Own Occupation Decides Whether an Attorney’s Disability Policy Pays [Podcast]

Own Occupation Decides Whether an Attorney’s Disability Policy Pays [Podcast]

Most attorneys who buy disability coverage believe own occupation guarantees their benefit the day they can no longer practice law. It is an umbrella term with tiers, and the version inside a group plan, or an individual policy bought without the right rider, pays very differently. Which tier an attorney owns decides whether the disability claim pays in full or drops to a fraction the moment it is filed. Ethan Abramowitz has watched that decision play out from both sides of the table. He spent nearly four years defending insurance carriers at Kirwan, Spellacy and Danner before joining Mark F. Seltzer and Associates, a national practice representing highly skilled professionals in private and group disability matters, where for more than 13 years he has represented physicians, dentists and attorneys whose claims were denied or stalled. Admitted in Florida, Pennsylvania and California, he meets these professionals years after the policy is signed, at the moment the carrier says no. I brought him onto the Income Protection Journal Podcast to work the story backward, from the denied claim to the contract language that caused it. Own-Occupation Coverage Separates an Attorney's Full Benefit From a Modified Trap The phrase attorneys think they understand is the phrase that fails them most often. True own occupation, sometimes called regular occupation, pays the full monthly benefit when a sickness or injury stops you from practicing law, even if you go earn a living doing something else. A modified own-occupation definition pays only while you are not working at all. Step back into any paid work and the claim collapses into a partial or residual analysis, the reduced benefit paid when you can still work but earn less. Own occupation, it's an umbrella term, and underneath that, there's different tiers of coverage. Ethan Abramowitz, a disability insurance attorney with Mark F. Seltzer and Associates for more than 13 years He watched the difference cost one physician most of her income. An OB/GYN in her late 30s developed rheumatoid arthritis, lost her clinical career and accepted a medical directorship with the residency program she had trained in. Because her individual policy carried a modified own-occupation definition rather than a true one, her earnings from the new role were offset against her benefit. The monthly check fell from $15,000 to two or three thousand. A true own-occupation policy would have paid the full $15,000 alongside her new salary with no offset. Attorneys assume this is a doctor's problem because a surgeon's disability looks obvious. It is not. Abramowitz has represented lawyers with Parkinson's disease, traumatic brain injuries and visual impairments who could no longer tolerate the physical and cognitive load of the work, the ability to sit for 10 or 12 hours, read voluminous records and hold a trial schedule together. When a lawyer with that kind of condition wants to teach or consult instead, only a true own-occupation definition lets the benefit and the new income coexist. If I can't be a lawyer, but I could go teach at a law school as an adjunct professor, I can do that and earn a living and do something I'm passionate about. Without the true own-occupation definition, I can't do that without having an offset. Ethan Abramowitz, who represents policyholders in disputed disability claims Group Long-Term Disability Converts an Attorney's Own-Occupation Term After 24 Months The group plan a firm provides is where most attorneys assume they are covered, and it is where the definitions quietly turn against them. An individual policy weighs the material and substantial duties of the occupation as you actually perform it, examining your billing records and your day-to-day work. A group long-term disability plan leans on a national-economy standard drawn from reference works like the Dictionary of Occupational Titles and O*NET, generalized rubrics that ask what a lawyer does, not what you do. The costlier problem sits deeper in the contract. Most employer plans limit own-occupation protection to the first 24 months, then shift the standard to any gainful occupation. When the policy does not spell out a replacement-income formula, that phrase defaults to the Social Security definition of disability. I always joke that if you can be a barista at Starbucks, no disrespect to them. Ethan Abramowitz, a former insurance-defense litigator who spent nearly four years defending insurance carriers Then the carrier can argue you are not disabled. A greeter's wage clears the bar. Group plans answer to the Employee Retirement Income Security Act, a federal statute that tilts the burden toward the carrier and forces a denied claimant through an internal appeal before any courtroom is available. Covered monthly earnings compound the shortfall. Many group plans count only base salary and exclude bonus, incentive and production pay. Abramowitz described an orthopedic surgeon earning about $800,000 who returned to work at half time. His individual policies paid a 50 percent partial benefit. His group plan, measuring only base compensation, required a 60 percent loss of total earnings before it paid anything, so it paid nothing. Attorneys on a modest salary and a large bonus face the same arithmetic. Four Attorney Disability Policy Features That Decide the Claim Asked which single feature he would refuse to give up on a policy of his own, Abramowitz did not hesitate. The true own-occupation definition comes first, followed by residual disability, a future increase option and a cost-of-living adjustment. Roughly 60 to 70 percent of his cases involve some component of partial disability, and only about 10 percent of disability claims trace to an accident, so the provisions that pay while you are working less matter far more than most buyers expect. Attorneys rate among the most favorable occupation classes for pricing, alongside architects, accountants and engineers. When I build individual own-occupation coverage for attorneys, I treat that pricing advantage as a reason to add the strong features rather than to buy the cheapest contract, because the group plan the firm owns can be cut or canceled at any renewal and does not follow you when you leave. Abramowitz put the same point on a billboard. No attorney should sign a disability policy until they have read the fine print. Ethan Abramowitz, who has represented physicians, dentists and attorneys in denied disability claims for more than a decade The same math decides it for solo practitioners and firm partners, the attorneys with no group plan behind them at all. On the r/personalfinance forum, a self-employed single parent asked whether an own-occupation policy is worth the higher premium, and whether a benefit that runs to age 65 makes sense. Abramowitz did not hedge. Absolutely. If you're self-employed and you're a single parent or a single income household, you're the breadwinner. You need to protect your income. Ethan Abramowitz, who has litigated insurance disputes from both the defense and policyholder side for more than 15 years The full conversation, including his account of a surgeon who kept operating with tremors because he could not afford to stop, and the elimination-period and pre-existing-condition traps that decide a claim before it is filed, is on the Income Protection Journal Podcast. What stays with me is that the outcome of a claim is usually written years earlier, on the day the policy is bought. Editor's note: I refer clients to Ethan Abramowitz when a disability claim is disputed, and some of the professionals he represents hold coverage I placed. Neither of us pays the other for referrals, and he received no compensation for this interview.

