A Letter to Insurance PART 2

Dear Ci.gna,


I don't really want to say thank you. I just want to let you know IT IS ABOUT TIME! You finally decided to do the right thing. It only took me 3 months, 3 appeals, multiple letters & support notes from myself and the doctors, lots of trips to the doctor for letters, a large amount of hoop jumping, too much stress and too many tears to count. I am sure you were hoping I would go away and not do all the work it required to get my daughter a simple lightweight pediatric wheelchair. WRONG!


After you had a meeting of your Medical Necessity Committee (which I opted to not sit in via conference call cause I let go and let God), you sent a letter to ME (not MM) telling me you will cover her chair. I am assuming the persons on this committee understood Spastic Diplegic Cerebral Palsy. I am quite sure this cost a large amount of extra money and time on your company's behalf. So, the chair will be whatever the price it is PLUS the cost of the 2 RNs & 1 MD on the committe, the cost of the letters (which were overnighted) and the appeals associates time. Not a very good use of resources in my opinion. I now know why my premiums keep going up and yet, you are paying for less. Sounds like your customers need to have a utilization review of your company and deny salary of certain people for creating BS work.


F#$k you very much for all of the added stress in my life. I am quite sure you will be denying my future claims for hypertension and anxiety.

Sincerely,

Meghatrons Mom

I will be writing to Variety, The Children's Charity, to thank them for covering the chair & the chair place will be refunding them their money. (I might need them to pay for her next chair)

Sometimes, it is worth the fight.

Brain Thaw

The sun has come out. I have my formal complaint filed, I am just waiting to here from the State BOE. If interested, here it is. Hope this helps if any of you ever have to do it, although I pray you never will. (all names have been replaced with *****) Let me know what you think, now that I feel I have a degree in special education law! LOL

Attachment to Formal Complaint

Note: Exhibits are attached with complaint. Recording is in minutes from the recording this parent made during the meeting.


#1 Failure to do Reevaluations in a timely manner.
--The District failed to not only provide but did not even begin the reevaluation process within the required time frame. The triennial reevaluations were due on March 8, 2009. (Exhibits A, B, C, D) The District did not even request for the reevaluations to be done until September 23, 2009 (Exhibit E). The District is out of compliance with IDEA part D Sec 300.303. Even being late, they were not done in a timely manner nor provided in a timely manner. The reports were still being done up until the IEP meeting on February 8, 2010. (Exhibit F.1) The District is out of compliance with IDEA part D Sec 300.301 (c) 1.i.
#2 Failure to comply with request to Review Records and Inspect Records in a timely manner
--The District failed to allow this parent to inspect and review any and all reports prior to the IEP meeting scheduled on January 26, 2010. An email was sent to *****, Resource & Case Manager, on January 20, 2010, requesting any of the reports, updates evaluations (which should have been triennial reevaluations) prior to the January 26, 2010, IEP meeting (Exhibit G) Only 2 reports were received, occupational therapy & physical therapy. The meeting had to be re-scheduled for February 9, 2010. Again, an email was sent on February 1, 2010 requesting the remaining reports (Exhibit H). An incomplete speech/language report was sent home with ***** on February 8, 2010 (Exhibit F.2). The District is out of compliance with IDEA 300.613 (a) comply with a request without unnecessary delay and before any meeting regarding an IEP
#3 Failure to comply with request to Review Records and Inspect Records in a timely manner
-- The District failed to allow this parent to review & inspect the psychology triennial reevaluation when requested. Emails were sent by this parent on January 20, 2010 & on February 1, 2010 (Exhibits G, H), requesting to review any reports prior to the IEP meeting. An email was sent on February 4, 2010, by *****, Resource & Case Manager. It stated that the school psychologist’s supervisor rather them go over the results with parents in person & she would be happy to do it 30 minutes prior to the meeting (Exhibit I). I then inquired during the IEP meeting on February 9, 2010 (which was recorded by this parent & The District), why I couldn't have had the report prior to since it is my right. *****, school psychologist, stated “it is our county policy to not” (Recording 1:46:52). The District is out of compliance with IDEA 300.613 (a). comply with a request without unnecessary delay and before any meeting regarding an IEP
--The District has failed to allow this parent to review any data collection or anecdotal made supporting the IEP goals. This parent asked multiple times during February 9, 2010, IEP meeting to see the data supporting goals from disciplines (SL/T Recording 1:40:12, 59:44; OT Recording 1:03:34; Resource Recording 21:05). As of this writing, no data has ever been provided to this parent. The District is out of compliance with IDEA 300.613 (a). comply with a request without unnecessary delay and before any meeting regarding an IEP

