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Income Protection Journal Podcast

Income Protection Journal Podcast

Di: Jamie K. Fleischner CLU ChFC LUTCF
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 Income Protection Journal Podcast: Latest on Disability Insurance, Life Insurance & Long-Term Care Insurance with host Jamie Fleischner, CLU, ChFC, LUTCFJamie K. Fleischner, CLU, ChFC, LUTCF Economia Gestione e leadership Leadership Politica e governo Ricerca del lavoro Successo personale
Episodi
  • Surgeon Realizes His Hands Are His Livelihood [Podcast]

    Surgeon Realizes His Hands Are His Livelihood [Podcast]
    Feb 10 2026
    When I spoke with board-certified trauma surgeon Dr. Nii Darko, DO, MBA, FACS for this episode of The Income Protection Journal Podcast, he started with a moment humiliating in its simplicity. He was cutting up a hospital mattress his town's local rubbish service wouldn't pick up, put a little too much tension on one finger, and felt what he described as a rubber band snapping. The next day he was supposed to drive four hours for a locums assignment. Instead, he went to urgent care, learned he had torn a ligament, and was told a wire would be drilled into his finger. He could not operate for weeks. That story lands differently when you hear it told out loud. In print, it reads like bad luck. In audio, you can hear the shift from annoyance to panic as he connects one small injury to a very large question: How do I bring in cash if I cannot do the thing I am paid to do? I wanted that tension on the record because it captures what young physicians miss in the years right after training. They think the hard part is over. They assume the attending paycheck solves the problems that accumulated during residency. Then the reality arrives with two hands on their throat at once: debt and dependence on income. Dr. Darko and his wife, an OB, started their careers with more than $600,000 in student loan debt, and when they stacked everything else on top of it, he estimated they were closer to $850,000 or $900,000 in total obligations. He did not describe that as a character-building experience. He described it as a set of constraints that quietly decided where they could live, what jobs they could tolerate, and how much freedom they actually had. That is why the episode is not really about debt payoff, even though the debt payoff story is extreme. It is about leverage. It is about what happens when the engine behind every financial plan is one person’s ability to show up and work. Dr. Nii Darko, DO, MBA, FACS, is a board-certified trauma surgeon and the longtime host of Docs Outside the Box, a podcast he launched in 2016 to spotlight physicians building unconventional careers beyond traditional medicine The “too expensive” policy that triggered a deeper problem One of the most revealing parts of my conversation with Dr. Darko had nothing to do with a carrier name or a feature. It was the origin story. He told me he bought disability coverage from someone he met at a club in Miami during his last year of residency. It was “way too expensive,” he said, and that was not even the most troubling part. After he got married, the advisor did not call to review beneficiaries or revisit whether the coverage still made sense. When Dr. Darko and his wife called and said the price was too high, the advisor’s response, in his telling, was essentially: budget better. What mattered was not that he met an advisor in a club. What mattered was what happened next. The couple looked at their finances and realized they were putting more money into disability premiums and a whole life plan than they were putting into student loans and savings. That was the spark. They started asking a question young doctors rarely ask early enough: What are we paying for, and what are we not protecting? In the episode, Dr. Darko described what many residents and new attendings feel but do not say out loud. They believe the attending paycheck turns every decision into an easy decision. He called it a naïveté. He also compared young physicians to athletes who suddenly land in the big leagues without a working understanding of money. The parallel was not meant as an insult. It was meant as a warning. High income does not create financial stability if obligations, lifestyle, and risk are misaligned. The pivot he described was blunt. They kept income protection in place, but at a cost that made sense, and then they attacked the debt with a discipline that made other people think they were insane. They lived on his wife’s part-time salary, sent the rest to loans, and used cash for groceries. At points, they budgeted $200 a month for food. He remembered friends outside medicine looking at them like they had lost their minds. He also remembered the interest. He described watching it fall from $3,000 a month to $1,500 to $1,000 and feeling satisfaction that he could not get from any luxury purchase. His language was not abstract. He said the interest felt like taking money and throwing it out a window. That line does a lot of work because it explains why debt is not just a number. It is pressure. It is an ongoing demand that pushes physicians into decisions they would not otherwise make. They started in October 2014 and finished in January 2017. When he said he felt a “huge monkey” come off his back, I believed him. Then he said something that matters even more for this audience. Paying off the debt did not just change their bank account. It changed his professional posture. It changed how he negotiated and how he interacted at work. It ...
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    34 min
  • Cat Bite Ends Veterinarian’s Career [Podcast]

