Harder, better, faster, stronger

Matias Ferreria was born in Uruguay and emigrated to America when he was three. Throughout his childhood, he was an athlete, and went on to play football, baseball and wrestling in high school. Like many immigrants, he was intensely patriotic, and in 2009, he joined the United States Marine Corps, trained as a machine gunner and became part of the 1st Batallion, 8th Marines assigned to Operation Enduring Freedom in Afghanistan.

In early January 2011, Matias took part in a large Coalition operation to secure a town in Helmand Province against the Taliban. Helmand, along with Kandahar, are the most dangerous parts of the country, where most Coalition casualties have occurred. The town was on the far side of a wadi, or dry riverbed, and since so many Coalition convoys had been blown up crossing such terrain, the SOP was to approach the town on foot first.

After initial reconnaissance reported the town as clear, Matias’s team moved in to set up a firing position. They selected a flat-topped building that had an excellent view of the surrounding area. To get there, Matias and his fellow soldiers climbed to the top of an adjacent pump shed and ascended to the roof from there.

Once the first team members were on the roof, Matias headed back to get the rest of his gear and his guys. Everything went according to plan until he jumped from the rooftop and landed on top of the pump shed, and he lost a few seconds of time. Suddenly he was on his back, with fellow soldiers screaming at him to stay still. Confused, and in deep shock, Matias eventually felt some pain in his lower body. That was when he noticed his helmet flashlight had been knocked loose and dangled before his eyes.

Instinctively, he checked his gear. Unlike a lot of his fellow soldiers, he had not removed his body armor once the town was thought to be clear. This was common practice for those who found the gear hot, bulky and uncomfortable. But Matias had kept his on, as well as his impact-resistant Oakleys. He searched for his 9mm sidearm. Still there. He couldn’t put his finger on what was out of place, just that he was suddenly starting to hurt badly. Then he realized what was missing wasn’t any of his equipment. It was his legs. Both of them, below the knee.

When Matias landed on the pump shed, he crashed through the roof and triggered an improvised explosive device hidden inside. IEDs killed 292 Coalition soldiers serving in Afghanistan in 2011, accounting for just over half of all Coalition combat fatalities that year. Matias probably would have been one of them had he removed his armor.

The snipers he teamed with called in a medevac and within 30 minutes, he was on his way to Bagram, where surgeons stabilized him so he could be sent to Germany, where he underwent more emergency surgery. A third round of surgery awaited him at the Walter Reed National Military Medical Center in Bethesda, Maryland. While in the ICU, he was finally able to see his family for the first time since the explosion. Because the blast had shattered his femur and broke his pelvis, he faced a long recuperation before he was transferred to the last, longest and most difficult phase of his recovery: therapy.

Staying in Walter Reed, Matias recalled, was like living in a hotel. Surrounded by fellow wounded soldiers, there was an instant camaraderie that helped cushion the realization that he had suffered a deeply debilitating injury. He had been in the war for only a few short months before he had been taken out of it, but that was not the worst part. The worst part was when Matias broke down in tears, realizing he would never play football again, never dance again, never go out with his friends again. His life, as he had known it, was over.

*

According to a 2001 World Health Organization report, more than one billion people across the planet live with some form of disability. Of these, some 200 million (roughly equal to the population of Brazil, the world’s fifth-most populous country) have conditions such as quadriplegia, severe depression or blindness, which impose serious difficulties in normal daily functions.

These numbers are only going to increase due to aging populations and a global increase in chronic health problems such as diabetes, cardiovascular disease, cancer and mental illness. In fact, they already have gone up; some 15% of the world’s population is currently considered to be disabled in some form or another. In 1970, that number was only 10%.

That same WHO report listed a host of possible ways to address global disability challenges, ranging from legislation, national awareness campaigns, accessibility standards for buildings, UN data collection, improving employment standards for workers with disabilities, and research on how physical limitations affect one’s quality of life. Incredibly, none of the 40 plus recommendations offered was for people to buy disability insurance.

Disability insurance is the oft-forgotten stepchild of the personal life and health insurance family. It is the one product that people do not prefer to buy in person; they would rather get it through work. Only one percent of consumers actually go looking to buy disability, and only 18 % of consumers can remember ever being approached to buy some. And even when somebody is poised to buy coverage, the factor most likely to turn them off is cost, which relegates the product from a must-buy to a maybe-later proposition.

According to industry statistics, the disability market collected some $473.1 million in premiums in 1996. That grew slowly but steadily, year over year. By 1999, disability premiums reached $481.8 million. By 2003, they reached $544.7 million. By 2006, $592.2 million.

In 2007, premiums jumped to $621.8, and went to $640.5 in 2008, but then came the Great Recession, and in 2009, premiums fell to 2005-06 levels, and they have never quite recovered. And while these numbers might seem large, they are chump change compared to what people pay for health insurance, life insurance and annuities.

That Americans would be so unengaged over this kind of coverage (and that the industry is less-than-zealous about selling it) flies in the face of a serious and growing need. According to LIMRA, the Windsor, Conn.-based insurance research firm, more than 70 percent of American households rely on two incomes to make ends meet, and ever since the economic downturn of 2008-2009, the prospect of a breadwinner suddenly experiencing a debilitating health problem without some kind of safety net spells financial doom. (The risk of foreclosure due to disability is 16 times greater than the risk of foreclosure due to death, says the National Safety Council.)

Moreover, disability is increasingly a product older Americans are turning to as they face increasing longevity and the health problems certain to come with it. Americans in the 50-59 and the 60+ age brackets both increased how much disability they bought in 2008 by double digits, something that cannot be said for any other age group. Disability statistics from Cornell University for 2009 noted that 26 percent of Americans ages 65 to 74 had disabilities. That number almost doubles for people 75 and older.

