[EsthersDoll]

I have a vision therapy evaluation scheduled for tomorrow afternoon.

The Dr. just wants to start with a one hour evaluation to see if there's a reason to do a longer evaluation.

I'm excited to think it might help me and nervous about it at the same time.

Neither my health insurance or my vision insurance covers the cost of the evaluation or therapy. It's really weird to realize that managed health care (HMO's and PPO's) are not set up to help people who sustain mild traumatic brain injuries adequately or even in a timely manner. I think this is something most people don't realize until they have to deal with a mTBI personally.

[camyam73]

Good luck - Hopefully it's not too expensive?

[EsthersDoll]

I've discovered that "not too expensive" is relative. When I was working full time, I wouldn't think it was that much and would spring for it if I needed it. Since I'm not working full time and can't even afford to pay for my own rent or gasoline, it seems like a lot.

The 1 hour evaluation will cost me $185, but that's because it includes the annual $50 exam that is covered by my vision insurance. If it's decided that I need more evaluations, I'll need to pay more.

Then the therapy can cost a lot of money on top of that, if it's determined that it can help me.

Luckily, I'm getting financial help from my boyfriend who's supporting me until I'm able to work full time again. (I owe him a lot of money at this point. Well, I owe him and other sources even more...)

We think if it can help me to recover faster and better than I would without it, at this point (22 months after the accident), then it will be worth it. We both are just feeling very desperate to have me better than I am and closer to my functioning level before the accident.

By the by, I'm also disappointed to learn how inadequate the average auto insurance policy is towards paying for someone to recover from a mTBI.

[xanadu00]

Originally Posted by EsthersDoll

By the by, I'm also disappointed to learn how inadequate the average auto insurance policy is towards paying for someone to recover from a mTBI.

Are you appealing their initial decisions? Like many types of insurance, they will often reject claims outright at first but end up paying if you are persistent enough and provide them with lots of documentation. Perhaps you have already done this; I thought it was worth mentioning just in case you haven't, or in case others aren't aware of this.

[EsthersDoll]

Originally Posted by xanadu00

Are you appealing their initial decisions? Like many types of insurance, they will often reject claims outright at first but end up paying if you are persistent enough and provide them with lots of documentation. Perhaps you have already done this; I thought it was worth mentioning just in case you haven't, or in case others aren't aware of this.

I'm involved in a lawsuit, so there hasn't been any kind of decisions made that I'm aware of at this point.

I'm generally speaking about the fact that the man who caused the accident that gave me the concussion that I'm still recovering from was covered for less than a tenth of what this accident has cost me so far. I don't think the mandated "minimum coverage" coverage is enough to pay for a mTBI, and I think mTBI's in auto accidents are somewhat common, so it disturbs me. I don't think people who drive really understand how much insurance they should have or how much money it will cost to rehabilitate someone they accidentally injure.

I just think that society isn't yet knowledgeable about concussions enough to be prepared for them like they are broken bones. And this frustration is just a part of that line of thinking.

[camyam73]

in canada, the minimum liability for insurance is one million.... I cannot believe that the guy who hit you doesn't have enough coverage to make sure that you are taken care of.

[EsthersDoll]

Originally Posted by camyam73

in canada, the minimum liability for insurance is one million.... I cannot believe that the guy who hit you doesn't have enough coverage to make sure that you are taken care of.

Yeah, that's what I'm talking about! Why can't people in the states have insurance like that?

I think the guy that caused the accident that I was injured in was only covered for $20,000.

It's such a mess. I don't want to be involved in a lawsuit. But, at the same time, I'm not able to work like I used to. And I feel like I've lost so much time trying to get better that I was planning on using towards advancing my career and education. I'm an ambitious and impatient person... almost two years to get not even half of myself back is just a bit depressing at times. The good news is that I'm still getting better - so there's hope!

[xanadu00]

Yeah, I'm filing a lawsuit as well, and while the other guy's insurance hasn't yet disclosed to my lawyer his liability limit, I'm guessing it is low. From what I hear, it's so hard to get adequate compensation for mTBIs anyway that it may not make much difference; with an "invisible" injury such as ours, we have a very high legal burden of proof in establishing and quantifying damages.

I figure that even if I were to recover tomorrow, it would take millions of dollars to compensate me for the hell this has put me through and the damage it has done to my career. (Think about it: Knowing what you know now, if you could go back to before your injury, how much would someone have to pay you in order for you to willingtly go through all of this?) I'm trying to accept the fact that there is no way I will be adequately compensated for the damage this has done to my life and the suffering it has caused me. The best I can hope for is something to slightly offset what I have lost.

[camyam73]

What about your own car insurance? Is it helping to cover your expenses?

[xanadu00]

My car insurance will cover up to $10,000 in medical expenses, plus I have $100,000 in underinsured motorist coverage. (A lot of people don't realize they have this. Be sure to check and see if you have it and for how much.)

Getting stuff covered under my own insurance is a real hassle. I have to pay first out of pocket, then get a statement from the clininc showing that I paid (and these statements are invariably vague, which forces me to submit additional documentation from my medical records, even though my insurance company has access to them).

At any rate, in my original comment I was referring to reimbursement from one's own insurance company, aside from settlement issues. One has to be persistent and submit thorough paperwork, even if they already have it (such as the relevant medical records) if one is to get reimbursement. If they deny the reimursement claim initially, you can often still get it covered if you submit additional paperwork.