Many times I feel like my life as an amputee would be easier if all I had to worry about was phantom limb pain and prosthetics. Instead, I am forced to work within an archaic Workers Compensation system to receive basic prosthetic care. The insurance quagmire is more of a handicap than the lack of my foot and ankle!
I received a notification that my Workman's Compensation carrier would like to settle the claim and offered to fund a "Medicare Set-Aside" account to cover my future medical care. When I examined the numbers I thought that it was a joke. In reality, I underestimated the heartless mentality of the insurance company adjustor!
It is apparent that my adjustor is planning for me to live my life dependent upon a wheelchair. They have allocated funds to purchase seven wheelchairs, nineteen cushions and thirty eight wheelchair tune-ups. I have been generously allocated seven additional knee scooters should I decide to rise out of my wheelchair. I currently have a wheelchair and a knee scooter; both are buried beneath a mountain of outgrown baby clothes in the corner of my basement.
Obviously, my insurance adjustor would prefer I not use a prosthetic. After all, prosthetics are more expensive than wheelchairs. I am allowed only seven prosthetics and sockets for the remainder of my life. I should only replace my prosthetic liner every five years (they have offered to provide seven during the course of my life). The fact that Medicare allows for four liners a year due to hygiene issues is apparently of no concern.
Of course, should my limb become infected because of poor hygiene, I am covered. I have generously been provided with one doctor visit per year, providing that the physician charges no more than $117.49. X-Rays have also been anticipated, but I will have to insist that my doctor take one per year, so he should choose his view wisely. I suppose I will also have to remind my doctor that he should not prescribe more than one pill per year as I have only been allocated with 38 for my lifetime. Let's hope an all-encompassing, super-antibiotic pill costing no more than $24.99 will be invented soon!
Of course, I suppose I could forgo the medication for a few years to create a "stash" to provide a full day of pain medication should the need arise. I am permitted only three limb revision surgeries during my lifetime. My adjustor must have a great deal of confidence in my ability to handle pain because my one pill a year allotment will certainly not provide much relief.
Every morning I wake up and put on my prosthetic, trying to make the best life possible for me and my son. I have accepted that my pre-injury life is over, and I have carved out a new life path. While there is no number great enough to compensate for the loss of my foot, I was infuriated with this paltry offer.
Researching the proposal, I discovered that the numbers were provided by a company called PMSI Settlement Solutions. Their website touts that they will provide the "lowest defensible allocations." (http://www.pmsionline.com/settlement-solutions/msa-services) I wonder if they would put their prosthetic dependent spouse, mother or daughter into a wheelchair because it is cheaper. Hiding behind their computer screens, these figure-fabricating insurance whores actually brag about low-balling medical care for amputees and others with disabilities!
Throughout this process I have become a faceless, soulless entity in the eyes of my insurance company. I am viewed merely as a liability that needs to be written off the books with as little monetary output as possible. My abilities, my aspirations, my lifestyle and my intelligence were never considered.
I have been asked to approve or deny the proposal. As far as I'm concerned, the allocation created by PMSI is nothing more than a gauntlet. Is responding, through fax, with a succinct SCREW YOU clear enough, or perhaps I should just say DENIED as they are wont to do?
I did not ask, nor did I contribute to the accident which caused me to be injured. Given the chance, I would choose to live my life with my natural foot but since that is not possible, I rely upon a prosthetic device to walk. I will accept nothing less than adequate prosthetic care. Perhaps the insurance company underestimating me is my strongest advantage.
To my insurance carrier and to PMSI Settlement Solutions, I say, "Bring it on." This AmputeeMommy is ready for a fight not just for me, but for all of us!