spinergydude

February 19, 2008
Investigators Target Health Insurers Over Practices

Lisa Girion of the Los Angeles Times discussed investigations in Los Angeles and New York into health insurance companies' policies on canceling coverage and pricing. Both investigations mark rare examples of involvement by law enforcement officials in the regulation of the health insurance industry.
"Health Insurers Become a Popular Target" (Brand, "Day to Day," NPR, 2/15).


Readers are invited to send feedback to: chl@chcf.org
http://www.californiahealthline.org/articles/2008/2/19/Investigators-Target-Health-Insurers-Over-Practices.aspx?topicID=38
Article located at the link above.

I started this in support of the United Spinal Association, and the publication they produce called: Action

The community is run by me, for disabled people to learn about Action, and the United Spinal Association, as well as have a alternative place to meet, and share informtion that is not on myspace.

Please join up show support, and if your a company or in the position to help spread the word please do. We are looking for companies who do not mind a possible donation or to support the needed help section I started, as sometimes money is not the only issue we disabled people face. It sometimes is for more simple things that we can not do alone, or afford ontop of our normal bills... But, would go a long ways to helping those who need the help. It is not a want, or wish list.

I hope to be able to open up communications for medical professionals to be able to offer INFOMRATIONAL help and insight, that the members will review with there medical Dr(s) in real life. We do not try to diagnos, and, only can provide our best educated guess, that people need to see a medical person about.

I want to be an extension of the Action publication, and be a informative cummity. Able bodied or not, a member of the United Spinal Association or not no matter, as long as you want to be active and help, and share what you may know, you are welcome.

http://community.livejournal.com/action_mag_live/

See you soon...

I will start it off...
Married 15 years 5-22-08 17 years knowing each other, I am the disabled half, my wife the abled half.

Injured in 1995 on the job freak accident, thought it was resolved after several years of treatments for Sciatica. I would re-awaken the little beast two more times... Resulting in me trying all available non surgical medical treatments for SJ Joint Dysfunction. Diagnosed 12 plus years later in Hydro Therapy. 9/07 I would have Radio Frequency Ablation done, and I was left permently fully disabled. In 2005 I applied or rather appealed SSD, it would be 2/08 when I finally was in front of the Admin Law Judge... Less than 20 minutes later I was sent out with my denial overturned. It now will be around 2009 when I will finally see my first SSD check. Good thing I am good looking, as I used that to pay my bills.

I then had to after 2 denials, fight Aetna to overturn the denial they made on my prescribed DME... Now my TiLite ZRA is beingm ade as I type this, and it included Spinergy wheels and customized cinfiguration. I thought my struggles from 1995 to 09/07 had been hard fought... Al lI can say is for anyone else who has done this also... I take my hat off to you. And, WOW! I had no idea, just how messed up the system really is... Advocacy is not easy, but I never had more fun than that fight with Aetna... So now I decided if I can not work, I will work on connecting people in need of support, and knowledge... :)

I am 38 years old, just a normal guy, no degrees, no actual college, even if I worked for three of them so far... My pain is level 8 out of ten that goes to level ten out of ten if I do most anything to long, move wrong, sometimes luagh to hard, sneeze, caough... O,o Sheesh... Meh oh well. Nothing touches it, so I need to learn to live with it...

Visit this bloggers information site about the legal side of blogging. :)

http://www.discoverythroughdesign.org/flash.html

Please take at look at some amazing women, who defy traditional ways of doing, and looking at the world of wheelchair design...

Way to go!

http://www.jfactivist.org/

Welcome to the Justice For All E-Mail Network

Justice For All (JFA) exists to defend and advance disability rights and is central to AAPD's mission of economic self-sufficiency and political empowerment of all adults and children with disabilities in the United States. In pursuit of these aims, JFA both shares information and issues high priority calls to action to individual advocates as well as organizations run by and for people with disabilities. JFA also supports the principle that people with disabilities and disability issues should be fully-integrated into all national political and policy discussions and decision-making. To this end, JFA also disseminates information about broader domestic policy and political debates that can and often do shape disability-specific priorities.

