Should Women Pay More for Disability Insurance?

Massachusetts is currently considering a bill that would prohibit disability insurers from charging higher rates to women than to men. Even if a woman is the same age, has the same job, and has the same health history as a man, she pays on average 25% more for the same protection, according to Massachusetts State Representative Ruth Balser.

This bill would prohibit discrimination in premium costs or benefits based on sex in individual disability, accident, or sickness insurance policies. It would also bar disability insurers from making any distinction in insurance policies based on conditions unique to one’s sex, such as pregnancy.

The disability insurance companies, on the other hand, say that the difference is necessary, due to the fact that women account for 70-80% of long-term claims nationwide. While they do purchase more policies than men (60% as compared to 40%), insurers argue that this isn’t enough to make up the difference in revenue. Insurers are in the business of making money, and paying out more in benefits than the amount of premiums coming in isn’t good for business.

According to the Affordable Care Act, health insurers can’t charge a woman more solely because she is a woman. Yet, Montana is the only state with a law requiring disability insurance to be gender neutral, and Massachusetts has a bill in the works. It remains to be seen whether Massachusetts will pass this bill, and other states will follow suit. With some of the major disability insurance carriers (such as Unum and Guardian/Berkshire) keeping corporate offices in Massachusetts, we doubt the bill will be passed without a fight.

What’s your opinion? Should women pay more in disability premiums than men with the same characteristics? Are the disability insurance companies’ arguments in favor of the disparity justified?


Essential Tremors (ET): Part 2

In Part 1 of this post, we looked at the risk factors, symptoms, and treatment options associated with ET.  In Part 2, we will discuss how having an essential tremor could potentially affect your total disability claim.

How do I file for total disability when I have ET?

For those with an “Own Occupation” policy, which means you are considered totally disabled if you can no longer work in your own profession, having ET would certainly qualify you for benefits if you are a medical professional.

Many physicians think that they can simply decrease the types of procedures they perform or amount of time spent at working as their ET becomes more disabling, but this is the wrong move to make.  Changing your work responsibilities can alter your “occupation” under the terms of your disability policy.  For example, if you forego performing medical procedures and merely manage your practice, the insurance company may claim that your occupation has changed from a physician to an office manager, and attempt to decrease or deny your benefits.  Similarly, if you start to work part-time instead of full-time, and then file for disability, an insurance company will likely classify you as a part-time worker, and thus only give you part-time benefits.

Other physicians may decide to continue working in spite of their ET.  This is also a mistake.  Trying to work when you have ET places your patients at risk.  If a patient did get injured and filed suit, his or her attorney would almost certainly assert that you should not have been working with patients and that you knew your ET could harm the patient.

The correct way to deal with insurance companies and your condition is to stop working as soon as it impinges on your ability to perform your occupation and file for disability insurance.  Since, in many cases, the onset of ET is gradual, it is important to discuss you symptoms with your doctor so he or she can determine when your condition will progress to the point that it affects your work.


ET is a condition that can have an effect on actions as small as carrying a water glass or tying your shoes.  It can also affect your occupation and the financial security that comes from having total disability insurance.  We encourage you to speak with your doctor if you think you may be at risk for or have ET, and to contact a disability insurance attorney to help with the claims process if you are planning on filing for disability benefits.


Essential Tremors (ET): Part 1

We’ve done a profile on how Parkinson’s disease can affect physicians and dentists, but did you know that essential tremors are eight times more common than Parkinson’s disease?  A hand tremor is one of the last things a physician or dentist wants.  Not only can it affect daily life, but working with patients safely becomes increasingly difficult.

In this post, we will list some of the risk factors and common symptoms associated with essential tremors and take a look at what can be done to perhaps alleviate symptoms.

What is an essential tremor and what are the symptoms?

An essential tremor (ET) is a neurological disorder that causes rhythmic shaking of part of the body—most often the hands, head, or voice.

The primary symptoms of ET are involuntary shaking, voice fluctuations, nodding head, balance problems, and tremors that get worse during periods of emotional stress, fatigue, caffeine use, and/or purposeful movement.  ET is a progressive disorder than can become worse over time.

What is the difference between Parkinson’s and ET?

