As the USS Abraham Lincoln heads home, concerns mount over how the military treats mental health
BLUF – As the USS Abraham Lincoln returned from its 322-day deployment, reporting highlighted concerns about sailors’ mental health, including eight suicide attempts across the strike group, while veterans and mental health experts questioned whether the military adequately recognizes and responds to psychological distress associated with prolonged deployments. For Navy Medicine, these concerns reinforce the importance of accessible behavioral healthcare, early intervention, reducing stigma around seeking treatment, and sustained mental health support after deployment.
Cost of Living Adjustment & Benefit Increase Rider: Crucial Disability Insurance Coverage Elements for Military Physicians
(DI4MDs.com is my preferred partner for disability insurance. They got me mine! Check out their article below. It is not a classic paid post you’ll see on some other blogs, but they have donated in support of the blog.)
Your ability to practice your specialty represents millions in career earnings and the military’s disability insurance benefits do not protect your total income. Your window to lock in critical protection for your total compensation is widest right now. Your annual military medical exam, while valuable, works against you when trying to medically qualify for individual disability insurance.
Leverage DI4MDs and our significant experience designing custom policies for our military physicians to build a policy that best protects your hard-earned income. We build plans that get the most out of your individual disability coverage now, by adding cost-of-living protection, and grow with your income in the future with a benefit increase rider.
Why military physicians should strongly consider a Cost-of-Living Adjustment (COLA) Rider
As a military resident physician, your initial individual disability insurance benefit maximum is $3,000 a month. Since this initial monthly benefit is lower, and it can take time for your income to qualify you for a higher monthly benefit, a COLA rider helps protect your purchasing power if a disability occurs before you’re earning enough to qualify for a higher benefit.
What COLA does
A COLA rider automatically increases your monthly disability benefit by 3%, compounded annually, starting after 12 months of disability. The longer you’re out on a disability claim, the more your disability benefit grows. Here’s what that looks like over time, using $3,000 as the monthly benefit at time of disability claim:
| Years on claim | Monthly benefit amounts with COLA Rider |
| Start | $3,000 |
| 5 years | ~$3,478 |
| 10 years | ~$4,032 |
| 15 years | ~$4,674 |
| 20 years | ~$5,418 |
Why a Benefit Increase Rider (BIR) is a must have feature
Because your initial individual disability insurance benefit is capped at $3,000 a month during your training and your income will not allow you to qualify for more until you become an attending and / or moonlight, you want to be able to increase your monthly benefit later regardless of changes in health / medical records in the interim. Our clients need flexibility to maximize their coverage as their income grows throughout their career, especially post-separation. That’s why the Benefit Increase Rider (BIR) is a must for military physicians. In short, a BIR protects your ability to increase your monthly benefit in the future up to $30,000 per month
- without new medical review
- and using the same discounts you locked in for your initial monthly benefit
Military physicians often moonlight with private practices for civilian pay. This represents a large amount of uninsured income that typically grows over time. Non-base pay can account for most of a military physicians’ income while they’re on active duty, and certainly post-separation. This income is often overlooked and requires income protection. Here is an example from one of our military physicians:
| Base Pay | $7,881 per month |
| Incentive Pay and Bonus Pay | $5,583 per month |
| Total Military Pay | $11,117 per month |
| Civilian Pay | $5,000 per month |
| Total Compensation | $18,464 per month |
| Uninsured income Individual Supplemental Disability Insurance Monthly Benefit | $10,583 per month $6,800 per month |
In this example the military only protects our physician’s military base income. This physician initially had only 40% of her income protected. Additionally, this benefit is taxable as income, further reducing this physician’s total coverage. Disability protection should replace at least 60% of income.
The solution for this under-insurance risk lies in designing custom individual plans that grow with folks’ income over time.
What The Benefit Increase Rider (BIR) does
The BIR allows you to apply for additional monthly benefit as you earn more income over the course of your career without additional medical approvals. With a benefit increase rider, you are able to maximize your coverage (up to $30,000 per month subject to income qualification) at regular intervals up to age 55. There is also a special window you can use to apply for more coverage if your income has increased 30% or more within the last 90 days, such as when you complete training or military service.
Post-separation, military physicians often qualify for substantially more individual income protection. Most importantly a BIR secures coverage increases with no additional medical underwriting. Typically, insurance companies review signed employment contracts, W2, paystubs, or 1099 documentation, and VA disability benefits to determine the amount of coverage increase they offer.
Why these riders are so critical for military physicians
- You can’t buy more base coverage – Since $3,000/month is the maximum benefit you are eligible to start with during residency as a military physician, the COLA rider is one of the few ways to grow the real value of your benefit without medical review during this stage of your career. As your income grows and you separate from the military, you can secure the ability to increase your monthly benefit before a disability with the BIR without new medical review
- You’re early in a long career – If a disability strikes during your residency / fellowship, you could be out on claim for decades. Compounding has more time to work in your favor. You will earn more as you grow in your career. Lock in the ability to increase your coverage in the future now when you start your individual disability insurance policy.
- Military service limits your starting benefit – Protecting your modest starting benefits from inflation matters more when there’s less cushion to begin with. Safeguard future earnings and ensure you can increase your coverage over time.
The Cost
COLA – Just $12-17 a month (about $144 – $204 / year) for this valuable income protection.*
* Based on a 30-year-old male outside CA, using all medical specialties
BIR – no cost to include on your policy. Any cost is quoted later when you exercise the option to increase coverage and is dependent on the additional monthly benefit qualified for and age at time you utilize the BIR.