#4 Failure to do Re-evaluations in a timely manner.
---The District failed to do a formal physical therapy reevaluation for my daughter’s triennial reevaluation (Recording 1:12:45). The physical therapist, *****, submitted a report to us on January 27, 2010, for the February 9, 2010, IEP meeting (Exhibit J,). The report was almost the same report from January 2009 (Exhibit K). It had errors in it as well (Exhibit J.1, J.2). The District is out of compliance of IDEA part D Sec 300.303 (b) (2) must occur at least once every 3 years.

#5 Failure to make Assistive Technology Available in order to receive FAPE
---The District has failed to provide what is required for my daughter to access all of her learning materials through her Assistive Technology (a label maker for answering worksheets, a word processor for writing homework) (Exhibit L). Instead the District has continued to require me to fund the label maker & refills, printer ink for school, printer ink for home, paper etc. (Exhibits M & O, Recording 53:40, 53:32 52:19) The occupational therapy reevaluation (January 12, 2010) clearly shows a need for Assistive Technology, listing label maker & computer (Exhibit N). The OT also stated during February 9. 2010, meeting that “underlying skills to complete written expression in a traditional fashion are limited and delayed, so there has to be some type of strategies for written expression” (Recording 54:28). The District has also refused to include the exact needs within the IEP as requested, only placing AT- Adapted Writing Tools under Supplementary Aids on the IEP (Exhibit R). The District is out of compliance with IDEA 602 (2) (B) purchasing, leasing, or otherwise providing for the acquisition of assistive technology devices by such child; 300.6 (c) Selecting, designing, fitting, customizing, adapting, applying, maintaining, repairing, or replacing assistive technology devices & 300.105 (b) On a case-by-case basis, the use of school-purchased assistive technology devices in a child's home or in other settings is required if the child's IEP Team determines that the child needs access to those devices in order to receive FAPE.

#6 The District Failed to provide FAPE by addressing goals that were met, instead continued to just allow the skills to stagnate instead of proposing new objectives/goals for there to be consistent educational progress (Exhibits P & Q).

#7 The District has failed to appropriately include within the IEP what is necessary for my daughter to travel safely on the bus under supplementary aids/services. A letter of concern in regards to bus safety was submitted by Dr. ***** at IEP meeting held April 28, 2009 (Exhibit S). These parents also expressed concern in The District wanting to remove daughter from a five point harness on the bus at meeting on February 9, 2010 (Recording 1:07:39). The principal, ***** stated “Assistant said she is getting too big for car seat on the bus. The driver has suggested maybe looking at a seat belt.” (Recording 1:09:34, 1:08:00) Parent stated “Seems straps need to be readjusted every morning like a smaller child rides in the seat too” (Recording 1:06:25, 28:37). The District is out of compliance with **** State Board of Education Rule 0520-1-9-.05 (3) (d). There were also bussing recommendations made at April 28, 2009 meeting that were not added back to current IEP (Exhibit T, PT discussed this Recording 1:09:15). A letter with list of objections was sent on February 23, 2010, to **** (Exhibit U). As of writing of this complaint, no reply has been made by The District.

#8 The District has continually failed to appropriately include any of our parental concerns on the IEP (Exhibits U& V). The February 9, 2010 IEP Parent Concerns part is left blank, even though we had several concerns in the meeting (Exhibit V, Recording: 1:28:45, 57:03, 56:00, 30:42, 24:50, 14:42) We were never formally asked our concerns as meetings in the past. The IEP is left blank on the parents stated draft (Exhibit V).

Where are you?

I miss the old me.

How I used to describe myself:
Love to laugh, joke & just have fun. A perfectionist who likes to succeed & do everything as the best. Not a jealous type. Not quick to anger. Peacemaker, fixer, go-getter. Not a yeller or a fighter. Assertive. Naive. Independent & self-reliant. Dreamer but a serious planner, who can be spontaneous (especially when it comes to road trips) Never skinny, but fit & curvy. Organized & a good housekeeper.