When it comes to people like Matias, in the 21 to 64 age bracket, only 10.4 percent of people have a disability. Moreover, this group suffers from a 67% unemployment rate.

The irony of all of this is that while Americans are deeply underinsured when it comes to disability, that might not be such a bad thing for insurers. According to Unum, one of the largest writers of disability coverage, nearly one in three Americans ages 35-65 will become disabled for more than 90 days. Once somebody is disabled for 90 days, their average disability claim is two years. More than 20 million Americans suffer disabling injuries each year, some two-thirds of which are not covered by workers compensation.

For disability insurers, what this means is that their greatest challenge isn’t selling more policies. It’s figuring out how to keep the claims from bleeding them white while remaining sensitive to the fact that nobody really wants to go on disability. Ask any disability insurer why they want to get policyholders back in the saddle, and some will say because it contains costs. But others will say because at some point, disability isn’t just about money. It’s about rebuilding people’s lives.

*

Back at Walter Reed, Matias dried his tears and let his Marine training kick in. When he first joined the Corps, an old, retired colonel once told him that the reason why Marines can get so many things done, despite the odds stacked against them, was because they can resolve mentally to achieve a task and let their bodies take over, running automatically from muscle memory. They remove from the equation that interface between mind and body that, once pain and fatigue kick in, allows the mind to build an argument to to convince the body to stop. Marines make that internal conversation impossible when they have to, and now, Matias realized he would have to do the same with himself regarding his injury.

He could no longer try to be the person he was, he told himself. And that was all right. He had nothing to prove to the world; his service had done more than enough of that already. Now, he just had to prove to himself that he would walk again.

It would not be easy. Some four months after his injury, he was finally moving around again. He started taking daily walks down the hallways of Walter Reed to the facility’s training center. One day, it was there that he met two women from Achilles International, an outreach group that worked with people with disabilities to help them train for, and compete in, athletic events. They wanted to know if Matias would be interested in riding a handcycle.

Handcycles are specially designed, three-wheeled bikes that can be pedaled with one’s hands. It sounds easy to ride one. And it is, for short distances. Try riding one for 20 miles, and one will learn just how poorly conditioned their arms really are.

At first, Matias was skeptical about the handcycles, but he figured if riding one might improve his condition, why not? He joined other wounded vets at Walter Reed on handbiking trips around Washington, D.C., just to get into shape, but very quickly, it turned into something more. Doing these workouts became a routine event for Matias and his colleagues, all of whom had been athletes of some kind or another, now in search for some new way to rebuild their physical ability.

Achilles would visit Walter Reed once a month to organize workouts and slowly, Matias worked himself up to the point where he signed up to ride in the Achilles Hope and Possibility 5-Mile race in Central Park, New York, on June 26, 2011. He handcycled it, but he knew he could have walked it. He resolved that in 2012, he would run the race. In the meantime, he began handcycling longer and longer distances.

Working with Achilles volunteers, he ran in a Navy 5-miler on September 25, 2011, which he dedicated to Edwin Gonzalez, a friend of Matias’ and a fellow Marine who was killed in Afghanistan. After that, Matias followed his physical therapist’s suggestion to run in an Army 10-miler on October 3. On October 16, he handcycled all the way through the Detroit marathon.

His next race was his first running with an Achilles Freedom Team of Wounded Veterans, a special support group within Achilles that was dedicated to helping injured military personnel. It was a Marine Corps 10K on October 30, in which Matias ran alongside a close personal friend who had served in Afghanistan, as well as his own father, who was a cancer survivor. On November 6, he handcycled the New York marathon.

His next objective? The Disney half-marathon on January 7, 2012. He had taken handcycling as fas as he wanted, and now he wanted to start running longer distances. The problem was he was never a particularly good runner, even before his injury. And while serving with the Marines, he could do a 27 or 30-mile hike with his gear, but running 13.1 miles was different. And on two artificial running legs, it would be really different. And while his friends and supporters at Achilles were convinced Matias could cross the finish line, the fact remained that in Achilles’ 30-year history, no double-leg amputee had ever successfully run a half-marathon. Matias was going to try just a few days before his first anniversary of the blast that nearly killed him.

*

In 1965, Dick Traum lost his right leg below the knee when he was hit by a car at a gas station. In 1976, he became the first person ever to run the New York marathon on an artificial leg. He had to start the run five hours ahead of time so he would not finish in the dark, but finish he did, and when the medals were given out to the winners of the marathon that evening, a special award was given to him for his achievement. He was greeted with a standing ovation.

But there was still a deep awkwardness regarding people with disabilities, Traum recalls, and he made it his mission to enable people with all kinds of disabilities – physical, mental, behavioral – to participate in mainstream athletic events. He partnered with the New York Roadrunners club and launched an eight-week running program for runners with disabilities. The program recruited a few runners and would met once a week to run together. By January 1983, they had their first race with the NY Roadrunners, and the program became the Achilles club, so named because at the time giving running groups Greek names was the thing to do, and Dick wanted to name the group after a figure who was a hero but who also had a disability of his own. He chose Achilles.

By the end of 1983, Achilles had six members running in the New York marathon, which was huge for Dick because disabled people simply were not doing that at the time. The number increased to 13 in the ’84 marathon and to 25 in ’85. Dick figured the numbers would top out there – how many people with disabilities could there be who wanted to run in marathons? – but Achilles kept growing by word of mouth.