Established in 1995 to defend and protect disability rights and disability programs specific to the 104th Congress, JFA has since grown to become a highly–respected and relied-upon source of national disability news and action alerts.

http://www.aapd-dc.org/JFA/index.php - links to the quote above and the home page entry spot. :)

DOT Increases Protections for Air Travelers with Disabilities

PRESS RELEASE FROM THE U.S. DEPARTMENT OF TRANSPORTATION (May 7):

DOT 67-08
Wednesday, May 7, 2008
Contact: Bill Mosley
Tel: (202) 366-4570

DOT Increases Protections for Air Travelers with Disabilities

People with disabilities will have additional protections against discrimination when they travel by air, as the result of a new rule issued today by the U.S. Department of Transportation (DOT) that strengthens the existing regulation implementing the Air Carrier Access Act (ACAA) and extends it to foreign airlines.

The new rule will apply to foreign air carriers operating a flight that begins or ends in the United States. It applies to U.S. air carrier operations worldwide. Passengers flying to Europe, Asia, or other destinations on foreign air carriers now will have similar protections against discriminatory policies and be entitled to the same accommodations as passengers flying on U.S. carriers. DOT will also be better able to take enforcement action against a foreign carrier if it discriminates against an individual because of his or her disability on flights to or from the United States.

“This revised rule expands the protections people with disabilities will enjoy while traveling by air,” U.S. Transportation Secretary Mary E. Peters said.

The new rule will also make it easier for passengers to use medical oxygen during flights by requiring airlines to allow the use in the passenger cabin of portable oxygen concentrators that meet applicable safety, security and hazardous materials requirements for safe use aboard aircraft. The Department will seek further comment in a supplemental notice of proposed rulemaking (SNPRM) about whether airlines should be required to provide medical oxygen to passengers upon request. The SNPRM will also address subjects such as accessibility of airline web sites, automated ticketing kiosks, and in flight entertainment systems.

The new rule will also provide greater accommodations for passengers with hearing impairments. It will require airlines to include easy-to-read captions for the hearing-impaired in its safety and informational videos. Airlines also must promptly provide the same information to hearing- and vision-impaired passengers that it provides to other passengers in airport terminals or on the aircraft – such as information on boarding, flight delays, schedule changes, weather conditions at the flight’s destination, connecting gate assignments, checking and claiming of baggage, and emergencies. The rule does not specify how carriers should make this information available to passengers who are deaf or hard of hearing.

The ACAA, enacted by Congress in 1986, prohibits airlines from discriminating against disabled passengers. The Department issued its first ACAA regulations in 1990 and has amended the rules several times since then.

The new rule will be effective in one year to give carriers enough time to begin implementing its provisions. The text of the final rule is available on the Internet at www.regulations.gov, docket number DOT-OST-2004-19482.

POSTED 5-7-08

Aetna

4-30-08

SpinergyDude

Subject: Final Appeal Decision

Dear Mr. SpinergyDude:

This letter is in response to the appeal request we received on April 30, 2008. This appeal is regarding the denied predetermination request for the TiLite ZRa wheelchair and accessories supplied by Monroe Wheelchair.

A medical director, board certified in internal medicine and geriatrics, who was not involved in the original decision, participated in the review of this appeal. We reviewed all available information including:
* your correspondence,
* clinical documentation submitted,
* and Aetna Clinical Policy Bulletin Number 271.

Our Decision
Based on our review of the above information, we are reversing our previous benefit decision and will now allow benefits for this TiLite wheelchair and accessories.

Upon review of the submitted clinical documentation and the related clinical policy bulletin on wheelchairs, the prior determination is overturned. Coverage will be allowed for the requested ultra light wheelchair, special wheels/tires, and other accessories. With the diagnosis of sacroiliac dysfunction and your unique clinical situation, this wheelchair appears to provide the most benefit to support activities of daily living with the least amount of discomfort and with improved mobility.

>>My original goal was to acquire myself independence inside my home. I did not expect to also find the system as broken as I did…