13 replies to this topic

[keeptrukin]

I was dinied my ultralight weight ridgid chair today.
I was told my hold up is that they don't know how long I will need it cause my injury is a rare one.
I went to my neuro doc who agian said we hope to see recovery, then was told it would take me a long time to see any returns. I asked how long is a long time? Response was at least a year. So am I to wait a year to see if I get it back and have to do with the crappy loaner wheelchair they gave me. This doesn't seem right. I am so tired of people telling me you will get better or you may not always be this way. I have seen no return since that week after my accident and it's been 3 months now. I havent' been wasting my time fighting for extra equipment which would make my life easier just focusing on neccessities.

I asked my neuro doc what is the best, worst, and inbetween scenerios. I was told no return at all, all return and somewhere inbetween. If that is the case then why can I not plan for the worst and hope for the best.

The workers comp insurance acts as if I am wanting this chair for some twisted reason other than need. I told the adjuster if I could walk do you think I'd be in this chair. It'd be really hard to fake a SCI and why the heck would I want to.

I asked my family if I could move back home to be closer but didn't want any special treatment. They have already had a family meeting of what will be done what they will buy and how it will work for me. I am upset cause this isn't what I wanted.

I guess I am just fed up with everyones responses to me.
- you'll get better just wait
- were just doing whats best for you
- you don't need a car right now we will help you get where your going
- we just care for you (while they are smothering me)

I was very indipendent before and just want to get back there as soon as I can. I'm not thinking grim but am going by what I can do now.
I feel everyones waiting on some huge change while I'm sitting at home twidling my thumbs.

thanks everyone for letting me vent, I know negitivity is not a good thing but I needed a out. So thanks for giving me a place I can do that.
L

[PetitMortVampyre]

I can go kick someones butt for ya??

I'm here if ya wanna vent!

Vette

[keeptrukin]

PetitMortVampyre, on Oct 24 2006, 12:32 AM, said:

I can go kick someones butt for ya??

I'm here if ya wanna vent!

Vette

thanks it's so frustrating at times

[Joed]

Sometimes it boils down to how the doctor words his recommendations. Insurance companies seem to have to have things said a certain way before they'll make a move.

Ask WC specifically, what info they need from your doctor in order to have this chair approved...then relay that to your doctor, stressing that it has to be worded just right.

After fighting for a year with my HMO to get surgical treatment out of 'the network', I discovered that the surgery order was finally accepted by them for a disk procedure...although I had much, much more going on than that, it seemed to satisfy all their requirements and things started to then move along. And it all hinged on the right insurance code. When I questioned my NS office about the disk surgery, they told me that they put that in because they knew that it would be more likely to get through.

Keep fighting....and don't be afraid to ask them questions as to what might move this along.

[gsp23]

Man, that really sucks... I went through a few weeks where I was told that my insurance probably wouldnt approve an UltraLight chair for me either then went through some different channels and then my insurance ended up approving both and UltraLight rigid and folding chair. Here is how I had to do it, any variation and I was denied but hopefully this will help.

1) Have PT make recommendation to doc that you need an UltraLight chair... make sure it says UltraLight on the request to doctor.

2) Doctor will send a perscription then to PT for an ultralight chair... again make sure the perscription says Ultralight on it (mine originally sent it saying light chair and the wheelchair company agreed with me that since there is a class of light chairs insurance would not approve an ultralight. PT then contacted doc again saying that I needed it to say ultralight)

3) Once PT has the perscription then find a wheelchair company IN-NETWORK near your PT sessions and have the rehab clinic setup a consultation during one of your sessions.

4) Rep from the wheelchair company came out and make recommendations, I told him what I wanted and we agreed on model(s).

5) Rep sends over paperwork to PT as to what they will need to justify for the insurance company beyone "standard" equipment. This includes why a standard or light chair wont work but why an ultralight is needed. QuickRelease wheels, any other things that are not on the standard $150 chairs.

6) PT completes all paperwork (ask them to be very detailed and thorough) and then sends that paperwork to wheelchair company.

7) Wheelchair company submits paperwork to insurance company.

At this point insurance will either approve or deny. If they approve then great. If they deny they will give a reason for denial at which point your doctors, pt and wheelchair company will then need to provide additional justification. They may request more medical history and paperwork from your PT and/or neuro as well. This process can go back and forth for a while. Luckily my PT was very very thorough and I have good insurance so it was all approved on the first shot and they also said they would pay for a folding chair too... so I got two UltraLight chairs at the same time.