I haven't been me since May 2000. Almost a decade since I lost myself. Time flies. I realize we all grow & change. This isn't just that.

After my bout of M.RS.A infection that could have cost me my life, I changed. That was a good thing. It made me appreciate life a little more. It made me not take things for granted. It scared me too, facing my own mortality. And I packed on weight.

A couple years later, we started trying to have a baby. It was hard and we lost a pregnancy. I fell apart. Trying to conceive took a toll on us, as it does everyone. Again, I changed. That brought on my first bout with anxiety/depression. I fought through it, with a little bit of meds. It made me angry, sad, jealous. I found out I wasn't good at everything I tried. I found out I can fail. I found out I do have a jealous bone or two in my body. Things that aren't all bad, but certainly different feelings for me. And I packed on weight.

I finally got pregnant with MM. I never complained at all during the pregnancy. It had a rocky start and horrific all-day sickness through out the entire pregnancy. I made it farther than anyone thought I would. I just kept plugging along, one day at a time. It wasn't the perfect pregnancy. Nothing went as I planned. It was okay though. We were having a baby. Then I developed preeclampsia & all things changed. It certainly was different being on the other side of the incubator. I had to rely on others to take care of me AND my child. I learned at times I was helpless. I realized I was, once again, a failure at something. I again learned anger. Anger at all the easy pregnancies; anger at babies being born on time; anger at ladies who got to have their babies in the room with them & leave the hospital with their babies. I learned I could be passive-aggressive with NICU nurses. I lost my ability to speak up when it came to MM & what was best because I was so sick myself. I also got intimidated by others cause they could care for my child better than me.


We brought her home & I thought we would live happily ever after. Wrong- there went my naivity. She was a lot of work, high maintenance. Slowly clutter over came the house. Then one diagnosis after another came. I was constantly on the road, going from one doctor or therapy to the next or people were coming to the house for treatment. Life became a whirlwind of this stuff along with working nearly full time. Something had to give, so the house became kind of clean and cluttered, not neat & spotless. Once more, anger boiled up cause my life wasn't kinder.mus.ic, mommy playdates & on time milestones. Helplessness came on cause of all the therapists knowing how to help fix what is wrong with my daughter. I lost all my spontaneity cause of all the incessant appointments, the autism, the sensory issues. I lost alot of my dreams. I learned I can't fix everything. More anxiety & depression set in, once I woke up from the first year fog, but it settled in and has stayed. I learned how quickly I could get angry at everyone when stressed. And I packed on weight.

Moving to the public school system was a real eye opener. I have learned I can fly off the handle and go from zero to pi$$ed off in 0.2 seconds. I have learned I can yell (at whoever is nearby) and FIGHT. OMG, can I fight, but mostly out of necessity. None of this is fun. I do have fun sometimes, but most of my life is stress & work.

So, like I said, I miss the old me. I am working hard trying to find parts of the old me as the new me moves through this life. I am trying to lose weight. So far, I have lost 11 lbs since the beginning of the year. Pretty good considering I have been on large amounts of ster.oids for the last 3 weeks. I have started keeping up with the house again. It has never been dirty, but it is now decluttered & super clean the way I like it. I am being more assertive when it comes to matters of MM and not just taking for granted what they tell me. I am working on not being so quick to anger & trying to be the happy-go-lucky once more. I am learning I don't have to be perfect all the time and its okay. I don't know if I can ever have back the spontaneity I used to enjoy with all of MM's issues. We ALL are affected by autism in that way. I am only feeling moderately depressed at times, not the severe gripping kind I have felt in the past. (That's not to say it won't creep up on me and grab me again. I take my meds & I will run to counseling when I feel it starting if I can recognize it) Most of all, I want to have lots of fun again. I don't know how I will get there, but I will, slowly but surely.

Posted on Blog.ger Mess.age Bo.ard---UPDATE

Your Blogs URL: tillthesshortbus.blogspot.com

I realize that Word Verification is a random assortment of letters and numbers designed to prevent spamming computers from leaving naughty responses on people's blogs. I realize that Blogger has certain measures in place to make sure that racist terms, foul language, etc never appear in a specific order.

That being said, I want to question WHY, on a blog about a child with disabilities, the R word came up for word verification. If you do not realize what the R word is, it is r-----*. This was on MY blog. I was mortified to read this in my comments.

