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  • Justifying Existence by Jumping Through Hoops

    Posted by deann-r on March 30, 2021 at 2:00 pm

    Last week when Alyssa posted about wheelchair wish lists I noticed a common thread among the responses. Every answer had a list of why those features were necessary. None of them were just because it’d be cool or fun even though it’s a valid reason in my book. Justifying our needs at this point is second nature. It gets tiring though. As you know I’m working on acquiring a Jaco Robotic Arm. Surprise, surprise it’s been denied by my insurance. Apparently it’s not “medically necessary.” Currently I’m working on an appeal. Yet again I have to justify my existence and demonstrate how this device would make life possible. Can’t it be enough that life would be easier with it?

    Thankfully I have a great team that can guide me through the process. It’s a little ironic that it takes an entire group of people to assert one person’s independence. That’s the process though. For someone who can’t stand I’ve become an expert at jumping through hoops. It makes me think about those who don’t have the support system to lend a hand. Their existence means just as much as mine. It’s frustrating to say the least. As I’m preparing this piece, my veterinarian just called. I’m on a program that provides service dogs with supplements to help maintain joints and support overall health. Of course you need a veterinarian to request it. He’s not familiar with the products so is hesitant to request them. Guess I’ll be jumping through more hoops. What’s the last thing you had to jump through hoops for? Any tips on making it easier?

    deann-r replied 3 years ago 3 Members · 4 Replies
  • 4 Replies
  • adam

    March 31, 2021 at 6:36 am

    Last thing was an adjustable bed. Honestly whenever I need something the first place my mind goes is towards building my argument. The bed was easy, I focused on the hi-lo function and said it was an occupational health & safety issue for my support workers without it. 3 months in I haven’t used the hi-lo function(its standard though was no $ difference), but the people saying ‘yes’ or ‘no’ will never know that. Also if I frame it like “I gotta get this bed to make sure someone else doesn’t get hurt” they worry if they don’t approve and someone does get hurt (other than me, that’s ok, just not employees), they might hold some responsibility. Invoking OH&S goes far in Australia – I use it whenever I can.

    I don’t lie but I certainly embellish and dramatise. For your robot arm go heavy on stuff that’d be a terrible look for them if they don’t approve it – get creative. It’s only a mega rich insurance company too whose business is for you to pay them & they then try all sorts of ways to refuse you service so never feel guilty getting 1 over them.

  • alyssa-silva

    March 31, 2021 at 9:49 am

    Every January I have to jump through hoops to get my insurance to cover the same medication I have taken for 17 years. It’s so frustrating. Long story short, the pills are cheaper so my insurance wants to pay for that. However, I can’t swallow pills so it’s a battle between me, my parents, and my doctors against the insurance company. It is SO ironic that it takes an army of people to cultivate independence in my life, but I’m so grateful nonetheless. My advice is to simply know how to advocate for yourself which I’m sure most of us here already know how to do. It may be exhausting at times, but in the end worth it.

    • adam

      March 31, 2021 at 11:06 pm

      That’s such bullshit. That argument should be required once – they are wasting more resources having that argument every year.

      Why would your army of experts waste time pushing something you didn’t actually need? Honest truth they’d rather you choke on a tablet if you cost more than you pay.

      Insurance companies want healthy risk averse people who never require their insurance but pay a premium for 60 odd years just in case. We suck because we’re gonna need it.

    • deann-r

      April 1, 2021 at 9:51 am

      I’m going through that now with one of my medications too. It’d be so much easier if I could just call them up and explain the situation but that’s not how it works.

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