Hope this helps, and good luck to you.

[John Anderson]

I was dinied my ultralight weight ridgid chair today.
Sorry to hear that, I know how that feels when you get dinied.

I was told my hold up is that they don't know how long I will need it cause my injury is a rare one.
Stupid reason!

I went to my neuro doc...
Another reason why I don't really like doctors, and don't really listen to them. Unless Colonel knows them and trust them of course.

I asked my neuro doc what is the best, worst, and inbetween scenerios...
I think I would have give you the same answer, and I'm not doctor!

I asked my family if I could move back home...
Col. was going to make me to back home with Rolling Joe (my great grandfather, why we call him rolling Joe? He's in a chair ) and give me "speical treatment" I told him, ok I will go visit Rolling Joe and get some tips from him but never ever make do do that s%^&.

I guess I am just fed up with everyones responses to me.
- you'll get better just wait
That's just a bunch of bull*%&
- were just doing whats best for you
AND THAT IS?!?
- you don't need a car right now we will help you get where your going
WTF?!?!

I was very indipendent before and just want to get back there as soon as I can. I'm not thinking grim but am going by what I can do now.
I feel everyones waiting on some huge change while I'm sitting at home twidling my thumbs.
[/quote]

I def know how you feel about this, I am very independent too and I don't want people to go all over me. After I got out of rehab, Col. was like this too, but I just told him to stop and I can do things by myself and that he was going to trust me. Thank goodness that worked. I totally know where you're coming from, need to chat, PM me or something

[xMaddiex]

thats what we're here for, so we can yell at eachother. it's a lot better than bottling it up and taking it out on people you love. on the plus side, when youre at the bottom, things can only go up! yeah, i know, i suck at being optimistic but there you go. so anyway, good luck with stuff, and we're akways here for ya.

[sharma]

hi. my name sharma i got spinal cord injury in an accident 9 yrs ago. In that accident my spinal cord got a fracture at D11 to D13. So, i cant walk with out help my lower half fully paralysed. Now iam doing my Master Degree in Computer Science. I want to share my feeling with someone like who is facing problem like me.

[gsp23]

sharma, on Nov 14 2006, 11:47 AM, said:

hi. my name sharma i got spinal cord injury in an accident 9 yrs ago. In that accident my spinal cord got a fracture at D11 to D13. So, i cant walk with out help my lower half fully paralysed. Now iam doing my Master Degree in Computer Science. I want to share my feeling with someone like who is facing problem like me.

I have never heard of D part of the spinal column, where is D11-D13?

[Avocado Baby]

Grrrrrrr! Some people are just infuriating aren't they?! IDIOTS!

I have never heard of D part of the spinal column, where is D11-D13?
[/quote]

I think this is them same as T11-T3. Is that right?

[DaveP]

[/quote]

I have never heard of D part of the spinal column, where is D11-D13?
[/quote]


D = T

In English we call it T (Thoracic) but in several other languages they call it D (I think it's Dorsal in Portuguese, so possibly similar in other languages).

[gsp23]

DaveP, on Nov 15 2006, 09:07 AM, said:

Quote

I have never heard of D part of the spinal column, where is D11-D13?

D = T

In English we call it T (Thoracic) but in several other languages they call it D (I think it's Dorsal in Portuguese, so possibly similar in other languages).

Thanks, I was wondering if it was T because of the high numbers used but wasnt quite sure. I appreciate the explination.

BTW.... It is possible to be called by different names in Portuguese, but I have always read it as região torácica when reading about it on Portuguese web sites.

Edited by gsp23, 15 November 2006 - 04:14 PM.

[amer]

my boyfriend had to wait and wait to get his own chair. The company kept jacking him around. He said that it really sucked that people have so few choices on who to get their equipment from,they get it from whoever is recommended to them t rehab, and they need it to live so the companies can treat people how ever they want. He also found out the company recommend to him at the hospital charged so much more than if he ordered things off line, so he ordered a lot of parts that way. Its not right they they get away with such crap

[sharma]

hi,

Its(D11-D13) between chest and belly. sorry my mother tounge is not english.
I am not that much fluent in english. Can i know about u, like ur Name, where are u from,etc.
I want a friend like u.Finally, thanks for replying .bye