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Are You Prepared for a Disability?
By Barbara Anan

It was late August last year and, following my usual half-day in the office on Saturday, I was looking forward to heading off to Rehoboth Beach, Del., for a few days of relaxation.

My husband and I arrived on Sunday, and the following morning set off on a bike ride along the boardwalk and down this quaint beach town's many side streets.

This pleasure trip turned to tragedy, though, when I blacked out and crashed to the ground.

When my husband didn't see me in his bike mirror he retraced his path and found me lying bleeding and unconscious on the ground, in the throes of a seizure. A passerby called an ambulance on a cell phone and I was rushed to the ER.

Learning to walk

A physician there took care of some sutures for a cut around my left eye and a neurosurgeon was brought in to diagnose the extent of my injuries. The diagnosis: a left temporal lobe contusion that caused a subarachnoid hemorrhage.

After the neurosurgeon performed a life-saving craniotomy and subsequent tracheotomy, I remained unconscious for eight days.

The etiology of the bike accident was and is still unknown. Tests have ruled out a myocardial infarction and an aneurysm. At 50, I have suffered from hypoglycemia for 29 years, but have no other medical conditions.

When I regained consciousness from this traumatic brain injury, the CCU nurse said that after I adjusted my glasses, my first words were, "I have patients tomorrow morning at 8:00."

But now, a year after the accident, I am still unable to provide care for my patients, and have had no choice but to sell my practice to the optometrist who filled in for me during my recovery.

My preliminary rehabilitation (I still suffer side effects of my brain injury) took five months and was a grueling journey. When I was transferred to a rehabilitation hospital, I could not sit up or walk. I had to relearn everything — how to lift a fork and glass, how to bend over to reach a pot in the kitchen cupboard, how to walk up and down stairs and shower. It wasn't until three weeks after the accident that I could walk unaided.

I have now regained functioning of numerous systems, but my vision and cognition still suffer the after-effects of my injury. I work on building muscle strength and body balance daily, and to this day, often walk with my head down to keep from falling. Shopping was and still is a chore. At first, the overload of visual and auditory stimuli made it unbearable to be in any store. I experienced dizziness and saw double.

At the end of January this year I was finally able to begin driving again, and went to the grocery store by myself. However, I still required help unloading my items onto the conveyor belt and carrying bags to and from the car.

I have had an extremely difficult time accepting the seriousness of the injury I suffered and the fact that it will have long-lasting effects on my lifestyle and daily functioning.

Still in recovery



Additional Resources
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In Summary
The Attorney: You should have the following personal emergency documents — a living will that details terms of life support and a general will that delegates power of attorney.

"It is advisable to expressly give the power of attorney for both your business and personal checking accounts," says Washington, D.C. attorney David Lynn.

This should also include any additional bank accounts for the business, such as savings. "It is necessary to arrange how the covering physician will be paid and what business management responsibilities they will have," Lynn adds.

The substitute doctor should have in his possession a key to the office just as a neighbor should have a key to your house. The covering physician also should have the name and phone number of your attorney and accountant, adds Lynn.

The Accountant: It's a good idea to meet with your covering physician before a disability occurs and go over the financial aspects of the practice, according to Mike Healy, a CPA with Goodman and McAllister in Rockville, Md. That means lining up a probable substitute ahead of time.

Make sure your spouse knows where all important practice papers, files and checks are kept, as well as the location of your safe deposit box. Equally important, he or she should know your account PIN numbers in these days of electronic transactions.

Other important numbers include the practice's federal tax ID number.

Make a list of which managed care plans your practice participates in, who does the billing, and how filing and payments are processed.

For physicians who use computer programs to write checks, balance accounts and keep patient financial data, "make sure your spouse knows your password for entering the system," Healy says.

The Financial Consultant: The physician's spouse should have the name of his or her financial planning firm and the consultant. "Depending on the type of retirement plan you have, you can withdraw money to meet financial obligations," says Ricardo Rosenberg, a vice president with Prudential Securities in Washington, D.C.

Various plans are subject to different tax levels on withdrawals that are used for disability. Find out whether your plan taxes only on the amount withdrawn or if a penalty tax on early withdrawal is assessed as well.