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Heather Mills - Amputee Forum
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Joe

1 Year update, Defeating Insurance Providers, and Static Electricity

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Hey everyone! I wanted to hop in and say hi and say thanks. My 1 year ampiversary passed a few weeks ago and I'm doing better than I imagined. Thanks so much for all of the info and support on here. It really made things a lot easier when I had questions. There have been many ups and downs and it has been quite a journey. Here's to the years to come!

After many months of battle, I have scored a decisive victory against my insurance company and their embarrasingly low maximums for prosthetics. I now have a Renegade LP-AT and can run and jump around. The usual goofyness returns!

Here's a few tips for how I did it:

1) Be relentless.

- Become a juggernaut, you are not here to be told no! Be firm and confident. Kill them with kindness. Be aggravatingly pleasant but stern. HAVING A PROPER PROSTHESIS THAT IS SUITABLE FOR YOUR SPECIFIC NEEDS IS NOT A PRIVILEGE! If you only need and plan on using the capabilities of a SACH foot for example then you should indeed get that with no hassle. If you can prove that you absolutely need and will use to the fullest extent (and absolutely nothing lower will do and if such a thing exists) a gold plated prosthesis with lasers and a time travel module, so be it it should be yours.

2) Make friends with EVERYONE relating to the new war you're fighting.

- The closer you are with them, the more info and time they'll be willing to volunteer to you. The more allies in your coalition, the better. The billing people will help just that much more. If there's a third party insurance broker, get them to help!

3) Get contact info of employees at your insurance provider.*

- Start from the bottom if you must. Work your way up until they are thouroughly annoyed with you, then keep pushing. My favorite presentation is, "I will not be giving up on this. I will call every day, repeatedly if necessary. If you have the authority to override the maximum allowance then it would be in everyone's best interest to go ahead and do it now. It'll save time, frustration, money for the company in the end. There's no need in fighting the inevitable." Something along those lines gets a lot of attention. (See Tip #1)

* I had some help getting to the right people fairly early on. I was able to contact my employer's insurance broker who helped everything get started and provided some good contacts. This ladies and gents was the shot heard 'round the world.

4) Set goals and see them to the end. These are your terms for the cease fire.

- Know what you want to be able to do with your prothesis. Have your prosthetist help you determine the components you'll need to get you where you want/need to be. Get a copy of their mock invoice so you have the codes and costs.

5) Attack from multiple fronts.

- Why stick to one form of communication when there are so many to choose from? In addition to having a coalation behind you helping with your deeds, make your own efforts that much more effective. Use telephone calls AND email! Write a letter when you get things in the mail. I even dusted off the fax machine. With multiple lines of communication, nobody can say they didn't get the message. The only reservation on this one is to try to keep it to no more than two people at the insurance company UNLESS you know that they are in constant communication with eachother. Otherwise they can use it against you and say that you've caused confusion and therefore delayed or non responses.

6) Immerse yourself but do not let it consume you.

- Stick to tip #1 but DO take breaks. Even if you build some momentum it can get frustrating to deal with it nonstop. You're trying to burn them out, not yourself.

7) See #1. Rinse. Repeat. Win.

This certainly isn't a surefire thing but it worked for me. If you're interested in knowing any more tactics or the specific ammunition I used, let me know! Unfortunately for the time being, much of what I used will only apply to those in the USA.

If you've made it this far, thank you. Hold on just a moment longer. Has anyone else noticed that they have static buildup and discharge more frequently since they became an amputee? I am constantly shocking myself now! My guess is that the socket and foot are creating some sort of insulator and becoming a capacitor of sorts. My shorts/pants are moving against the socket creating the charge and what do you know, I'm electro man.

- Joe

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Hi Joe

Nice to hear from you and glad you are doing ok.

I am so glad you have mentioned the static electricity thing, because I am getting static shocks all the time at the moment, particularly off my new legs (b/k's) .... am wondering if they are using different materials or whatever, as I never used to get this, but now am getting it all the time, every time I take the legs off, also from the car, shopping trolleys etc. etc. is anyone else noticing this?

Ann

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Good for you Joe. Someone once told me that I'm my best advocate. You have to fight for what is right. You're lucky that you won this war. Have you put any thought into how you'll handle replacement sockets and feet? I guess the battle will begin again. Unfortunately, there are many doctors and legshops out there prescribing outrageous prosthetics for people who don't need them. They seem to think that bigger is better and it will help them walk better. I can't tell you how many C-legs I see on people in wheelchairs. That's a $40K waste. Insurance companies are not totally to blame for our situation.

I haven't noticed an increase in static electricity since becoming an amp. It's mostly a problem in the winter when the air is drier here.

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You're awesome and helpful to others.

Don't you just love the new AT Renegade. Best foot I've tried.

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Hi Joe,

Your outline how to get what you need is great! Persistence and pleasantness can work wonders much of the time. I've learned to keep notes who I spoke to, their full name (way to many Sues', Bills' Steven etc in the world) and direct line and email (if I can).

I just return from my first cruise this past Thursday and found your tactics are so right on in everyday life. Gale force winds and all (NJ to Bermuda) the trip was great fun and something I hope to do again. The statement for on board charges was extensive as I found myself to be very thirsty on this trip. Royal Caribbean policy is that any disputes should be addressed on board by 6AM the morning of departure. I didn't see the summary until I left my cabin for breakfast 8AM on the last day. A quick scan showed some charges that looked amiss but there was not time to do anything about it on board. Once home I checked all pockets for receipts and still couldn't match three bar charges totaling $59.

Calling the company billing department yesterday I explained getting the summary at the last minute and the three questionable charges. After some more conversation I was offered a compromise that the company would waive half the charges and I would pay the difference. I would not take the offer since I didn't think any of the three charges were mine. I persisted and asked to have the company receipts pulled. Their customer service rep. was pleasant but reluctant to do this but I stood firm that I wouldn't pay for what I didn't think I drank. She explained it would be 5 to 7 business day before she expected a response from the ship.

However in just under three hours she called back yesterday with details. All turned out to be nothing that I ordered - though the rum & orange juice drink sounded very tasty - and a full refund will be credited to my bill. The beverage bill was still substantial but it was at least just what I enjoyed.

My knee & foot warranties will be up in Nov. 2013 and these tactics will be so important in working with the leg and the insurance company. My Endolite knee may still be my best fit but I plan to look over all options. Not being a newbie should help a lot in selecting what does work best.

I think there is a saying out there - "a pinch of sugar can be better than a ton of something, something .... " - can't quite recall but the idea is there.

Have a great day everyone!

Jane

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