In the past I've written about my frustrations with my Workman's Comp insurance adjuster. I've assigned her the name of "Elsie" to protect her identity, although I do not think that she is deserving of this courtesy. Elsie is also an amputee which makes her actions and treatment of me even more despicable.
I consider myself to be a relatively low-need amputee. I have my prosthetics, and my limb health has been stable. Yes, there is the nagging bone spur/ bursa that I need to address medically at some point, but because I haven't broached my doctor about it, the insurance company is unaware of this problem. As far as Elsie is concerned, my needs have been minimal.
My dealings with Elsie are limited to twice a year--when I need new liners. I delay the request because my interactions with her lead to frustrations, headaches and, inevitably tears. My commonplace request of a new prosthetic liner always involves mountains of paperwork, dozens of unreturned phone calls and a plethora of "misplaced" faxes. Historically, my requests are only approved when my lawyer has to intervene.
I resent having to get legal counsel involved for the acquisition of my liners. I am not asking for anything extravagant, nor am I requesting something that is unusual for an amputee. Because Elsie is also an amputee, I remain shocked that I am put through the paperwork ringer in order to obtain my liners. In my biased opinion, Elsie has become nothing more than a whore for the insurance company.
I was hoping that I would not have to write about this topic again. Unfortunately, I continue to encounter the same barriers to receiving approval for basic prosthetic care. I consider myself to be a well-adjusted amputee, but these insurance battles feel like salt being rubbed into a wound.
I requested my new liners in October. Yesterday I received a phone call that the liners have finally been approved and that I would be receiving them this week after a wait of 4.5 months. Of course, considering that their job seems to be delaying payment and making my life as an amputee difficult, I suppose that Elsie is probably employee of the month.
About Me
- Peggy
- 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.
Elsie must have a twin sister working in Kansas! Sad, but so often true. I've often wished that the people I deal with were amputees so that they would understand, but obviously, from your story, that doesn't make a difference.
ReplyDeleteIt's insane there is a 3 month approval process to replace something that lasts 6-12 months. For me (different state, insurance, process), my GP sends through orders for parts the week I call them in. You should gather up your correspondence with Elsie and make a complaint to your state insurance commissioner.
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