Monday, May 31, 2010
Help Me Howard: Wheelchair for Aden
If you have a medical necessity and you have insurance to cover it, it would be frustrating to not get the help. The only thing worse: your disabled child couldn't get the help they needed. So how can you get something you should be able to acquire? One way: call Help Me Howard with Patrick Fraser.
WSVN -- Aden isn't like the other kids in school. Your eyes will tell you that.
Debra Antell: "He's unable to walk. He can't stand unattended. He's fully dependent for feeding and for bathing, toileting, everything."
But Aden goes to school everyday and loves it. His teacher will tell you that.
Debbie Tersigni, Aden's Teacher: "Aden is pretty amazing."
Aden has cerebal palsy but could get around if he had a specially-built wheelchair his father ordered from a supply company.
Debra Antell: "They said, they would submit the claim form for the permanent chair, order it."
That was two years ago. In the meantime, they gave Aden a loaner chair, allowing him to take the bus to school, to play with his brothers and sisters and enjoy family outings.
Debra Antell: "He's sweet. He has a good personality, and he's happy."
But then tragedy: Aden's father was killed in a motorcycle accident, leaving Debra to raise their four children.
Debra Antell: "I'm very strong, but I cry."
Then, two months ago, Aden's loaner wheelchair broke down, and Debra found out, the specially-built wheelchair she was expecting for her son was never ordered, leaving him stranded at school.
Debbie Tersigni: "That is Aden's only way of getting around the school campus."
Turns out the company didn't order the chair, because they were never paid by the insurance company.
Debra Antell: "That's really no fault of mine. I had an adequate prescription. I had two forms of insurance. So I just don't feel it's fair to punish an innocent child."
Debra was never told the chair was not approved, meaning Aden now has to sit in a wooden chair at school. His disability limits him. No wheelchair locks him down.
Debbie Tersigni: "Everything is a battle to get things for these kids. It's very hard. It almost seems impossible sometimes."
Debra is an attorney fighting every day for her clients. But she says, this battle for someone she deeply loves has frustrated her.
Debra Antell: "Even though I'm an attorney, I still can't get justice for my own child."
Well Howard, Debra has the insurance to pay for the chair. But how does she get it?
Howard Finkelstein: "In cases like these, you first depend on your doctor to send you to the best and cheapest company to get the wheelchair. Then, you depend on that company to make sure your insurance company will cover the chair that the doctor ordered. In this case, it didn't happen."
When we talked to the wheelchair company, they said, they submitted the paperwork for the chair, but they were turned down, because they were an out-of-network provider. Debra wasn't told that, because the company was trying to get approved as an in-network provider. And to help Aden, they gave him the loaner for free.
We then contacted Debra's insurance company ourselves. Give them credit. After we spoke to them, they found a new company that could provide a specially-built wheelchair, and it's being rushed to Aden.
Aden has special needs, but no matter what you need, find out one thing from your insurance company.
Howard Finkelstein: "Every insurance company can provide you with a book that lists the doctors and the companies that they work with. So before you go to a doctor or company, make sure they are in the book. And don't take the word of the vendor. Some of them want your money and may mislead you."
Another hurdle out of the way for Debra. And after losing her husband, fortunately, she has help from the people who care about her.
Debra Antell: "I have amazing children, and I work in a really great law firm. I've been there for 14 years, and they're very understanding of my situation."
Patrick Fraser: "It's understandable that this wheelchair was delayed. After all, Aden's father was handling the new chair, and after he passed away, needless to say, Debra's life has been a little on the hectic and difficult side. Bottom line, though: Aden will now get the special wheelchair and be ready for fun this summer and the next school year."
Inspired to improve your lot in life? Looking for someone to supply the assistance? Contact us. We may not solve every problem, but we will try and try.