Many people believe that Parkinson’s and ET are the same thing.  However, there are some subtle differences between the two conditions, including:

  1. Timing: ET usually occurs when you are in motion, while Parkinson’s is most noticeable when you are at rest.
  1. Related Conditions: ET generally does not cause other health problems, but Parkinson’s has been connected to poor posture, a shuffling gait, and slow movement.
  1. Parts of Body Affected: ET is most common in the hands, head, and voice. Parkinson’s most often starts in your hands and may also affect the legs and chin.

What are the causes and how do you know if you are at risk?

ET appears to be a genetic disorder, because approximately 50% of people with ET have a particular genetic mutation.  However, scientists are not sure what causes ET in people who do not have the genetic mutation.  Researchers have found that changes in specific areas of the brain may contribute to development of the condition, but such studies are inconclusive.

Because the other causes of ET are unknown, the primary way to determine whether you have a high risk of developing essential tremors is to check your family history.  Due to the fact that the mutation is an autosomal dominant disorder, if one of your parents has ET, you have a 50% chance of developing the disorder.  Another risk factor is age—people over 40 are more likely to have an ET.

Is there a cure for ET or a way to prevent it?

Unfortunately, is currently not a cure for ET.  However, now that scientists have found a genetic link, further research could potentially discover ways to prevent ET.

How can I alleviate my symptoms?

Since emotional stress is one of the things that can aggravate ET, look for ways to relieve your stress. Other methods of alleviating ET include decreasing your coffee and caffeine intake and making sure that you get an adequate amount of sleep each night.  Certain medications may also can help with ET, although it is important to speak with your doctor before starting any sort of treatment.  Finally, surgery may be an option in some cases, although surgery certainly is not without its risks.  Surgery for ET generally involves the implantation of a DBS, or a Deep Brain Stimulator.  The DBS is a small device that delivers targeted electrical stimulation to the brain in an effort to reduce the frequency of tremors.

In addition to the foregoing methods of alleviating ET symptoms, there are other things that you can do to make living with ET easier, such as using a travel mug or straw for drinks, using heavier utensils for eating, wearing clothes that don’t have difficult buttons or laces, and saving your most difficult tasks for days when your tremor is least pronounced.


Disability Insurance Profiles: Principal Life

We are expanding our list of insurance company profiles that specifically market to dentists and doctors to include Principal Life.

See our other profiles of Great-West, MassMutual, MetLife, Northwestern Mutual, Guardian, Hartford, and Standard.

Principal Life (also known as “Principal Financial Group”) was founded in 1879.  Initially, Principal Life operated primarily as an insurance company. Principal Life is now a member of the Fortune 500, and offers several additional services, such as retirement and asset management. Principal has most recently realized a growth in net income from $1.112 billion in June of 2014 to $1.290 billion in June of 2015.

Company: Principal Financial Group or The Principal.

Location: Des Moines, Iowa.

Associated Entities: Principal Financial Services, Inc.; Principal Life Insurance Company; Principal Real Estate Investors, LLC; Spectrum Asset Management, Inc.; Post Advisory Group, LLC; Columbus Circle Investors; Edge Management, Inc.; Morley Financial Services Inc.; Finisterre Capital, LLP.

Assets: $530.3 billion.

Notable Policy Features:

Principal Life sells polices that define “disability” as “own occupation”, which means that you are considered totally disabled if you are unable to perform the duties of your occupation. While this may seem like the right policy for a medical professional, you should be aware of a couple caveats.  Coverage under a Principal Life policy is, in part, based upon a key definition that is usually referred to as your “occupation period.”  Essentially, your “occupation period” is the time frame during which the “own occupation” definition of totally disabled applied.  Once the “occupation period” has expired, Principal Life will only pay you benefits if you are unable to work in any occupation that you are reasonably suited to work in, based on your education, training, and experience.

The length of your “occupation period” can range from a base of 2 years after your disability to a period of 5 years, until age 65, until age 67, or until age 70, depending on your “occupation class.”  Oftentimes, the policy provisions regarding “occupation periods” can be convoluted and difficult to decipher.  If you unsure about the length of your “occupation period” under the terms of the policy, an experienced disability insurance attorney can help you understand the applicable policy language.

Claims Management Approach:

In comparison with other insurance companies, Principal Life generally conducts more in-person field interviews with claimants.  Principal Life will not only conduct a field interview when you initially file your claim, but will also likely conduct several additional follow up interviews throughout the claims process.

