Ervin: Managed care mobility device replacement

I’m trying to word my appeal. Actually, I’m trying to word my appeal of the denial of my appeal. My first appeal was denied so my next recourse is to appeal for the right to appeal the denial of my appeal.

If that’s successful, I will go back and appeal the denial of my appeal. But if my appeal to appeal the denial of my appeal is denied, I will appeal for the right to appeal the denial of my appeal for the right to appeal the denial of my original appeal.

By Mike Ervin, New Mobility August 1, 2016

This is very high stakes for me because I really need a new wheelchair and that’s what this is all about. Once upon a time, if a guy like me needed the state to buy him a new wheelchair, he went to a state office and did six tons of paperwork and jumped through a bunch of degrading hoops, only to be denied in the end. But things have changed.

The state now contracts with private managed care corporations. So now, if a guy like me needs the state to buy him a new wheelchair, he goes to the office of a managed care corporation and does six tons of paperwork and jumps through a bunch of degrading hoops, only to be denied in the end.

I’m not sure how this saves the beleaguered taxpayers money. I guess managed care corporations pay their employees a lot less than the state pays its employees to not do anything.

The state swears that turning everything over to managed care corporations will “improve the level of customer satisfaction” for guys like me. So when it came time for me to apply for a new wheelchair, I told myself what the hell, I’m going for broke! I saw an internet video that was an ad for this cool new motorized wheelchair. I know they’re making wheelchairs cooler and cooler these days, but this is the coolest chair ever!

They call it the Seduction wheelchair. Apparently if a guy drives it down the street, women throw themselves at him. They can’t resist. It must emit a powerful invisible pheromone or something because in the video this badass quad wearing wraparound sunglasses was cruising in his Seduction wheelchair through the Hot Babe District, which is that section of the city where every woman is knockout gorgeous and wears a tight dress. And every last one of these women was jonesing to get their hands on this sexy quad. He had two women sitting on his lap and another riding on the back of his chair. He had women all over him like pigeons on a statue. Women stomped over each other for a chance to get next to him. Cat fights broke out all around.

So I decided I’d get the managed care corporation to approve me for a brand new Seduction wheelchair. That would sure as hell improve my level of customer satisfaction. I went to the office of a managed care corporation and did six tons of paperwork and jumped through a bunch of degrading hoops.

Six months later, my request was denied due to lack of “medical necessity.” However, the notice said the managed care corporation approved me for the purchase of a different mobility device, listed as DME Code 046. So I consulted the Big Book of DME Codes (a must-have item for every cripple survival kit) and discovered that DME Code 046 is a shopping cart.

Of course I immediately appealed. In order to make my case that a Seduction wheelchair is a medical necessity, I threw the words of the managed care corporation right back at them. They say their mission is to “promote long term health and wellbeing.” Well, I wrote, what could promote a man’s long term health and wellbeing more than having knockout gorgeous women in tight dresses stomping over each other for a chance to get next to him? If that’s not a medical necessity, what is?

I was still denied. But I won’t give up! My long term health and wellbeing is at stake! I don’t want to look like a real dork cruising through the Hot Babe District in a shopping cart.

Source New Mobility