, check that.

[Toby Lason @tobylason]

@JonLuskin it's boring until a claim hits... then of course it becomes the thing people talk about. usually I just have to mention the stats to prospective clients: 1 in 4 people will suffer a disability before retirement. not sexy, but powerful.

[Jon Luskin, CFP® @JonLuskin]

More advisors need to talk about disability insurance.

It's so important.

Unfortunately, it's also boring.

Tax planning gets a lot of attention because everyone hates taxes.

Of course, everyone loves talking about investing - because that's where the money is.

Retirement is something many want, also a hot topic.

I wish there was something alluring about disability insurance - so we could talk about it more.

[Toby Lason @tobylason]

@kevinmd This is why specialist surgeons should have the "loss of license" rider on their disability policies, which exists for exactly this scenario. Almost nobody buys it, and most physicians don't even know it's an option until they need it.

[Toby Lason @tobylason]

"60% income replacement" is the marketing copy on most hospital LTD plans. The math after the benefit cap usually lands closer to 35%. After tax it lands closer to 25%.

For a CRNA earning $230k base plus call pay, a $10k monthly cap turns a 60% formula into something closer to 38% of true earnings. Then federal and state tax come out of the benefit. Take-home replacement on a six-figure salary often ends up at 25-28%.

Most CRNAs assume the brochure number is the number. The arithmetic underneath it is what actually pays.

https://t.co/tz0tWp13u9

[Toby Lason @tobylason]

@zachmelloh26 the DI line is the one that trips most people up... group LTD through work and an individual own-occ aren't really the same product. nobody notices until they actually try to file

[Toby Lason @tobylason]

A 35-year-old physician earning $400,000 has roughly $12 million in remaining career earnings. No raises factored in. That number doesn’t appear on any balance sheet, but everything on the balance sheet depends on it.

$3,000 to $6,000 a year to insure $12 million in earning capacity is one of the cheapest insurance ratios in personal finance. The "too expensive" objection tends to dissolve once you measure the premium against the asset instead of the monthly budget.

[Toby Lason @tobylason]

AI-assisted surgery is going to create a disability underwriting problem no carrier has started solving.

Occupational classifications are built on decades of claims data from physically intensive procedures. If AI reduces the demands, the actuarial models shift. And if a surgeon becomes reliant on an AI platform then loses access to it? That’s a claim scenario the contracts don’t address.

[Toby Lason @tobylason]

@WCInvestor it shows!

[Toby Lason @tobylason]

A disability policy paying $10,000/month today still pays $10,000/month in year ten without a cost-of-living rider. Adjusted for 3% inflation, that’s $7,400 in purchasing power.

Over a 25-year claim with a 3% compound COLA, the monthly benefit grows to roughly $20,900. The cumulative difference exceeds $1 million. The rider costs a fraction of that and can’t be added once a claim starts.

Younger professionals carry the most inflation exposure and get the most value from it.

[Toby Lason @tobylason]

Good example of why the actual COLA rider language matters. Most professionals buying individual DI never read the rider text before they sign. The compounding method, the benefit period interaction, and the cap structure all vary by carrier. Reading the contract language is an underrated step in the process.

[Toby Lason @tobylason]

@kevinmd Nobody's talking about the disability insurance side of this. If AI changes what a radiologist actually does day to day, their policy's definition of "own occupation" doesn't update with it. That gap is going to get weird fast.

[Toby Lason @tobylason]

Carriers have deep classification systems for physicians. Orthopedic surgeon vs. dermatologist, different pricing, decades of claims data behind the distinctions.

Attorneys get one or two occupation classes for the entire profession. A trial attorney in court 200 days a year pays roughly what a corporate attorney at a desk pays. The risk profiles aren’t close, but the pricing treats them the same.

Own-occ definitions diverge even further. For a surgeon it’s relatively clear: can you operate? For an attorney, whether "litigator" and "attorney" count as the same occupation depends entirely on the contract language.

https://t.co/GF7RK7Azn6

[Toby Lason @tobylason]

Good list. The disability insurance line is the one that trips people up most. Many high earners I work with are carrying group coverage that replaces 40–50% of income after taxes, or an individual policy they bought in residency and never updated. "I have disability insurance" and "my coverage would actually sustain my household" are very different things.

[Toby Lason @tobylason]

Incredibly important topic. One thing I'd add is that if the employer is paying the premium (usually the case), those benefits are considered taxable income. So a plan that says $10K/month on paper nets closer to $6-7K after taxes. For a physician earning $350K+, that coverage gap goes from bad to genuinely unsustainable

[Toby Lason @tobylason]

Group disability plans cap monthly benefits regardless of salary. A physician earning $400,000 with a $10,000/month cap gets 30% replacement, not the 60% the summary says. Add taxes on employer-paid premiums and the effective coverage drops below 25% of take-home.

Individual policies are after-tax dollars in, tax-free benefits out. Portable, can’t be cancelled by the employer, and the definitions of disability are usually stronger.

Most high earners have the first one and have never looked at the second.

https://t.co/HegXQkFfjX

[Toby Lason @tobylason]

This comparison should get more airtime than it does. The own-occ point is especially important because carriers define 'occupation' very differently from each other, and we see surgeons, for example, discover at claim time that their policy was written broader than they realized when they signed it

[Toby Lason @tobylason]

every specialty on the right, especially those on the bottom right quadrant, should ensure they have full mental health coverage on their disability insurance policies. if burnout causes any underlying conditions, such as depression, anxiety, insomnia, or cognitive dysfunction, claims generally qualify

[Toby Lason @tobylason]

@PhysicianCents whatever questions may arise - be sure to do a deep dive on an Own-Occupation definition of disability!

[Toby Lason @tobylason]

@WCInvestor The physicians I've worked with who have attended WCICON consistently say it changed how they think about their financial picture, not just investments, but the entire structure around protecting and growing what they earn.