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Charlie is feeling pretty excited about finally being taller than his therapist. He is finally able to use a very special wheelchair to come to standing any time he needs to! This is a huge life change for Charlie, and it is the result of many hours of advocacy by his therapist. Over a year ago, Charlie’s team determined that having a standing function on his wheelchair was medically necessary and would make a big impact on his independence with daily living skills. Being able to stand throughout his day helps to stretch his legs, improves his breathing capacity, helps his stomach and bladder work better, and relieves pressure and pain. In his daily life, it allows him to reach up into his closet to pick clothing, reach into the refrigerator, and even make his own food in the microwave- and his favorite, being able to talk to people at eye level! As a young adult, not relying on caregivers is incredibly empowering.
However, Charlie’s medical insurance denied the initial request, noting the chair was “un-necessary” and “too expensive”. Charlie and his therapist appealed the denial, but the chair was again refused. The issue was finally taken to a what is called a “fair hearing”, where Charlie and his representative and the insurance company and all their legal team present their cases to a Judge. After 3 court hearings, 4 long letters of medical justification, and submission of countless research articles, the Judge agreed—it was medically necessary! This process required MANY hours that would be considered unbillable by a traditional therapy clinic, and would likely not have been pursued, Charlie would not have gotten the chair he needed. Having a therapist through the WA Elks Therapy Program has allowed Charlie to continue to grow and become a more independent young man. He is currently taking computer courses in college, playing power soccer, and loving his new wheels.
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