by Jim Biesterfelt
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When Scott Calev, DDS, graduated from dental school nearly 30 years ago, a career-ending disability was never on his radar screen. He built a successful practice in Phoenix, Ariz., which eventually evolved into providing care at a reduced fee for low-income single mothers, grandparents raising grandkids, and the children. "I felt that I was filling a very important need," Dr. Calev says.
For almost a decade, he even neglected to buy disability insurance until a good friend in the insurance business learned that Dr. Calev had no disability coverage. "He insisted that I buy a small policy, which I did," Dr. Calev recalls. "Then I bought another policy through the American Dental Association."
Worst-case scenario
Years later, Dr. Calev noticed progressive achiness and swelling in his joints. In 1993, he was diagnosed with psoriatic arthritis. "At that point, I couldn't qualify medically to increase my disability insurance, but I didn't worry about it at the time because I planned to keep working," he says.
Medications enabled Dr. Calev to practice for another nine years until he began losing significant strength in his arms and shoulders, and surgery revealed severe deterioration in his rotator cuff. The best-case scenario: It would take months to recuperate. Worst case: He would no longer be able to practice dentistry. Either way, it was time to file for disability benefits. That's when Dr. Calev learned that an insurer's track record for paying claims and providing service is as important as the coverage itself.
Same facts, different approaches
"The claims examiner for my ADA plan quickly saw the facts in my medical records – my health was compromised," Dr. Calev recounts. "The policy began paying benefits, and now the examiner does a straightforward review once a year."
The other insurance carrier sent a private investigator to Dr. Calev's home and office, interviewed people he hadn't talked to in years, and used what Dr. Calev calls the "trick-question technique" (asking the same question three different ways to see if the answer would change). Eventually, the company agreed to begin paying the claim, but Dr. Calev says they continue to reinvestigate his case to see if he still has a health problem. "It wasn't what I expected, and it made me very uncomfortable," he says.
Dr. Calev admits that it was difficult to sell his practice and accept the fact that he had to leave the "special world of taking care of people" as he puts it. But he didn't sit on the sidelines for long. Today, he is a business consultant to dentists in the Phoenix area and works part-time reviewing dental records for the state of Arizona's refugee program.
Neither job affects Dr. Calev's disability benefits. Because his coverage has an "own-occupation" definition of disability, he receives benefits due to the fact that he cannot perform clinical dentistry, even though he can work in another occupation. In addition, his benefits are not reduced by his other earnings.
Rainy day planning
Asked to share some tips with other dentists based on his experience, Dr. Calev offers the following:
- Plan for a rainy day. "In dentistry, if something happens to your body, the rainy day is here," he says. "So get the insurance you need while you can qualify for it."
- Start early. Dr. Calev is adamant that new dentists should have disability insurance from day one of their careers.
- Check out the insurance company. Research its financial strength and reputation for service and claims-paying.
- Understand the policy. For example, know how disability is defined (such as "own-occupation").
- Review yearly. Dr. Calev recommends circling a date on your calendar to review your coverage and increase it as needed to keep pace with your income.
"When you want to be a dentist, you never want to go on disability," he concludes. "Try to keep a disability at bay with exercise, medications, and adjusting the way you practice. But if you do get to the point where you have to file for benefits, make sure that you have a good insurer in your corner."
Editor's Note: This article does not constitute legal, tax, or financial advice. Please seek professional input as appropriate to your situation.
Jim Biesterfelt is vice president of Group Special Accounts at Great-West Life & Annuity Insurance Company, which underwrites and administers the ADA Insurance Plans and is the sole provider of ADA-sponsored life and disability insurance to ADA members. For more information, call (866) 607-5330, e-mail [email protected], or go to www.insurance.ada.org.