Most insurance companies require you to fill out generic questionnaires that ask for information about the nature of your disability, among other things.  Because Principal Life handles a lot of disability claims by physicians, it has created a particular “Medical Professional Occupation and Financial Questionnaire” that is more comprehensive than a generic questionnaire, and is specifically tailored towards collecting information from medical professionals.  The questionnaire is quite extensive, and asks about a wide variety of information, from your ownership interest in your practice, to whether your practice participates in a health care network, to the credentials of the medical professional owners and associate professionals you work with, to whether you receive any reimbursements from prescriptions.  If you are unsure about the content or scope of any questionnaire you receive, an experienced disability insurance attorney can help answer any questions you may have.


Alternative Treatments for Chronic Pain

Often, when an insured begins to suffer chronic pain, the insured’s first thought is to contact his or her doctor to seek out a prescription for pain medication.  At the same time, many insureds do not want to take pain medication because such medication can often have harmful side effects.  In this post, we will be looking at some alternative methods of treating chronic pain that insureds who are hesitant about taking pain medication may want to consider.


This is a technique where practitioners stimulate specific points on the body by inserting thin needles into the skin.

The Case For.  Results from several studies suggest that acupuncture is an effective method of treating chronic pain, particularly low-back pain, neck pain, and osteoarthritis/knee pain.

The Case Against.  Studies also suggest that, although acupuncture can help relieve back pain immediately after treatment, it is less effective as a long-term solution.  Additionally, improperly performed acupuncture can cause serious side effects, including infections, punctured organs, collapsed lungs, and injury to the central nervous system.


Stress often aggravates and increases chronic pain.  Hypnosis seeks to lessen pain levels by alleviating stress levels.

The Case For.  Multiple studies have shown that hypnosis is useful for reducing pain, including an analysis of studies by the Mount Sinai School of Medicine that revealed moderate to large pain-relieving effects from hypnosis.

The Case Against.  Other studies suggest that the positive effects of hypnosis are merely the result of a placebo effect.


While exercise is often recommended as a treatment for chronic pain, many insureds fear that rigorous exercise will actually increase, not lessen, their pain.  Yoga offers a gentle way to exercise that doesn’t involve too much stress on joints while still enabling you to strengthen the muscles around your joints.

The Case For.  Duke University Medical Center completed a review of 20 years’ worth of studies and found that yoga is an effective treatment for many forms of chronic pain, including osteoarthritis, carpal tunnel syndrome, and fibromyalgia.

The Case Against.  Yoga can be difficult for people who aren’t very flexible, and classes can sometimes be too strenuous for those just starting out.  Beginners should start with basic poses before attempting advanced poses that could exacerbate their pain if not performed properly.


Many people assert that altering your diet is an effective method of fighting pain-causing illnesses.  More specifically, foods that have been linked to lowering pain levels include:

  • Cherries (arthritis, muscle pain)
  • Ginger (migraines, arthritis, sore muscles)
  • Salmon (aching back, neck, and joints)
  • Turmeric (aching joints)
  • Edamame (arthritis)
  • Hot peppers (arthritis)

The Case For.  All of these foods are easy to find and fairly easy to work into your diet.  They are also present a natural alternative to medicines that may have potentially harmful side effects.

The Case Against.  These treatment options won’t necessarily work unless the rest of your diet is fairly healthy.  The potentially helpful effects of these foods will often be offset by the junk food that many people consume.  Consequently, a major overhaul your diet may be necessary in order to see any meaningful results.

Continue reading Alternative Treatments for Chronic Pain


Pain Killers and Their Risks


We have talked extensively about how various disabilities, such as arthritis, carpal tunnel syndrome, and chronic neck and back pain, can affect you and your practice. One of the ways of dealing with all of these disabilities is to take painkillers such as Advil and Aleve, or NSAIDs (non-steroidal anti-inflammatory drugs). Many people will be prescribed these medications, or take them over-the-counter, for issues ranging from a small headache to disabling pain.

However, just because these drugs are common doesn’t mean they’re completely foolproof or safe. Recently, the FDA has announced that there should be changes made to the labels of NSAIDs regarding their risks. Instead of saying that they “may cause” an increased risk of heart attack or stroke, the FDA urges that the wording should state that they do “cause an increased risk”.

