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Red Flags for Residents/Fellows when Applying for Disability Insurance

Many trainees have discovered that qualifying for an individual disability insurance policy can be difficult.

Insurance companies are notoriously picky and scrutinize health records (sourced from multiple databases of your prescription history, health insurance claims history, and other confidential sources of information about you).

How are insurance companies allowed to know this private information about you?

In addition to self-disclosing your health history by completing an invasive questionnaire, you grant the insurance companies permission to verify your responses by signing an authorization to release confidential information when you apply for a policy.

This is called medical underwriting, and the insurance companies do it to determine whether they will offer you coverage.

Health histories that typically don’t occur to most physicians as being a big deal or clinically significant are often consequential for an insurance company.

Commonly, physicians get penalized for:

-Anxiety/depression/GAD/therapy, and any associated Rx (or self Rx)


-GERD, migraines, Eczema, Apnea

-BMI, surgery, injury, pain, Chiropractic, etc.

Fortunately, trainees at many institutions may be eligible for a special disability insurance underwriting option called a Guaranteed Standard Issue (GSI) program.

As the name implies, GSI programs offer a safety net that guarantees trainees the opportunity to qualify for a personal disability insurance policy with no health/Rx history disclosure, no price penalty, and often no pre-existing exclusions.

But the BIG catch is that you typically forfeit your eligibility for a GSI program if you first apply for a policy by disclosing your health history and are either declined or approved for a policy, but with a penalty (exclusion for pre-existing condition, price increase, modification).

Because of this nuance, it is imperative that you pre-screen your health history before disclosing it to an insurance company.

But caveat emptor! Not all insurance agents are likely to put your best interest first.

A good way to spot whether someone is working on your behalf versus working on theirs is, assuming they ask about your health background up front, if they say in reply to a concern you may raise, “the only way to know is to apply and find out.”

To which you can reply, “Are you aware whether there is a Guaranteed Standard Issue (GSI) program at my training institution?

I want to ask for your written guarantee that my application with you will not impact my eligibility for the GSI program (meaning no modified offer, exclusions, or decline)?”

If you find yourself answering “yes” to anything more than a routine physical, think GSI first:

Have you ever been medically evaluated for, diagnosed with, or treated for:

  1. High blood pressure or high cholesterol levels?
  2. Disorder of the eyes, ears, nose, or throat?
  3. Dizziness, vertigo, fainting, seizures, headache; speech defect, tremor, neuropathy, paralysis, multiple sclerosis, stroke, transient ischemic attack (TIA), memory loss, dementia, or any other disorder of the brain or nervous system?
  4. Shortness of breath, chronic cough, bronchitis, asthma, emphysema, chronic obstructive pulmonary disease (COPD), sleep apnea, or chronic respiratory disorder?
  5. Chest pain, irregular heartbeat, heart murmur, palpitations, heart valve disease, heart attack, coronary artery disease, heart failure, aneurysm, or other disorder of the heart or blood vessels?
  6. Intestinal bleeding, inflammatory bowel disease (including Chron’s disease or ulcerative colitis), hepatitis, diverticulitis, recurrent digestion, or other disorder of the esophagus, stomach, spleen, intestines, rectum, pancreas, liver, or gallbladder?
  7. Sugar, protein, or blood in urine; sexually transmitted disease (excluding HIV); chronic kidney disease, kidney stone, or other disorder of the kidneys or bladder?
  8. Diabetes, elevated blood sugar, thyroid, pituitary, adrenal, or other endocrine (glandular) disorders?
  9. Disorder of the breasts, reproductive system (including infertility), genital organs, or prostate?
  10. C-section, miscarriage, or complication of pregnancy?
  11. Arthritis, gout, lupus, connective tissue disorder, multiple sclerosis, Parkinson’s disease, or disorder of or injury to the bones, muscles, wrists, hips, knees, or other joints?
  12. Spinal, neck or back disorder or injury, including sprains, strains, or disc disorder?
  13. Mass, polyp, cyst, tumor, or cancer?
  14. Allergies; disorder of the skin; anemia, bleeding, clotting, or other disorder of the blood?
  15. Anxiety, depression, stress, attention deficit disorder (ADD), attention deficit hyperactivity disorder (ADHD), post-traumatic stress disorder (PTSD), eating disorder, or other psychiatric or mental health disorder?
  16. Chronic fatigue, chronic pain, fibromyalgia, neuritis, neuralgia, narcolepsy, insomnia, restless leg syndrome, Epstein Barr virus, Lyme Disease, muscle weakness, or fever of unknown cause?

Are you currently pregnant?

Within the past ten years, have you received any speech, physical, or occupational therapy?

Are you currently taking prescription medication or have been prescribed any medication within the past 6 months that was not already disclosed?

Are you currently taking non-prescription medication or supplements?

Other than noted above, have you within the past five years:

  1. Consulted or received treatment from a chiropractor?
  2. Had a checkup, consultation, illness, injury, or surgery; been a patient in a hospital, rehabilitation center or other medical facility; had an X-ray, EKG, heart scan, MRI or CT scan, biopsy, or another diagnostic test?
  3. Been advised by a licensed medical professional to have any diagnostic test, hospitalization, or surgery which has not been completed?

Within the past ten years, have you ever:

  1. Used marijuana, cocaine, heroin, barbiturates, tranquilizers, hallucinogens, amphetamines, narcotics, or any other drug, except as legally prescribed by a physician?
  2. Sought, received, or been advised to seek medical treatment, counseling, or participation in a support group for the use of alcohol or drugs?
  3. Consumed alcoholic beverages?

Have you been diagnosed by a licensed medical professional as having Acquired Immune Deficiency Syndrome (AIDS) or ever tested positive for Human Immunodeficiency Virus (HIV)?

Have you or your immediate family members (parents, brothers, and sisters) died of or been diagnosed as having coronary artery disease, stroke, diabetes, cancer, polycystic kidney disease, or Huntington’s disease prior to age 60?

Hurley Associates works with physicians who are concerned with starting their careers in balance: paying off yesterday, saving for tomorrow, while living a financially confident life today.

As the preferred disability insurance broker for some of the largest graduate medical education programs in America, Hurley Associates has been successful in helping physicians find peace-of-mind with protecting their income, in their medical specialty, and keeping within their budget.

Dan Sklenka is a CERTIFIED FINANCIAL PLANNER™ professional with Hurley Associates.

Registered Representative and Financial Advisor of Park Avenue Securities LLC (PAS). OSJ: 244 Boulevard of the Allies; Pittsburgh, PA 15222. Phone: (412) 391-6700. Securities products and advisory services offered through PAS, member FINRA, SIPC. Financial Representative of The Guardian Life Insurance Company of America®(Guardian), New York, NY. PAS is a wholly owned subsidiary of Guardian. Hurley Associates is not an affiliate or subsidiary of PAS or Guardian and is not registered in any state or with the U.S. Securities and Exchange Commission as a Registered Investment Advisor.

By providing this content Park Avenue Securities, The Guardian Life Insurance Company of America®, and your financial representative are not undertaking to provide advice or make a recommendation for a specific individual or situation, or to otherwise act in a fiduciary capacity. CA Ins. License ID#: 0L77727. 2023-156635 Exp 6/25