She Was Talked Out of a Disability Policy. Here’s What It Cost Her.

Group long-term disability through your employer typically pays $2,000 to $15,000 a month before tax, far less than what high-income working professionals actually earn. Independent insurance broker Analisa Cleland explains the four-part group LTD trap, the worksite-product portability path for the uninsurable, and why 92 percent of brokers licensed to sell disability insurance don't.

CEO Shares Lessons Learned Watching High Earners Lose Everything [Podcast]

Gretchen Rosenberg has watched agents at her brokerage get sick, stop working, and find out how little income protection they had. When that happened, colleagues sometimes stepped in. They covered showings, managed contracts, and kept deals from unraveling. What they could never replace was her paycheck. Five years ago, Rosenberg launched a foundation at Kentwood Real Estate that provides emergency grants to employees and agents dealing with cancer, car accidents, and medical crises. It has made a real difference for a number of people. It is not income protection for self-employed professionals. And Rosenberg says not enough of her agents carry one. Rosenberg is President and CEO of Kentwood Real Estate, a luxury brokerage serving communities across Colorado’s Front Range from Denver to Boulder, Fort Collins to Colorado Springs, and into the mountain communities of Summit and Grand counties. Kentwood is Colorado’s exclusive affiliate of Home Services of America and one of the largest residential real estate companies in the country. She started her career as a single mother, spent six months without closing a sale, and built her way to leading one of the state’s largest brokerages over nearly 30 years in a production-only industry. I sat down with Rosenberg on the Income Protection Journal Podcast to talk about what she has observed across those three decades: what commission earners assume will protect them when something goes wrong, why those assumptions often fail, and what she did about her own income when she was just starting out and could least afford to be unprepared. Commission Income Has No Floor and No Benefits Real estate agents are independent contractors. Nearly all of them file 1099s, pay their own taxes, and carry no employer benefits. No health insurance. No life insurance. No 401K unless they build one themselves. “The agent is responsible for paying all their taxes, all their insurance,” Rosenberg says. “They have no benefits, they have no health insurance. It’s all on them.” What makes this particularly difficult is the gap between perception and reality. Television shows about real estate create the impression that agents are uniformly wealthy. The reality, Rosenberg says, is that most agents pay listing marketing costs out of pocket before they know whether a house will sell. Every deal is speculation. Every paycheck is earned from scratch. Commission income does not come with a floor. It comes with cycles, market shifts, slow seasons, divorces, and bodies that eventually wear out. Rosenberg has watched agents navigate all of those. What carries the successful ones through, she says, is almost never what they assumed would. “They’re out there protecting their clients, and they forget to protect themselves,” Rosenberg says. What Illness Actually Does to a Commission-Based Income When I asked Rosenberg what she has seen happen to agents who fell ill or were injured and could not work, her answer was direct. “I’ve seen some really sad things happen, and it’s because they’re unprepared,” she says. One agent Rosenberg knows lost her home to IRS liens after spending a commission check before setting aside her estimated taxes. Others who were struck by illness had no reserve to carry them through a year of reduced or no income. The Kentwood Cares Foundation fills some of the gap. But a grant to get through a rough month is a different instrument than coverage that replaces months or years of income when a medical condition prevents someone from working. Most commission earners Rosenberg knows do not have the second thing. “Not enough think about it,” she says, when I asked whether agents in her firm protect their income. “I think they think, ‘I’ll always be able to sell a house.’” That mindset is understandable. Real estate attracts people who believe in their ability to hustle. It is also, Rosenberg says, a physically demanding job. Agents pull up carpet corners at inspections, climb stairs at showings, and work weekends and evenings for clients whose timelines rarely align with anyone’s preferred schedule. The ability to do that work is not guaranteed indefinitely. What High Earners Assume Will Be Enough A common belief among high-earning self-employed professionals is that savings or investment portfolios will carry them through any disruption. The most financially disciplined agents at Kentwood, Rosenberg says, do invest well and are genuinely prepared. Most are not those agents. Housing equity is at an all-time high nationally. But equity does not replace income when someone cannot work. It takes time to access, selling under duress is rarely good timing, and drawing down assets is not the same as having coverage that pays a monthly benefit during a disability. Rosenberg’s advice to anyone transitioning from a salary into commission-based work is to have at least $25,000 to $30,000 in cash reserve before starting. Even after closing a deal, the commission may not arrive for months. “That’s why we have insurance,” she says. I work with self-employed professionals and independent contractors on individual disability insurance built around the income their work generates. The policies that protect commission earners are structured differently from group plans, and understanding those differences matters before something goes wrong. Rosenberg got her own policy in the early months of her career, when she had no income and no certainty about when she would close her first sale. She was a single mother starting over. She has never needed to file a claim. “I’m always grateful I have it,” she says. The specifics of what Rosenberg has seen happen to commission earners who prepared and commission earners who did not, and the conversation she and I had about the gap between earning well and being protected, are in this episode of the Income Protection Journal Podcast. It is a conversation worth hearing before the need arises.