In 2013, a study found that high doses of NSAIDs heightened the risk of heart attack by one-third. In a 2014 study, people taking NSAIDs were 19% more likely to die from a stroke. It is also important to understand that while higher risks occur at higher doses, the FDA warns that the increased chance of heart attack and stroke can occur as early as one week into treatment. Also noteworthy is that if you, or your family, have a history of heart disease, you are even more susceptible.

Even more interesting is that taking antidepressants and NSAIDs at the same time has been shown to heighten one’s risk for intracranial hemorrhage, which is bleeding that occurs around the brain. While the occurrence of bleeding was still relatively low (only about 6 per 1000 people studied), the combination of the two drugs increased occurrence by 60%.

This is especially relevant not only due to doctors and dentists having a great chance to develop debilitating pain due simply to their professions, but also because it is shown that doctors and dentists are also at a higher risk for depression and mental illness.

While we certainly don’t encourage you to stop taking your NSAIDs, we simply advise that you stay educated about what these medications mean for your health. We also recommend speaking with a doctor about your options and what would be best for your specific health needs. If your pain is so incapacitating that you you think you may need to file for disability, be sure to contact a disability insurance lawyer so they they can help you with the process.


More than a Deep Breath: Stress in Doctors, and How to Handle It


We’ve talked about how medical professionals are more susceptible to mental health issues, so it shouldn’t be shocking that doctors and dentists are also more stressed out than the general populace. In fact, a study has shown threshold levels of stress that stay constant at about 28%, which is quite a bit higher than the general working population’s level of 18%. This shouldn’t be surprising, even if you disregard all the data associated with medical professionals and mental health; physicians are put in high risk situations every day.

While many physicians may assert that they have been dealing with stress their whole life and thus know how to handle it, it is important to be sure that you know how to recognize the signs of stress and how to properly decrease stress levels. Simply working through it or ignoring your stress may not get rid of it, and could even lead to other complications. For instance, stress increases the risk of conditions such as heart disease, Alzheimer’s, diabetes, depression, and obesity.

We created a list of some of the signs of stress, as well as a list of things that you can do to make your life a little less stressful both during work and outside of the office.

Signs of Stress

Some of these signs are very noticeable, and you could probably identify them in a second, but others are more subtle. If you suffer some of these symptoms on a daily basis, you may think that they are just part of your daily life, but it is important to note that many of these symptoms can be prevented.

Continue reading More than a Deep Breath: Stress in Doctors, and How to Handle It


Unum Denies Its Own Employee Disability Benefits

In previous posts, we have discussed how Unum is notorious for wrongfully denying disability claims.  Recently, Unum refused to pay its own employee disability benefits.[1]

Apparently, the Unum employee suffered from carpal tunnel—due to all the typing that her job required—and also suffered a back injury in her home office.  Naturally, the Unum employee saw a hand specialist for the carpal tunnel, and a back specialist for the back injury.  After the Unum employee had surgery on her hand to treat the carpal tunnel, the Unum employee’s primary care physician placed her on work restrictions.  However, the primary care physician did not send the work restrictions to Unum because she thought that the other doctors had already documented the restrictions.

Unfortunately for the Unum employee, the other doctors had not forwarded the restrictions to Unum.  Instead of reaching out to the Unum employee’s doctors to see if the disability claim was legitimate, Unum simply denied the long term disability claim due to a lack of documentation.  At that point, the primary care physician came forward and expressly told Unum that she supported the restrictions, but Unum still refused to pay any benefits.

[1] See


Better Treatment for Back Pain?

Chronic back pain is one of the issues that countless doctors and dentists face every day. Many of our clients have suffered from pain that doesn’t allow for effective practice, and thus have had to deal with the disability insurance claims process. According to the American Society of Anesthesiologists, there is a new treatment that could help alleviate some forms of back pain in certain patients. We’re going to be taking a look at the study they published regarding spinal cord stimulation (SCS), as well as answer some questions about SCS for those who don’t know about it.

