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  The cost of the unexpected
Posted September 30, 2002 in Living with ALS

WHENEVER Hugh Pirnie sends an e-mail, it automatically ends with a quote from Albert Einstein:

"There are two ways to live your life: One is though nothing is a miracle. The other is as though everything is a miracle."

Today, Pirnie, a 51-year-old graphic designer and marketing manager, is living on miracles.

The founder of an award-winning design firm, Pirnie saw his world changed drastically on the same day America was shaken by the terrorist attacks.

Pirnie was at the office of his neurologist, who had just delivered a devastating personal blow: Pirnie had a neurological disease that later was confirmed to be the rare Lou Gehrig's disease. The medical name is amyotrophic lateral sclerosis, or ALS, and it is a debilitating fatal disease, the same one that afflicts physicist Stephen Hawking.

"Being told I had a neuromuscular disease on Sept. 11, 2001, just about the same time the airplanes were crashing into the twin towers, made the whole world change completely forever," Pirnie recalls. "There are so many emotional and spiritual issues that a terminal illness brings up, and one of the biggest is financial."

Pirnie has no disability insurance.

When he was laid off in 1996 from a corporate position, he and his wife, Bonnie, a copywriter, canceled their disability insurance policy because of the monthly cost. Money was tight since they were starting their own graphic design business again.

"This was a decision that will haunt me forever," Pirnie says.

Pirnie has had to depend on the largess of others to help pay living and medical expenses. His Web site markmireles.com/mmir/hughpirnie/main.htm states starkly: "I have ALS, and I need help."

The family, which includes a daughter in high school and a son in college, had to adjust lifestyles to make ends meet.

Wal-Mart and thift shops are the norm instead of Neiman Marcus and Foley's. Their son gave up a part-time job to help at home.

The Pirnies still have clients, but their income has dropped by about 90 percent since he can only work two hours a day. Their church raised $5,000 in a benefit concert.

"Anyone who has their own business should have disability insurance," Bonnie Pirnie says. "You think about life insurance, but you don't think about a disabling disease that might keep you from working and keep both of us from working full time. He can't, and I'm taking care of him."

The Pirnies' plight is exactly what the statistics warn about. Consider the following:

In the course of one's career, a person is 3 1/2 times more likely to be injured and need disability than to die and need life insurance, according to the Health Insurance Association of America.

Think you're too young to buy disability insurance? The average 20-year-old worker has a 30 percent chance of becoming disabled before retirement, compared with a 17 percent chance of dying before retirement, the Social Security Administration says.

And finally, one more sobering statistic: About 30 percent of all those 35 to 65 will suffer a disability for at least three months.

One in seven will become disabled for five years or more, according to the Health Insurance Association of America.

"I try to push disability insurance more than life insurance," says Michael Parmet, a certified public accountant and principal of Parmet Chapman Key in Houston. "Most people think they'll never use it. They're very resistant to providing it for their employees and somewhat resistant to providing it for themselves."

It's expensive for individual policies.

An individual disability premium for a woman who is 45 and earns $50,000 a year will cost about $116 a month. That will give her a benefit of $3 ,000 a month. A 55-year-old man earning $55,000 a year will pay $133 a month for a $3 ,000 monthly benefit.

A 50-year-old man earning $100,000 a year would pay $222 per month for a $5,000 monthly benefit.

"The younger you are, the cheaper it is," says Tim Johnson, an employee benefits consultant and owner of the Johnson Group Insurance. "If you buy a contract and lock it in, typically your premium will stay the same price."

But most entrepreneurs don't have disability insurance on their radar screen.

"The type of individual who opens his own business is a very ambitious, creative thinker. They have the sense they can do it all, they don't need any help, they don't need any protection. They just need someone to educate them on what their liabilities are," points out Debra White Stephens, a certified financial planner at Financial Network and former president of the Houston chapter of the International Association for Financial Planning (now the Financial Planning Association).

Stephens, whose clients are mostly small-business owners, says she typically must bring up disability insurance to the entrepreneurs.

"The disability creates unique financial needs, much more so than a death," she says, explaining that in addition to loss of income, one must pay extra medical expenses not covered by health insurance.

Most experts say business owners should structure their disability insurance so they will receive benefits tax-free by paying the premium with after-tax dollars. If policyholders choose to take a tax deduction on the premium, they will later be taxed on the benefits.

