Disability Insurance Decision Tree

Who this is for

Residents, fellows, and attending physicians through mid-career. Not relevant for late-career or retired physicians, when invested assets typically replace the need for coverage. The chart starts with whether you have any disability insurance at all, then sorts by what kind (employer group LTD vs individual own-occ vs nothing), and routes you to either the action playbook, a warning about gaps, or the eligibility check for dropping coverage entirely.

The decision this chart helps you make

Disability insurance covers the one catastrophe no other physician financial product addresses: the loss of the ability to practice. Two facts drive the chart. First, employer group LTD almost always replaces ~24% of physician income after taxes, far below what most attendings need to maintain their household. The cap is usually $10K to $15K per month, the definition is "any occupation" (a surgeon who can teach loses the benefit), and employer-paid premiums make the payout taxable. Second, true own-occupation individual coverage is the most physician-specific financial product on the market: a dermatologist who can no longer perform procedures but who can do telemedicine still collects the full benefit AND earns income in the new role. The chart maps the four common decisions that you might face: (1) do you have coverage at all, (2) is it the right kind (true own-occ vs modified vs group), (3) how much benefit to buy and from which Big 5 carrier (Guardian, MassMutual, Standard, Principal, or Ameritas), and (4) when do you stop. The last question matters more than most physicians realize. Once your invested assets hit roughly 15x annual spending and your loans are paid off, a disability becomes a lifestyle adjustment, not a catastrophe. At that point the premium becomes optional.

Essentials vs Ultimate

Essentials covers the four-question framework: do you have coverage, is it the right type, what should you buy, and when can you drop. It also includes the 5 universal defaults (true own-occ, noncancelable + guaranteed renewable, 90-day elimination, benefit to age 65, Big 5 carrier only). Ultimate adds the rider matrix (FIO, COLA, Catastrophic, Enhanced Own-Occ, BOE for practice owners, Student Loan rider for loans above $200K), the spouse-income adjustment for sizing, the resident vs attending pricing structure, and specific guidance on what to confirm before signing the policy.

How to read this chart

Start at the top. The first question (Do you have ANY disability insurance?) routes you to one of three branches: covered well, covered inadequately, or not covered. The chart uses six box types: • Dark green diamond boxes are decision questions (the branching points) • Pale red boxes with ⚠ flag inadequate coverage (group LTD limits, modified own-occ traps) • Pale green boxes with ✓ are affirmative outcomes (good foundation, eligible to drop coverage) • Pale cream boxes with green headers are action playbooks (the 5 defaults, rider menus) • Pale orange boxes flag reassessment triggers (career milestones, spouse income changes) • Pale parchment boxes are context (sizing formula, resident vs attending notes) Most attendings reach a decision within four to six questions. Use the toggle above to switch to Essentials if the Ultimate view is too dense.