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insurance company

Grief, Guest Posts

A Moving Letter From A Mother To an Insurance Company After They Denied Her Brain Injured Son The Care He Needed.

April 10, 2014

Beloveds, Jen here. This was a submission sent in yesterday to my site and I felt I had to get it up as soon as possible. I am sitting here in tears. Such love. Such love. Let’s make this viral. Thank you to Demetra for being the daughter you are and sending this in. 

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My mom wrote this today and posted it to her Facebook account. I think it should be shared with the world so I stole it and am sending it to Jen. My brother, Damon, was in a car accident two years ago and lives with a brain injury. She posted this as a pretend letter to our insurance company… I think it is a good reminder to just be really compassionate and to think about how all of our actions affect others, plus I think it’s beautiful. I hope you like it. I put her bio in with the article and also attached a photo of her and my brother. Thank you, Demetra Szatkowski.

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I’d like to meet you. I’d like to understand better. I’d like to know who you are.
 I’d like to know if you have legs that work, a body that responds, a fully functioning brain. I’d like to know if you think twice before standing up, before walking to the bathroom, before reaching up and opening the kitchen cabinet. I’d like to know if you go for a run after work, ride a bike, hike, or just stroll through the woods. I’d like to know if you know what it would be like if you couldn’t do any of those things. I’d like to know if you have ever remotely known anyone with a disability and if you have ever felt even one ounce of compassion.

I’d like to know if when you slammed the rubber stamp of total denial down on our request for the power chair that offers the option of standing and seat elevation for my son, providing so many degrees of independence, you thought outside the box at all. I’d like to know if you even tried to come up with a solution or a compromise that would be in the best interest not only of your company but my boy, as well.

Your words: “Denied completely because based on the medical director’s scientific and/or clinical judgment, the documentation shows this service, group 4 power wheelchair and accessories, is not medically necessary. The power standing feature and power seat elevator are noncovered because they are not primarily medical in nature. THESE ARE CONSIDERED CONVENIENCE ITEMS. Therefore, this request is denied.”

I’d like to know why standing and reaching and living more normally are a convenience. I’d like to know why weight bearing on those legs, independently, without needing the help of an outside person, helping them to regain function, is not at all medical. I’d like to know if you think using your legs is just a convenience. Do you think that wanting a multifunctional higher end chair is the same as wanting a high-end sports car? Do you think we are greedy in asking?

I understand that the chair costs as much as a new car. And we are more than willing to fund as much as we have to. I just don’t understand though, if you are willing to pay for any type of wheelchair at all, why those funds cannot be used towards the purchase of this chair, with us making up the difference. I am not even asking you to spend a dime more than you would on the other type of chair. I’d like to know why when you saw the chair model you immediately denied it and will not compromise. Why not price the lower end model and offer us that amount toward the chair? I am naïve to your reasons. Please help me to understand.

Your use of the words, “convenience items” honestly makes me sick to my stomach. There are other words….there are other ways.

I’d like to know if you know that if we based our outlook on other doctors’ “scientific and/or clinical judgment” a couple of years ago, our son would not be here today?

No matter what we have to do, my son will get the chair that is best suited for him. We won’t compromise. I wish you did.

I have no respect for your “scientific and/or clinical judgment.”

 

Never mind. I don’t want to meet you.

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Karen Pyros-Szatkowski is a full time caregiver, nurse, cleaning lady, cook, and the best mother in the world all in one. Her 19-year-old son, Damon Szatkowski, was in a car accident a little over two years ago and lives with a TBI (traumatic brain injury.) She is also the mother of two beautiful daughters (can you tell her daughter wrote this bio?) You can follow her story or contact her through

Facebook, or at kpszat@aol.com.

mom and damon

 

Jennifer Pastiloff is a writer living on an airplane. She’s the founder of The Manifest-Station. She’s leading a weekend retreat in May to Ojai, Calif as well as 4 day retreat over Labor Day in Ojai, Calif. All retreats are a combo of yoga/writing for all levels. She and bestselling author Emily Rapp will be leading another writing retreat to Vermont in October. Check out her site jenniferpastiloff.com for all retreat listings and workshops to attend one in a city near you. Next up is Dallas, Seattle and London July 6. (London sells out fast so book soon if you plan on attending!)