Disability Insurance Awareness Month with CDIA President Bob Herum [Podcast]

A doctor who could no longer practice medicine after a neurological diagnosis started painting watercolors and selling them to make up what his disability benefits did not cover. His policy had been sufficient when he first bought it, but his income had grown beyond what the coverage was designed to replace, and no one had reviewed it in the years between. Bob Herum was a young agent at Provident at the time, delivering benefit checks to that doctor’s door, and one of those watercolors has hung in his hallway ever since. Herum is the president of the Council for Disability Income Awareness, a nonprofit whose mission is to make sure working Americans understand what income protection is before they need it. He entered the disability insurance business in 1986 after eight and a half years of military service, spent fourteen years as a vice president of sales and marketing at Provident, one of the country’s largest disability carriers, and has spent the past two and a half years rebuilding the CDIA after the organization went through a difficult leadership transition. The CDIA, which recently added the word “income” to its name to distinguish its mission from general disability services, now reaches nearly 40,000 agents and advisors and has expanded its membership to include Munich Re, major general agencies such as Ash Brokerage and DI Brokers East, and carrier members including Principal, Unum, and Lincoln Financial. I sat down with Herum on the Income Protection Journal Podcast during Disability Insurance Awareness Month to talk about the painting, the doctor, and what he has observed across four decades watching what happens when working Americans are covered and when they are not. It is a conversation I plan to return to. The Gap Most Workers With Group Coverage Have Never Thought to Check The story of the watercolor doctor is not unusual. The disability does not always arrive with drama. It comes from a neurological issue, a cancer diagnosis, a hand injury, a joint that stops cooperating. What makes it costly is the gap between what a worker assumes their coverage does and what the certificate of insurance actually says. Most workers with employer-provided coverage have never read that certificate. Herum spent ten years marketing group long-term disability and short-term disability products, and he is direct about what most of those plans do and do not cover. The benefit is typically 60 percent of base salary, calculated only on compensation from that employer. The portion the employer pays is taxable as federal income tax. And the coverage does not follow the worker if they change jobs. “Do you realize that if you leave that employer, that coverage stays with the company? It doesn’t travel with you,” Herum says. Most group long-term disability plans also include a provision that, after an initial period, shifts the definition of disability from inability to perform your own occupation to inability to perform any occupation at all. For a physician, attorney, or specialist whose income depends on a specific set of skills, that shift matters. Herum’s consistent message is not that group coverage is inadequate across the board. It is that very few workers have taken the time to understand what they actually have. The organizing idea behind the CDIA is that most people do not make a conscious decision to leave themselves unprotected. They make an unconscious one. They receive an enrollment form at work, they mean to look into it, and they never do. “Their lack of planning becomes their plan,” Herum says. The statistic the CDIA returns to is not an abstraction. A Milliman study confirmed what Herum first encountered in 1986: one out of four working Americans will experience at least a 90-day disability during their working career. “If I knew that there was a 25 percent chance that when I crossed the road, I was going to get hit by a car, I probably wouldn’t cross the road,” Herum says. The problem is not that people reject the risk when they confront it. The problem is that most people never confront it clearly enough to make a real decision. The Resources the CDIA Makes Available to Agents and Working Americans The tools the CDIA produces are free and available at cdia.org. For agents and advisors, there is a database of nearly 40,000 professionals receiving regular outreach, a library of more than 900 blog articles organized by coverage topic, training sessions focused on specific policy mechanics, and marketing materials designed to support client conversations year-round. For the working American who lands on the site, the CDIA is building video content designed to help answer a basic question: what do I actually have, and is it enough? One newer program certifies employers whose disability benefit offerings meet a defined standard. Herum envisions the database becoming a tool workers use when comparing job offers, letting them see which employers have built a real disability program rather than a nominal one. The first certificate was awarded days before our conversation. Carriers including Unum are already marketing the program to their employer clients. I work with high-income professionals and self-employed individuals on individual disability income coverage built around the specifics of their occupation and income. The coverage I place is structured differently from what most group plans provide, and understanding those differences before something goes wrong is exactly what Disability Insurance Awareness Month is designed to prompt. Herum’s framing is that every month should carry that prompt. May is the annual occasion to raise the conversation. The CDIA’s job is to make sure the conversation keeps happening in June, October, and January as well. The full conversation, including Herum’s account of a second claim story from his early career in Columbus involving a dentist who redirected his career to managing practices after his own disability, and his view on why only four out of every 100 licensed agents discuss disability insurance with their clients, is available on the Income Protection Journal Podcast. The resources he describes are at cdia.org.