With the large population of special needs blogs, both parents and others use Blogger as a networking tool to support one another. I think it is disgusting that you have not taken measures to prevent such a terrible word from appearing. Yes, it is true that certain populations of people do not understand why this is such a big deal. However, there is a huge number who understand how truly offensive this word is. As http://www.r-word.org/ says, "our language frames how we see each other". Allowing this as word verification just continues the pejorative attitude towards people with disabilities.

I hope & expect that action will be taken to prevent this from happening again. I do not want this on my blog. It would also be nice if a PUBLIC apology would be made to me and my fellow special needs bloggers.

I was unable to find where else to send this to. It needs to go to the top of the chain at Blogger.

*Did not want to use word here, but did in post

**Allie, I hope you don't mind, but I used your wonderful post as a guideline & paraphrased some of what you said.**

I encourage all of you to contact blogger as well. As soon as I find out where else to send this, I will. Anyone out there know?

******************************************************************
Okay, I posted a question on the help message board.

Now, here is the response I got from nite.cruzr (which if you just happen to click on his name in the post you can get his email)
As you state, word verification is a random jumble of letters and numbers. I'd be surprised if there are no world languages which don't see some "naughty" or "offensive" words pop up there, from time to time.

I realise that seeing "idiot" or "retard" from time to time will not fill you with joy. That said, if seeing that come up during word verification is the only offensive experience that you have during any given day, you must have a pretty darn good day overall.

I have forwarded this for Blogger's attention, however.

Nice, huh? He also asked if I was Ally cause she had posted as well.

Here is my reply to him:

to nitecruzr:

No, I am not Ally. She is the one who posted on my blog.

"HIS POST"

I did not ask for YOUR opinion about being offended. I asked for help in who I can contact. I have a child with special needs. You have NO IDEA what I encounter day in & day out, so please don't presume what type of day I have. There are a few assumptions I could make about you too, but I am not going to do that, cause that would be sinking to your level

I am thinking he might need some other emails or posts, huh? Oy vay.

THANKS FOR NOTHING GO.OGLE/BL.OGGER

Therapy Waiting Room

One of my first pieces of advice is in regards to the Therapy Waiting Room.

At first, you will dread the room. It is where you first make your entrance and see all of "those children". The ones that are in desperate need of help. You will sit there, holding your little one on your lap and anxiously await your child's session. You go back & watch as they evaluate the child. Then you get all the info & find out you will be making many a trip back to that waiting room. When you first start therapy you want to watch everything they do with your child. You want to observe so you can duplicate the toys, exercises, equipment needed to help your child. I don't know about any of you, but I took notes in my little notebook. I would also try my best not to intervene & let her "get out of" her exercises. You will learn to trust the therapist with your little one & see they are capable. Then, one day, the therapist will suggest you sit out in the WAITING ROOM while your child gets therapized (my little word for it).



WHAT? NO WAY! I NEED TO BE THERE!



That is what I thought. Then, I found out she did a little better without me there. She learned to not be dependent on me for prompts. She got comfortable & came to love those special people.


And there I sat in that WAITING ROOM.


Slowly, my eyes were opened. "Those children" were just like MM. They needed the extra help to function in this world. "Those children" had mommies & daddies just like us. They were just as nervous, anxious, unsure of the rest of the day, let alone the future. There were also the parents who I looked up to. They were the ones who had an older child. They had been down the road, making so many trips. They knew where most of the bumps & roadblocks were. They appeared to be able to navigate the new potholes that crept up with grace & finesse.

I actually began to enjoy my time in the waiting room.

Let yourself make friends with the other parents of SNKs in the Waiting Room. They are valuable resources. Sitting out in the waiting room while your child gets therapy is wonderful. First, let them take care of your child for the 30-45 minute session so you get some "down" time. You don't have to be back there for every session. If I don't feel like talking to anyone, I bring my laptop and am able to get a lot of things done. Second, talking to the moms in the waiting room teaches you so much. They have been there, done that & have all the tricks to getting you access to local services. Third, it is very therapeutic for you. I find it to be a mini psychotherapy group many a time. They are in the same boat as you and REALLY understand.

It is that camaraderie I have come to enjoy, even look forward, as I take her to therapy week after week.