Your biggest asset is not your house or your 403(b) - it is two or three decades of future clinical income. Disability insurance is how you keep the asset on the books.
A physician one year out of fellowship is carrying an asset worth somewhere between $5 million and $12 million: the present value of a career of clinical earnings. Industry estimates put the odds of at least one extended disability episode during a working career at roughly one in four. Almost nobody would leave a $7 million building uninsured, yet that is exactly the position of an attending relying on a group policy they have never read.
The phrase that matters is true own-occupation: the policy pays if you can no longer perform the material duties of your medical specialty, even if you can - and do - earn income doing something else. A hand surgeon with a tremor who moves into utilization review collects the full benefit under true own-occ. Under weaker definitions ("any occupation," "transitional," or own-occ that terminates if you work elsewhere) the same surgeon may collect little or nothing.
Proceduralists and surgeons have the most to lose from weak definitions, but the principle applies to every specialty: you trained for one job; insure that job.
Individual policies typically run 1-4% of the income being protected per year, priced on age, sex, health, specialty, and state. Two facts reward buying early: premiums lock at your purchase age, and underwriting locks at your purchase health. Many training programs have guaranteed standard issue (GSI) arrangements that skip medical underwriting entirely - often the only chance to get cleanly covered if you have any medical history. A typical approach: buy a starter benefit as a resident, then exercise increase options as income grows.
Riders that often fail the value test: return-of-premium features, which mostly return your own money with worse expected value than simply buying less insurance.
Employer long-term disability looks free and generous - until the details. Group plans commonly switch from own-occupation to any-occupation after 24 months, cap benefits at a percentage of base salary that ignores bonuses and RVU pay, pay benefits that are taxable when the employer pays premiums, and evaporate when you change jobs. The standard structure for attendings is an individual own-occupation policy targeting around 60% of gross income (insurers cap near there), paid with post-tax dollars so benefits arrive tax-free, with group coverage as a bonus layer on top.
Stress-test your coverage in minutes
The Disability Simulator models elimination periods, riders, and specialty-specific risk so you can see exactly what a policy is worth before you buy.
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