When Dual Incomes Become One, Does Pediatrician’s Policy Actually? [Podcast]

A physician with fifteen years in clinical practice and a dual household income had the financial plan most parents assume they have. She had started a 529 college savings account before her daughter was born, carried benefits through a large integrated health system, and expected a pension to grow alongside her career. Then her marriage ended when her daughter was five, and the plan she had counted on needed to hold for one. Dr. Katie Richardson is a board-certified pediatrician and the CEO of Lantern, a Colorado-based national nonprofit that delivers childhood development resources to more than 500,000 families across the United States through text messaging. More than 65 percent of those families live in low-income zip codes, giving Richardson a data-informed view of financial disruption at scale that few clinicians can match. She joins me on the Income Protection Journal Podcast to discuss what two decades of working with families, and one personal financial disruption, taught her about building financial security that survives the unexpected. What Families Build For and What They Miss Richardson’s work puts her inside the financial lives of families across the economic spectrum. Through Lantern, she oversees programs reaching families in more than 30 states. She also draws on fifteen-plus years of clinical observation watching middle-class and upper-middle-class families make healthcare decisions based on cost and coverage rather than clinical need alone. A 2024 advisory from the Office of the Surgeon General on parental stress confirmed what Richardson had already observed at scale: financial pressure shapes how parents show up at work, at home, and in the exam room. She saw the shift firsthand in her clinical practice. Families that once agreed to imaging studies or specialist referrals without hesitation began asking whether the test was covered and what it would cost. That pattern, she says, spans the full income range. Even among higher-earning families, the financial pressure is real. The households with the nicest cars are often under the same stress as households with far fewer resources, she says. They have simply scaled the problem up. She describes the cascading expenses parents rarely anticipate before they arrive: the gap between what school systems cover and what children with developmental or educational needs actually require, the cost of travel sports, and the outlays that accumulate from pregnancy through the early school years. Lantern has measured this directly. A food insecurity program the organization piloted in Colorado found that 75 percent of participating families reported reduced food insecurity after receiving targeted text-message resources, and more than 85 percent said they discovered local programs they had not known existed. The same pattern holds for financial planning, Richardson says. Families often lack access to basic information, not the willingness to use it. The larger finding from her two decades of work is that family financial planning tends to address the scenario where everything goes as expected. The scenario where it does not tends to go unaddressed until it is no longer hypothetical. The Policies She Made Sure Were Hers What shaped Richardson’s financial thinking was not a seminar or a planning worksheet. It was growing up with a mother who had not planned, and then navigating her own divorce. “I was brought up by a single mom who, when I was in high school, we had creditors calling our house all the time,” she says. “And so I know what it can look like to have someone who hasn’t planned.” That history made her deliberate. She watched her mother trying to make retirement work on $36,000 a year in Social Security and a small supplement, and decided she would not arrive in the same position. She kept life insurance and disability coverage alongside her employer benefits, specifically because she understood that employer benefits require the employer. “My biggest fear going through my divorce was, am I going to be able to do this financially on my own? I need to make sure that no matter what happens, whether it be divorce, illness, any of those things, that I have really thought and made sure that my daughter is going to be okay,” Richardson says. The question she asked during her divorce is the same question a life insurance policy is designed to answer before the moment arrives. The answer depends entirely on what was put in