The Study

This study compared the effectiveness of high frequency to traditional SCS therapy for back and leg pain. Researchers treated 90 patients with high frequency therapy while 81 received the traditional SCS. After three months, 85% of back pain patients, and 83% of leg pain patients reported a 50% or greater reduction in pain, while only 44% of back pain patients and 56% of leg pain patients in the traditional SCS group experienced a 50% reduction in pain.

Also, more patients (55% to 32%) in the high frequency group stated that they were “very satisfied” with their pain relief. Patients of the high frequency treatment didn’t experience any paresthesia, which is commonly associated with SCS.

SCS Questions

  1. What is SCS?

SCS is therapy that delivers low-level electrical signals to the spinal cord or to specific nerves in order to block pain signals from reaching the brain.

  1. How does SCS work?

A device is implanted in the back near the spinal cord through a needle and generator is placed through a small incision in the upper buttock. The patient is able to adjust the intensity of the signals or turn the current on or off.

  1. How does the SCS stay charged?

It depends on the device: some SCS systems have a pulse generator, which is like a battery, some have a rechargeable pulse generator system that can be charged through the skin, and others do not require recharging but last a shorter time before they need to be replaced.

  1. How much higher is the high frequency SCS?

The high frequency SCS pulses at 10,000 Hz, while traditional SCS has a frequency between 40 and 60 Hz.

  1. What is paresthesia?

Paresthesia is a sensation such as tingling or buzzing that is commonly associated with SCS. It is thought to potentially mask a patient’s perception of pain, and is often distracting or uncomfortable, thus limiting the effectiveness or desirability of SCS treatment.

  1. What are the risks of SCS?

SCS doesn’t address the source of the pain; it merely interrupts the pain signals sent to the brain from your body. If you have pain that stems from a correctable anatomical problem, it is probably best to look for treatment that will address this problem first. SCS also involves an implant and surgery, which naturally comes with risks and potential complications.

            These include:

  • Allergic reactions to the implanted material
  • Bleeding
  • Infection
  • Weakness, numbing, clumsiness, paralysis
  • Fluid lead from the spinal cord
  • Migration of the electrode
  1. What is this treatment called?

The treatment is being called HF10™.


This study is just the first step in a new treatment that could bring relief to people suffering from chronic pain. We encourage you to speak with your doctor before starting any sort of treatment.


Can Your iPhone Tell You if You are Depressed?

Smartphones are getting smarter, and the desire for convenience and streamlined administration is at an all-time high. We have taken a look at how Skype doctors could potentially influence your medical treatment, but what if your smartphone could predict depression without the help of a medical professional? A new app claims to be able to identify people who are at a higher risk for depression.

The Purple Robot

The “Purple Robot” is an app in development at Northwestern University. While it isn’t available to the public yet, the app was able to identify 87% of participants who were determined to be at risk of depression. How? By tracking GPS data that showed how much users moved between their regular locations. The more users moved, the less likely they were to be considered at-risk.

The Purple Robot also could detect 74% of higher-risk participants by figuring out who used their phone the most for texting, playing games, and checking social media. Talking on the phone more frequently, on the other hand, was not indicative of a greater chance of depression. Unfortunately, there wasn’t enough data, probably due to the small number of participants in the study, for researchers to determine the effectiveness of the app using both GPS and phone usage trends.

Pros and Cons?

Currently, this app only can tell you if you have an above-average chance of having depression and cannot diagnose it. While it certainly could help people to recognize if they need to see their doctor to discuss their potential depression, it could also potentially incorrectly identify you for being at risk. The test in the study used a low cutoff score, so it may have identified people for being at risk when they actually weren’t.

The Purple Robot is still in testing, and its developers at Northwestern University are planning on including more data, such as how long people talk on the phone and who they talk to, into the analysis. They are also encrypting the data, which provides some peace of mind for those who are concerned about data leaks.

Even if the app is changed to become more accurate, the GPS capabilities may be a turn-off for some people. Especially due to the hype surrounding multiple recent data hacks, having your GPS location at risk is definitely something to consider before using this app.


Since this app has not been revealed to the public, we don’t know quite what effect it would have on the disability insurance claims process. We do, however, recommend that you are cautious about the apps that you use that involve your health, especially if you think you may eventually have to file for disability.

We would also advise that you speak with your doctor if you think that you may be depressed. While these apps may assist you in realizing that you need to seek help, they aren’t yet able to substitute for diagnosis from a medical professional.