Wheelchairs, A Necessary Evil
For those who may be reading this and know me personally, you may already know of the saga that has preoccupied my life for the past year with my new wheelchair. If so, I am sorry in advance for rehashing a bunch of details that you already have heard from me. This post will be directed more towards those who have been through something similar, who may need to know this information before applying for their own wheelchairs, or are just simply curious about the struggle that comes along with this country's healthcare system. That being said, this post will only cover one small portion of the current problems with our healthcare system, as there are many more. For some context, I have attached an image of my wheelchair.
Before going into my story that will inevitably turn into a rant, let me preface this with some background into the process of obtaining a wheelchair. Again this is only on my experience with the United States.
In this country, most insurance companies will cover the cost of a wheelchair approximately every five years. Most of these companies only cover some of the costs, and the rest falls in the hands of the families. If someone is like me and needs a wheelchair their entire life, they may need a new chair sooner than five years, especially in childhood, when a person grows the most. In that case, insurance will cover some of the cost of what is known as a "growth kit". This "kit" of sorts means that the child or adult is given the same chair that they had for the previous five years, only it is a bit larger to fit them better. Then, before you can even get the whole process started, you must make an appointment with a physical therapist to prove that you indeed have a disability and need a wheelchair, even after you provide medical records that prove this.
Now onto my story.
It all started last August. I was about three weeks away from moving back to college and decided I wanted to get the process moving for a new chair so that I could come home for Thanksgiving and have a new chair. My current one at the time was quite literally falling apart; pieces were missing, the brakes did not brake at all, etc. This is when I realize that I need to see a physical therapist when I do not see one, meaning that most will not just make one appointment with me to simply prove my disability. Luckily, the company that I was using to build my new chair had a list of therapists that agreed to see me once. More on this company later. A lot more.
Let's flash forward a few months. The physical therapy appointment went well, I had picked out the color of my chair (purple, my favorite color, therefore not a surprise), and had customized the features of the chair to fit my needs and body. Now came the waiting time. They told me it would take approximately ninety days at most, and it was likely to be less. Yeah. Right. Once the ninety-day mark came and went, I grew antsy. Then, I get a call from the company. While filling out the form for my disability, my doctor had missed that the company now requires several other forms. By the time I had finally gotten all of the necessary paperwork in, there were ten new forms that no one from the company had communicated to myself, my parents, or my doctor until after we had thought we had all the necessary forms completed. This issue stalled the chair process by another month.
Now, I am about four months into the process and no wheelchair. That December, I get another call from the company. Now, my insurance has denied the request for the chair. This means one of two things: (1) I could wait until I come back home in the spring to go through the whole process again to find another chair or (2) my parents have to pay the cost of the chair out of pocket (which, by the way, can cost anywhere from $3,000 to around $10,000, and that is just for a manual wheelchair).
So, we call the insurance company. This is when we find out that we had the medical paperwork that we needed to be done with the first form and not the many others that the chair company says we needed. Okay, annoying, but whatever. Then, the most infuriating part. The company that we were working with NEVER sent the chair request to my insurance, meaning that they hadn't denied anything, because they haven't even seen anything about the new chair.
Now I am getting frustrated and call the wheelchair manufacturer. They insist that the insurance had received the request, and after a back-and-forth that seemed to last an eternity, they finally admit to not sending it and actually do so. Flash forward ANOTHER month. My insurance has now received the request and has denied it. This time for real. The reason? Because the chair that I was interested in was incorrectly labeled as a sports chair by the manufacturer. One thing I should mention here is that insurance will not cover any type of recreational adaptive sports equipment. Makes sense. So again I am placing yet another call to this company. They realize their mistake and places another request. It ends up going through but now I must wait several more months just to get the chair.
Finally, in early March, I come home for Spring Break and have a new chair.