place when everything was still intact. Richardson maintained individual policies throughout her career at that health system, and she is direct about why. “Some of my insurances definitely and always has been outside of my employer, because even if I’m not working at an employer that offers those benefits, I know that I still have those things,” she says. After nearly sixteen years at that health system, she made the decision to leave. The individual coverage she had maintained was part of what made the transition possible. Planning outside her employer had given her the financial flexibility to walk away when the organization’s direction no longer aligned with her own. After thirty years of advising physicians, dentists, and other high-income professionals at Set for Life Insurance in Greenwood Village, Colorado, what Richardson describes is one of the most consistent findings I see: an employer benefit is a workplace benefit, and it ends when the employment does. Among the executives I advise, the ones with the most options when their employment situation changes are the ones carrying executive disability coverage outside their group plan. Individual life insurance and disability policies, issued in the policyholder’s name and not tied to any employment relationship, follow the insured regardless of where their career leads. Why even high-income professionals consistently underestimate how much of their future earning capacity goes unprotected is examined in a conversation with Michael Sir of One Protection, whose software makes the true size of the income gap visible in dollar terms. What Richardson Tells Parents Now Richardson is not an insurance professional. What she brings to this conversation is a physician’s and nonprofit leader’s perspective on how financial disruption actually lands on families, and firsthand experience navigating one. Colorado recently joined a growing number of states requiring financial literacy education for every high school student, a development Richardson calls a meaningful starting point. She does not think it is sufficient on its own. Most families, she says, lack the background to make consequential insurance and planning decisions without professional guidance, and she was no exception. She sought out advisors for investments and coverage precisely because she understood that wanting to make good decisions is not the same as having the knowledge to make them. She observes one more pattern worth naming. Through Lantern’s work with families accessing food banks and community resources, Richardson has seen how much shame attaches to asking for help. She sees the same dynamic in insurance. Families who have paid premiums for years sometimes hesitate to file a claim because the act of filing feels like an admission. Richardson says her answer to that hesitation is the same whether the resource is a food pantry or a disability policy: that is exactly what it is there for. The families she works with through Lantern lose their financial footing for reasons most of them did not anticipate: a job loss, a health diagnosis, a family structure that changes without warning. What she observes consistently is that the families with the most flexibility when those moments arrive are the ones who built it before they needed it. .lwrp.link-whisper-related-posts{ margin-top: 40px; margin-bottom: 30px; } .lwrp .lwrp-title{ }.lwrp .lwrp-description{ } .lwrp .lwrp-list-container{ } .lwrp .lwrp-list-multi-container{ display: flex; } .lwrp .lwrp-list-double{ width: 48%; } .lwrp .lwrp-list-triple{ width: 32%; } .lwrp .lwrp-list-row-container{ display: flex; justify-content: space-between; } .lwrp .lwrp-list-row-container .lwrp-list-item{ width: calc(100% - 20px); } .lwrp .lwrp-list-item:not(.lwrp-no-posts-message-item){ max-width: 150px; } .lwrp .lwrp-list-item img{ max-width: 100%; height: auto; object-fit: cover; aspect-ratio: 1 / 1; } .lwrp .lwrp-list-item.lwrp-empty-list-item{ background: initial !important; } .lwrp .lwrp-list-item .lwrp-list-link .lwrp-list-link-title-text, .lwrp .lwrp-list-item .lwrp-list-no-posts-message{ color: #036f3d; }@media screen and (max-width: 480px) { .lwrp.link-whisper-related-posts{ } .lwrp .lwrp-title{ }.lwrp .lwrp-description{ } .lwrp .lwrp-list-multi-container{ flex-direction: column; } .lwrp .lwrp-list-multi-container ul.lwrp-list{ margin-top: 0px; margin-bottom: 0px; padding-top: 0px; padding-bottom: 0px; } .lwrp .lwrp-list-double, .lwrp .lwrp-list-triple{ width: 100%; } .lwrp .lwrp-list-row-container{ ...