Thursday, November 4, 2010

6.

I was pre-approved for 30 days of the Brain Injury Day Program. After the therapists assessed me,it was suggested that I would need about 6 months worth of therapy. Yes, you read that correctly - I was approved for 1 month of treatment when 6 months would have been more beneficial. I have received individual sessions of therapy to include speech, occupational & physical therapy. Therapy has been sporadic but at least it is available. My medical insurance has to be asked for an extension each time the pre-approved amount of time has expired. The first time the the 30 days expired we appealed to insurance for an extension, it was denied. We appealed again and 2 months later I was approved for 8 more sessions.






I should also say that insurance has covered ALOT, I received the medical attention I so badly needed and they do try and work with me to see if there are any ways they can get more therapy for me. Insurance can be both God-send and extremely frustrating. My insurance coverage was great while I was in the hospital, all in-patient treatment was well covered. The weakest and most frustrating thing about my insurance plan is the out-patient services. My particular policy had no coverage for the comprehensive outpatient brain injury therapy I needed and they do not recognize cognitive therapy which is a cornerstone for healing from a brain injury. My case managers were resourceful and exchanged my nursing home benefit (which I did not need) for 30 days in the brain injury program at Scripps hospital in Encinitas.

Explain to me how you can look at me , listen to me speak , and watch me struggle with the simplest of tasks all the while seeing photos of my former-life and hearing stories about my life prior to this accident yet deny me the best chance for the most recovery by denying any extension to my time at the Brain Injury Program. Explain it to me and I will do my best not to call you names - I can't make any promises though. I can promise that I won't laugh at your mistakes, I promise that I will do my damnedest to not wish this struggle of recovering from a traumatic brain injury on you. I will tell you this: if someone in front of you is walking slowly and they don't have any outward signs of an injury don't be a jerk to them, they might have a brain injury or any other number of things affecting their speed of walking or coping with day-to-day duties. I don't intentionally walk slowly through the grocery store, I simply can't go any quicker and my vision was affected by hitting my head so hard, it takes me time to figure out if what I am seeing is real and it takes time to figure out if the floor is really moving in waves. I will tell you this, if someone near me is intentionally being an ass I may slow down just a little bit more because it is rather fun to see a person (who is fully capable of doing everything for themselves at a normal rate of speed) be an ass just to be an ass or because they think that they are so much more important than everyone else - I'm just saying before you judge anyone else, take a look at your own behavior, kindness never hurt anyone and you just might make the world a little bit better place to be.

5 comments:

  1. I'm so sorry to hear about your insurance company struggles (I work for one, so I have some understanding as to how frustrating they are). Glad to heear your case managers are resourceful. You are such an inspiration! Keep being as strong as you are!

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