So why would I tell my story? I did this for several reasons. The first was I want anyone reading this who uses a chair to know that these situations do happen and they are not uncommon. I want people to be prepared for these kinds of mistakes. The second reason is I want to educate those who may not understand the process of getting a chair because they have not experienced it. I hope through this post and future posts that I can raise awareness of these types of issues, so that maybe, one day, they might get fixed.
Anyway, I promise next week will by less rant-based. Thanks for reading!
Before going into my story that will inevitably turn into a rant, let me preface this with some background into the process of obtaining a wheelchair. Again this is only on my experience with the United States.
In this country, most insurance companies will cover the cost of a wheelchair approximately every five years. Most of these companies only cover some of the costs, and the rest falls in the hands of the families. If someone is like me and needs a wheelchair their entire life, they may need a new chair sooner than five years, especially in childhood, when a person grows the most. In that case, insurance will cover some of the cost of what is known as a "growth kit". This "kit" of sorts means that the child or adult is given the same chair that they had for the previous five years, only it is a bit larger to fit them better. Then, before you can even get the whole process started, you must make an appointment with a physical therapist to prove that you indeed have a disability and need a wheelchair, even after you provide medical records that prove this.
Now onto my story.
It all started last August. I was about three weeks away from moving back to college and decided I wanted to get the process moving for a new chair so that I could come home for Thanksgiving and have a new chair. My current one at the time was quite literally falling apart; pieces were missing, the brakes did not brake at all, etc. This is when I realize that I need to see a physical therapist when I do not see one, meaning that most will not just make one appointment with me to simply prove my disability. Luckily, the company that I was using to build my new chair had a list of therapists that agreed to see me once. More on this company later. A lot more.
Let's flash forward a few months. The physical therapy appointment went well, I had picked out the color of my chair (purple, my favorite color, therefore not a surprise), and had customized the features of the chair to fit my needs and body. Now came the waiting time. They told me it would take approximately ninety days at most, and it was likely to be less. Yeah. Right. Once the ninety-day mark came and went, I grew antsy. Then, I get a call from the company. While filling out the form for my disability, my doctor had missed that the company now requires several other forms. By the time I had finally gotten all of the necessary paperwork in, there were ten new forms that no one from the company had communicated to myself, my parents, or my doctor until after we had thought we had all the necessary forms completed. This issue stalled the chair process by another month.
Now, I am about four months into the process and no wheelchair. That December, I get another call from the company. Now, my insurance has denied the request for the chair. This means one of two things: (1) I could wait until I come back home in the spring to go through the whole process again to find another chair or (2) my parents have to pay the cost of the chair out of pocket (which, by the way, can cost anywhere from $3,000 to around $10,000, and that is just for a manual wheelchair).
So, we call the insurance company. This is when we find out that we had the medical paperwork that we needed to be done with the first form and not the many others that the chair company says we needed. Okay, annoying, but whatever. Then, the most infuriating part. The company that we were working with NEVER sent the chair request to my insurance, meaning that they hadn't denied anything, because they haven't even seen anything about the new chair.
Now I am getting frustrated and call the wheelchair manufacturer. They insist that the insurance had received the request, and after a back-and-forth that seemed to last an eternity, they finally admit to not sending it and actually do so. Flash forward ANOTHER month. My insurance has now received the request and has denied it. This time for real. The reason? Because the chair that I was interested in was incorrectly labeled as a sports chair by the manufacturer. One thing I should mention here is that insurance will not cover any type of recreational adaptive sports equipment. Makes sense. So again I am placing yet another call to this company. They realize their mistake and places another request. It ends up going through but now I must wait several more months just to get the chair.
Finally, in early March, I come home for Spring Break and have a new chair.
So why would I tell my story? I did this for several reasons. The first was I want anyone reading this who uses a chair to know that these situations do happen and they are not uncommon. I want people to be prepared for these kinds of mistakes. The second reason is I want to educate those who may not understand the process of getting a chair because they have not experienced it. I hope through this post and future posts that I can raise awareness of these types of issues, so that maybe, one day, they might get fixed.
Anyway, I promise next week will by less rant-based. Thanks for reading!
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