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I am a below knee amputee. More importantly, I am also Mommy to two boys, a very active 10 year old (Robby) and an mischievous toddler (Timmy). I have learned that being a parent with a disability can create some unusual and sometimes humorous situations. This blogger is available for hire! Let's talk and learn how a blog can expand your business.

Thursday, May 28, 2009

Insurance woes...

I lost my leg due to an accident I sustained at work. Hence, I have a Workman's Compensation claim that covers my medical and prosthetic costs. Or, at least, they are supposed to cover my costs.

I have an adjuster assigned to my case whom I will refer to as "Elsie." This is not her real name, but I feel compelled to provide her with some anonymity. (Although, to be quite honest, I am not sure that she deserves this courtesy.) Elsie apparently has the authority to approve or to deny claims. This power has gone to her head.

Elsie has systematically denied payment for numerous prosthetic devices. I have been calling to secure prosthetic liners since February, to no avail. Apparently the liners have been approved, but payment has yet to be processed.

The true irony in my relationship with Elsie is that I have yet to meet her. In actuality, she has never spoken with me. I have made numerous attempts to make contact, but my calls have yet to be returned. I wish I could have voice mail pick up my calls all day! I am frustrated that somebody whom I have yet to meet has such power and control over my body and lifestyle.

Another surprising fact about Elsie is that she is an amputee. I am astounded that somebody with the same disability would work to handicap me further by denying proper prosthetic devices. I hope that her insurance company meets her need with the same compassion and competence she displays.

I become dismayed when I think about my future. I envision myself being 92 years old, happily living in a nursing home. In the meantime, some pencil pushing insurance adjuster is going to be questioning my doctors about my projected longevity. "Do you really think she'll be living beyond 6 months? How can you be sure? Perhaps we should seek another opinion, because she could die before using the leg...."

They are going to try to deny a leg or liner on the basis of my age because they will bank on my dying before the appeal can be processed. I feel overwhelmed when I contemplate my future because I know that I will encounter endless roadblocks and obstacles. Maybe insurance companies count on beating patients into submission.

In many ways, I am more handicapped by the red tape put forth by Elsie than by the amputation itself. Given the proper devices, I lead an active and healthy lifestyle. Unfortunately, Elsie puts a monetary value on my quality of life and frequently denies claims for standard medical equipment. If you have challenges with your insurance company, you are not alone. It is really frustrating, isn't it?

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