    Cat Bite Ends Veterinarian’s Career [Podcast]
    Feb 3 2026
    Disability coverage for veterinarians is often treated like something you think about later, after the practice is stable, after the loans feel manageable, after life quiets down. In my conversation with Dr. Michelle Custead, a board-certified veterinary medical oncologist and practice owner, what stood out was how rarely “later” arrives on schedule — and how quickly an ordinary day can turn into a career interruption that no one planned for. Custead runs Ally Veterinary Specialty Center, a boutique referral practice in Waltham, Massachusetts. When we started talking about disability risk, she didn’t begin with dramatic scenarios. She began with the temperament of the profession. Veterinarians, she said, are “a really hardy bunch.” They work hands-on, do hard work every day, and tend not to center themselves. The attention stays on the animal, the client, the case. That mindset is part of what makes veterinarians good at what they do. It is also part of what delays income protection planning until it becomes urgent. When I asked why disability planning feels more culturally obvious for physicians and dentists than for veterinarians, Custead’s answer was blunt in its simplicity. Veterinarians aren’t taught to protect their income as part of training. They aren’t guided through “how to protect your wealth or your income.” And because many vets have made it through years of physically demanding work without being seriously injured, a quiet belief sets in: we’ve been fine so far, we’ll probably be fine tomorrow. The episode turns when Custead starts talking about the injuries she’s seen — not as horror stories, but as normal occupational events. Cat bite makes risk feel unavoidable Cats don’t bite like dogs. Custead described cat teeth as “little, teeny daggers” that can inject bacteria deep into tissue. The wound can close quickly, trapping infection underneath. She’s known “numerous” veterinarians who needed multiple surgeries on their hands to recover from a bite and the infection that followed. Those aren’t minor injuries in a profession built on dexterity, grip strength, restraint, injections, procedures, and physical control of frightened animals. To understand why that matters, you have to listen to the way she describes it. It isn’t dramatic. It’s matter-of-fact, almost routine. And that tone is the point. This kind of disabling event isn’t framed inside veterinary culture as “disability.” It’s framed as something that happens to people who do real work. That is exactly why disability insurance is so often delayed. Equine injuries push the point further. Custead has stories from colleagues in equine practice that are the kind of accidents no one imagines until they’ve heard them once. A horse leaning against a barn door and crushing a clinician’s hands. Fractures on both arms in an instant. A surgeon unable to operate. Again, the important detail isn’t just the injury. It’s how sudden it is, and how quickly “I’m fine” becomes “I can’t work.” There is a common assumption that veterinarians are less exposed than human clinicians. Custead argued the opposite. Many human physicians are not at meaningful risk of being bitten or kicked at work. Veterinarians are. Some veterinarians develop allergies to pets that can worsen over time. And many vets carry the same scale of educational debt as physicians — hundreds of thousands of dollars — without the same institutional compensation structure. When the conversation moved from individual disability to practice ownership, Custead’s perspective shifted from personal planning to operational continuity. As a practice owner, she now feels responsibility not only to colleagues and patients, but to payroll, employees, and their livelihoods. The question becomes: if the doctor can’t work, what happens to the people and patients who depend on that doctor? That’s when disability stops being a personal product decision and becomes a business resilience issue. Custead described building her practice from the ground up and trying to create a culture different from what she had seen elsewhere — a practice where clinicians feel supported and seen by leadership. She spoke about the split that often appears in medical businesses: business leadership in one silo, medical staff in another, with limited communication between them. That disconnect, she said, can generate resentment and burnout because staff don’t understand the decisions being made and don’t feel protected. The conversation does not stay in the safe territory of physical injury. Custead raised a more difficult risk: veterinary mental health. She said that among medical professions, veterinarians are often cited as having an unusually high suicide rate, and that the profession has built a movement around the idea of “Not One More Vet.” She described hearing, with disturbing regularity, about colleagues who have died. ...
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    43 min
  • His Disability Policy Looked Fine — Until a Claim Tested It [Podcast]