How much disability insurance should business owners buy? Most disability carriers only allow you to buy enough to cover 60 percent to 70 percent of your income - enough to cover all your bills. But before you rush to buy that amount, Stephens says its important to analyze all your expenses, assets, investment income, and income from a spouse, trust or inheritance.

Common mistakes Stephens warns against:

Buying a maximum monthly benefit that is too low. When disability is offered through the health insurance carrier as a group policy, often the benefit amount mentioned in the contract is $5,000 a month. While that may be adequate for the rank-and-file employee, it may not cover the needs of the business owner. For only pennies more on the dollar, you can increase coverage to $10,000 a month.

Not defining "disability" in a way that allows you to keep your benefits until you're able to return to your occupation. Most contracts says you are "disabled" if you are unable to perform the substantial and material duties of your own occupation for the first 24 months. After that two-year period, many carriers stop paying disability benefits if you can perform any occupation you are reasonably suited for by training. But that may not be what you want. For example, a surgeon who is disabled may not be able to operate but can still teach.

This has not been much of an issue since inflation has hovered at 1.1 percent, but those who recall double-digit inflation in the 1980s know what happens when income doesn't keep pace with inflation. Of course, adding a rider like this will increase the premium.

If a business owner has a 20 percent or more reduction in earnings as a result of a disability that limits working hours, the owner can collect a partial monthly disability benefit.

Getting group disability insurance before buying an individual policy. Stephens says if you already have a group insurance policy in place, it is highly unlikely a carrier will sell you an individual policy because the carrier believes you are adequately covered under the group policy. Although a group policy will give you coverage, no questions asked, Stephens warns that a group policy is not as high-quality as an individual one that requires that you qualify for it medically.

UnumProvident and the Principal Financial Group in Des Moines, Iowa, are excellent carriers of disability insurance, Stephens says.

Clients who are considered high-risk medically - for example, someone who once took antidepressants - can usually find coverage with Lloyd's of London. When choosing a carrier, Johnson, the benefits consultant, says consumers should find out how long the carrier has been in business and how long it has been writing disability policies.

A 50-year-old insurance company that has been doing disability insurance for 25 years is a good sign. Also, choose a company that sells a lot of disability insurance and that has local representation.

Find out about the steps to processing a claim - before you need to do so, Johnson advises.

Parmet, the accountant, says all small-business owners need two types of disability:

Business continuation insurance, which provides ongoing income for the business for two years to ensure an orderly shutdown and make the enterprise a sellable one.

Individual policies for owners.

Architect Michael Cooper, a founding partner of Ziegler Cooper Architects in Houston, says he is grateful he bought disability insurance 16 years ago when he was 36.

This past year, he has had two operations - on his Achilles tendon and spinal surgery to fuse four vertebrae - that have put him on disability twice. The first time he was out four months. Four weeks ago, he was out for his spinal surgery and this week is returning for only 12 to 15 hours a week.

"Two policies right now are almost covering my monthly income," says Cooper, whose wife is a full-time mom to their three sons.

Cooper admits he might not have bought disability insurance if it hadn't been for his financial planner, Stephens, suggesting it, followed by his father-in-law dying from Lou Gehrig's disease at 62 without disability insurance.

"It depleted his finances completely," Cooper says. "It was really hard - his 401(k), all his IRA plans."

In the meantime, friends of Hugh Pirnie in the creative arts community are gearing up to help him.

Phil Morabito, chief executive and founder of Pierpont Communications, is organizing a committee of 20 partners who will commit to raising $2,500 a year for three years, totaling $50,000 a year.

So far, seven people have made that commitment, including Larry Smith, chief executive of Somerset House Publishing, the oldest publisher of limited edition of fine art prints and one of Pirnie's former employers.

"As a small-business owner, you realize the critical nature if you get ill. It can have an impact on your business," Morabito says. "I know Hugh Pirnie, and he's always been such an honest, hard-working guy. It's been a very, very feel-good project."

Working on this has prompted Morabito to re-examine his own disability insurance to make sure he has enough to cover his needs.

Pirnie says that in the beginning, asking for help made him feel like a failure. Now he has learned to accept help graciously and thankfully, and has realized he is giving others a chance to feel good about themselves as they help someone else.

But he warns: "Don't live your life like there are hundreds of tomorrows. If you do not have disability insurance, get it tomorrow. Let me be the example of what happens when you don't plan for the unexpected."

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