Important things to know about COLA + BIRs
COLA provides the strongest value during a long-term disability, so physicians under age 50 should strongly consider adding it to their policy, it doesn’t do anything if you do not become disabled or have a claim less than 12 months. But, given how low the premium is relative to what’s being protected, it’s a small price to pay for meaningful long-term security when you are starting coverage early in your career and cannot qualify for more than $3,000 / month in income protection.
BIR only comes into play if you plan on earning more than your military physician salary and plan on separating and earning civilian pay. Many military physicians do at least some moonlighting and will ultimately practice outside of the military. For these physicians adding the BIR is massively impactful.
Have questions about structuring your disability coverage? Reach out — we’re happy to walk through your options.
Andy G. Borgia CLU
D.K. Unger
Jenna Borgia Karamanos
858-523-7518
Tricare and FEDVIP Open Seasons: When to Enroll and What You Can Do
BLUF – Military.com explains that TRICARE Open Season allows eligible military families and retirees to enroll in or switch between TRICARE Prime and Select, while the separate Federal Employees Dental and Vision Insurance Program (FEDVIP) open season permits eligible beneficiaries to enroll in or modify dental and vision coverage; outside these periods, changes generally require a qualifying life event. For Navy Medicine, the annual enrollment period provides an important opportunity to educate beneficiaries about coverage options, provider networks and continuity of care, particularly for families facing specialty-care access challenges or transitioning to retirement.
Soldiers seriously wounded in Iranian drone strike tell AP the military’s medical system failed them
BLUF – Nine U.S. soldiers wounded in the March 1 Iranian drone strike at Port Shuaiba, Kuwait—which killed six troops and injured dozens—told the Associated Press that inadequate mass-casualty planning, evacuation problems, administrative errors and delayed recognition of serious injuries, particularly traumatic brain injuries, left them struggling to obtain appropriate treatment, while the Pentagon maintains that wounded personnel received appropriate evaluations and care. For Navy Medicine, the experience highlights critical requirements for large-scale combat operations: forward trauma capability, rehearsed casualty evacuation plans, reliable patient tracking and medical documentation, early TBI screening, and seamless continuity of care from the point of injury through Landstuhl and stateside specialty treatment.
Stay or Go Tool to Review
Dr. Mitch Day (an Active Duty Internist/Flight Surgeon) built a tool called Stay or go? that estimates Navy physician pay and compares military and civilian compensation, including retirement benefits:
As he approaches his own decision point, he developed this interactive tool for a graduate class project to explore how compensation, civilian opportunities, and pension eligibility affect the financial trade offs of staying in Navy Medicine versus separating. It’s as much an emotional decision as a financial one, and he hopes the tool helps clarify one part of that choice. He’d welcome feedback on its assumptions and usefulness.
Please send feedback to jday6@hawaii.edu.
USS Abraham Lincoln Returns to San Diego After 10-Month Combat Deployment
BLUF – The USS Abraham Lincoln returned to San Diego following a 321-day deployment during which its carrier strike group spearheaded U.S. naval combat operations against Iran, demonstrating the Navy’s ability to sustain prolonged, high-tempo operations far from home. For Navy Medicine, the deployment highlights the importance of sustained medical readiness, resilient logistics, behavioral health support and post-deployment recovery for sailors returning from extended combat operations.
Naval Special Warfare Command failed to identify, treat TBI in service members: Watchdog
BLUF – A Defense Department Inspector General investigation found Naval Special Warfare Command repeatedly failed to identify, evaluate and provide follow-up care for Special Warfare Combatant-craft Crewmen with potential traumatic brain injuries, including 634 TBI exposure reports from 2020–2026 without a single documented MACE-2 concussion assessment or required follow-up appointment. Navy Times For Navy Medicine, the findings highlight major gaps in concussion screening, corpsman protocols and continuity of care—particularly for repetitive wave-impact injuries—and the IG recommended standardized TBI assessment criteria and stronger mechanisms to ensure required medical follow-up occurs despite operational pressures.
Navy Medicine Stories – Ep. 3: The Science of Seeing, the Art of Healing
BLUF – In this episode of Navy Medicine Stories, we sit down with U.S. Navy Hospital Corpsman Shokoufeh Shadabi, who is preparing for medical school through the Enlisted to Medical Degree Preparatory Program at the Uniformed Services University. Pursuing her lifelong passion for fine art, her micro-miniature historical paintings the size of postage stamps have earned places in the Salmagundi Fine Art Club in New York City, the Naval History and Heritage Command, and the permanent collection of the National Veterans Art Museum. Tune in as she shares her miliary service, medical aspirations and artistic devotion as a unified calling dedicated to the care, readiness and well-being of service members and their families.
https://www.dvidshub.net/audio/94138/navy-medicine-stories-ep-3-science-seeing-art-healing
For This Navy Doctor, Studying Death Is Part of Serving the Living
BLUF – Navy Lt. Cmdr. (Dr.) Emerson Maniwang, a 2019 USU graduate and former Seabee battalion surgeon, is completing a forensic pathology fellowship at the Georgia Bureau of Investigation to develop expertise in determining causes of death, identifying remains and recognizing mortality trends that can inform public health and prevention. For Navy Medicine, his training demonstrates how forensic pathology can improve combat casualty care and force protection by identifying preventable deaths and potentially survivable battlefield injuries while preparing medical teams for casualty identification and mortality analysis during large-scale combat operations.
https://news.usuhs.edu/2026/10/for-this-navy-doctor-studying-death-is.html
Navy Medicine Force’s Focus – 1 OCT 2026
BLUF – The Office of the Navy Medicine Force Master Chief has released a publication designed specifically for active duty and reserve Hospital Corpsmen across the fleet and operating forces. Developed directly from fleet feedback, the two-page newsletter serves as a direct line of communication from the Force Master Chief to provide actionable career management tools and highlight operational excellence within the Hospital Corps rating.