    His Disability Policy Looked Fine — Until a Claim Tested It [Podcast]
    Jan 27 2026
    I went into this conversation expecting to talk about claims the way most people imagine them: paperwork, delays, frustration, maybe a denial that needs to be appealed. What I didn’t expect was how quickly the discussion shifted to something more unsettling—the realization that many people buy disability insurance believing they’re protected, only to discover years later that the policy language quietly gives the insurer a way out. In this episode of The Income Protection Journal Podcast, I talk to Mark DeBofsky, an ERISA litigation attorney with more than four decades of experience challenging insurer and plan-administrator benefit denials, is the principal of DeBofsky Law Ltd. and a frequent author, congressional witness, and adjunct law professor on disability and insurance law who has litigated disability claims in federal courts, including cases that helped shape how insurers define disability in the first place. His vantage point is different from brokers, carriers, or consultants. He sees policies only after they’re tested—when income has already stopped, work has already changed, and assumptions collide with contract language. The perspective changed everything. When disability policies get tested There’s a point in many careers when insurance decisions fade into the background. Policies are purchased early, premiums get paid automatically, and life moves on. What came through clearly in this conversation is how dangerous that quiet period can be. Mark Debofsky kept returning to the same idea: disability insurance rarely fails in dramatic fashion. It fails through definitions—through terms that sound reassuring when a policy is sold and become restrictive only when a claim is filed. One case he described has stayed with me. A dentist believed he had own-occupation coverage. When a medical condition limited his ability to practice dentistry full time, he adapted. He taught part time. He earned less than half of what he once made. And then the insurer denied his claim anyway. The denial wasn’t based on medicine. It was based on a single word. The policy said “own occupation,” but it also said benefits wouldn’t be paid if the insured was engaged in another “gainful occupation,” according to DeBofsky. The policy never defined what “gainful” meant. The insurer did—after the fact—by deciding that any work paying more than the median wage in the state disqualified the claim. Hearing that logic explained out loud, in real time, lands differently than reading a summary, DeBofsky said. There’s a moment in the audio where you can hear how routine this kind of reasoning has become inside claims disputes—and how jarring it still sounds when you step back and listen to it. Why true own-occupation isn’t just a checkbox We spent a lot of time talking about own-occupation coverage, not as a feature list, but as something that behaves very differently once a claim is underway. Mark made a distinction that often gets lost in sales conversations. A true own-occupation policy pays benefits if you can’t perform your occupation, even if you go on to work elsewhere and even if you earn significant income doing so. Many policies marketed as own occupation quietly reduce benefits once the insured earns income in another role, reclassifying the disability as partial. That distinction matters most for specialists—surgeons, interventional physicians, dentists, litigators—whose skills don’t transfer cleanly. A minor hand tremor can end a surgical career. A cognitive impairment can derail a trial attorney. In those situations, the ability to pivot shouldn’t come at the cost of losing benefits, but in many policies, it does. What’s striking in the conversation is not just the rule itself, but how often professionals don’t realize which version they bought. Mark talks about this without exaggeration. You can hear how frequently he encounters policies that look protective on paper and behave very differently in practice. Group coverage and the illusion of security Another assumption we challenged in the episode is the idea that employer-provided disability coverage is “good enough.” I hear this constantly from high-income professionals: I have a solid group plan through work. I’ll be fine. What Mark DeBofsky describes is a different reality. Group disability policies are designed to protect salary at a moment in time, not long-term earning power. They usually replace a percentage of income up to a cap, integrate with Social Security Disability, and often switch to an any-occupation definition after a limited period. For high earners, that structure creates gaps that aren’t obvious until work stops. There’s a moment in the conversation where we talk through how insurers decide what “any occupation” means—using vocational assessments and transferable skills analyses that often rely more on internal guidelines than on treating physicians’ opinions. Listening...
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    37 min
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