For Dr. Jones, a flip over the handlebars leads to two surgeries and time away from his practice. See how he managed to keep things afloat with disability insurance.
Posted in Long Term Disability Insurance on Monday, May 18, 2026
David Jones, DC, an avid mountain biker, hit the trails with his son on a Saturday morning. The trail they were traversing was also frequented by people walking their dogs. Unfortunately, about 15 minutes into their ride, a loose dog darted out in front of the pair, causing Dr. Jones to lose control of his bike and veer off the trail.
He careened into a stump and flew over the handlebars, seriously injuring his arm and wrist. The immediate pain, swelling, and lack of mobility made it obvious that a trip to the emergency room was in order.
The Diagnosis
An X-ray confirmed a fracture of the right radius, which would require an open reduction internal fixation (ORIF) to realign the bone. This type of injury meant that Dr. Jones would be unable to practice chiropractic for approximately three months. To keep the practice running, he hired a newly licensed DC on a part-time basis.
A Second Surgery
The surgery seemingly went well, but throughout physical therapy and recovery, Dr. Jones continued to experience pain and instability in his wrist. Doctors determined that his scaphoid bone was also fractured, requiring a second ORIF surgery.
This would mean even more time away from his practice — potentially three or four additional months. To cover the practice, Dr. Jones promoted the part-time DC to full time. At this point, bills were piling up.
Dr. Jones Files A Disability Claim
Dr. Jones had purchased the DC Long Term Disability Insurance Plan, issued by The Prudential Insurance Company of America, a few years prior — just in case.
Based on his income at the time, he’d applied for an $8,000 monthly benefit amount, with a 90-day Elimination Period. He submitted a claim shortly after his injury.
Fortunately, Dr. Jones had enough emergency funds in savings to keep his practice afloat for the initial three months after the injury and first surgery, which served as the 90-day elimination period. Any benefits payable would start thereafter.
How Benefits Were Calculated
When the insurance company received Dr. Jones’ claim, they considered the following to determine benefits payable.
- Before his injury, Dr. Jones was paying himself a monthly salary of $8,000. His practice, of which he owned 100%, was set up as a corporation and produced an average profit of $6,000 per month. This adds up to pre-disability chiropractic earnings of $14,000 per month.
- Dr. Jones’ policy could replace up to 60% of his pre-disability earnings, which is generally the case with group disability insurance plans. So, 60% of his $14,000 pre-disability monthly earnings is $8,400.
- After his injury and resulting surgeries, Dr. Jones reduced his salary to $0 per month to offset the increase in expenses incurred when he hired the other DC. In addition, his practice revenue decreased, resulting in a post-surgery practice profit of $3,000 per month.
- The plan maximum monthly benefit amount, and the amount Dr. Jones had applied for, is $8,000. Based on the above figures, he was eligible to receive the full monthly benefit amount of $8,000.
What Can We Learn
- Chiropractic is a hands-on, physical profession. An injury or illness can easily prevent a DC from being physically able to treat patients.
- Long term disability insurance can provide much-needed monthly benefits for DCs if they are unable to practice and earn an income. Benefits can be used however DCs choose: for personal and practice expenses, or medical bills related to the disability.
- The sooner a disability claim is filed after an injury or illness, the better to avoid unnecessary processing delays.
- One feature of the DC Long Term Disability Insurance Plan is that a recurrent disability within 6 months does not require completion of another elimination period. (In this case, the second surgery was a recurrent disability.)
- When determining benefits payable, earnings include both practice profits and salary.
The above scenario is not based on a single case. Instead, it’s an example of what can easily happen without adequate insurance coverage, based on claims we’ve encountered.
In this example, we assume Dr. Jones paid for his DC Long Term Disability Insurance Plan with post-tax dollars and that benefits were tax free. Indexed earnings were not factored into this calculation.
NCMIC Insurance Services is the exclusive agent for the DC Long Term Disability Insurance Plan. California license #0B84564. IA License #2002515. In NY: NCMIC Insurance Agency. In MI: NCMIC Insurance Services Agency, Inc.
This plan is sponsored by and for members of the National Business Association for Chiropractors (NBAC). Disability benefits payable may be adjusted by other deductible sources of income for which you qualify. Disability insurance does include a preexisting condition limitation.
This plan is not available in Alaska or New Hampshire.
Group Insurance coverages are issued by The Prudential Insurance Company of America, a Prudential Financial company, Newark, NJ. The Booklet-Certificate contains all details, including any policy exclusions, limitations, and restrictions, which may apply. If there is a discrepancy between this document and the Booklet-Certificate/Group Contract issued by The Prudential Insurance Company of America, the Group Contract will govern. In Washington, the controlling document is the Certificate, not the Contract. Contract Series: 83500
This policy provides disability income insurance only. It does NOT provide basic hospital, basic medical, or major medical insurance as defined by the New York State Department of Financial Services.
North Carolina Residents: THIS IS NOT A MEDICARE SUPPLEMENT PLAN. If you are eligible for Medicare, review the Guide to Health Insurance for People with Medicare, which is available from the company.
THIS IS AN EXCEPTED BENEFITS POLICY. IT PROVIDES COVERAGE ONLY FOR THE LIMITED BENEFITS OR SERVICES SPECIFIED IN THE POLICY.
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