SERVICES ARE DENIED

[Sarahsmom46]

There has GOT to be a mistake!!!!  I'll try not to get too emotional as I state this question to you all, but its hard.

My doctor signed off on my request for paratransit services while I was still in the hospital.  He asked that I be granted at least 6 months of service while we figure out what is wrong with me and how I will respond to PT.  First of all I must tell you guys that I am legally blind and have never been able to drive, so I depend entirely on my feet to get me around.  I was given a temporary use of the service until I was formally evaluated.  I had the eval last Tuesday by a physical therapist who told me that she saw absolutely no reason why I wouldn't be granted services.  The docs were faxed to the transit agency that afternoon, and by the next morning some moron in the transit office reviewed my eval and application and sent me out a letter that day denying service.  It was form letter that stated "You were found not eligible because it was deemed by our reviewer that your disability does not prevent you from using public transportation".  

That was all it said.  I'll write up more in my journal, because I need to vent this out, but my questions is "HOW DO I FIGHT THIS"?  I have 5 days to respond and I'm hopeful that it will get resolved quickly as there had to obviously be some mistake.  Has this happened to anyone else?

Julie

[Lulu54]

Julie,
By the time I found this it appears your problem was creatively solved by everyone else.  Bravo for the thinking women here who can outsmart the bureaucrats.  

Go get 'em

Laura

[Sarahsmom46]

So I spent at least 24 hours in tears and now I am over that and fighting mad.  I called a friend of mine who's fiance is an attorney.  I hated having to ask for help, but she was more than willing to lend a hand. She lent more than a hand.  She wrote the entire appeal after researching the criteria the transit agency uses in reviewing claims.  She cited the ADA act and why they were wrong in denying me services when I fully met the criteria. And by the way, my DOCTOR and the PT felt strongly that I needed this service.  So I am filling in a few of the blanks and will send it off.  You bet I will follow-up on Monday to see that they got it and that it is being addressed.  I am still thinking that this was an administrative mistake but was very careful not to blame them for making such a mistake. That could cause more problems.  I am feeling better now that this is taken care of.  Now all I need to do is wait to see what happens - and it better not take them too long or it will just make me madder.  

Funny thing is that I actually applied for a position with the Metro Rider's Advisory Council and was interviewed and almost selected for the position.  I will probably get the position next time there is an opening.  How ironic, ha?!!!

Thanks you guys for your support.  It means so much.  

Julie

P.S.  I like the cc: idea.  I wonder if Mayor Fente in Washington DC, would get on them on my behalf :)  We'll see.

[Quixotic1]

Amen!

Death by CC!

Q

[Amyloo]

I would add that any letter of appeal should show "cc" at the bottom to everyone Quix mentioned above.  List them all, from the mayor to the doctor to the ADA.   That will put these lame-o's on notice that you have sounded the alarm.  Bless you, Amy

[Quixotic1]

Oh, And get your letter of appeal to them immediately to preserve your rights.

Q

[Quixotic1]

Ahh..Now you got my dander up!  I suspect one nagry call to the office supervisor will solve your problem.  Nagry and Angry!

Your legal blind status would qualify you on it's own I would think!  A disability to getting around is a disability.  But, even not, now with the other problems, it was just an error or a brush off!

Quix

[Quixotic1]

Personally, I would also get ahold of the supervisor of the transit services and tell them that you need a justification why someone who can't see and can't walk was denied.  Tell them you expect a real reason immediately and they can expect to hear from your attorney if it is denied.  Tell them you have the doctor's request and the Physical Therapy eval to back this up.

I would be blunt and succinct.  The other threat that is easy to make good on is a word to the local newspaper, and to the mayor's office, not to mention the state Human Services Department.  The ADA would also back you up here.  Mayors HATE to here about things like this.

I, myself would not go first to the doctors and the PT, as they have done their job.  Go to where the scr*w up was.  And go to the top!  It was a kneejerk reaction by some lowerling who was tring to clear his desk.

Quix

[Sarahsmom46]

Rena to the rescue!!!

Thanks so much for your suggestions.  They make perfect sense and I will do each an every one to help appeal my case.  The only thing that really irks me is that this will take time and that stinks.  The more time it takes to get it resolved, the harder it is for me to move toward independence.  I am stuck now with trying to find a way to get here and there without spending lots of money I don't have on taxis.  I know that it will get resolved, but it will come at a cost to me for sure.  Just another bump in the road, literally.  Thanks again Rena.  Your help and ideas are always appreciated.

Julie

[Rena705]

Hey Julie...you have 5 days to appeal their decision...you need to think this through carefully and get as many professionals behind you as possible.

I would first off notify the doctor that signed off the request for these services.  This dr. may know of a way to contact the powers that be to have this decision rescinded.

Secondly, I would contact the physical therapist and let her know that you were denied the service despite her report that said you are not able to use public transportation.

It also may help to contact the transit office and tell them that you need to know exactly why you were denied as it was not stated in the "form letter" you received from them.  I would imagine that it is a responsibility of theirs to explain their decision.

Did you get to see the documents that were faxed to the transit authority?  I ask because I am wondering if your disability with your sight was included in this report and if it wasn't it would have a great bearing on the transit authorities decision I would think.

I am sure that if you are able to contact the doctor that first signed the forms stating that you needed this assistance he will respond appropriately because he is not going to like being second guessed by this "moron" in the transit authority.  I hope that you will have some success with your appeal and if all else fails,  you could always write a letter to your ombudsman or the editor of the local paper explaining your dilemma and the transit authority making your situation many times worse with their decision!  When I asked my doctor for a "disability parking pass" she granted it for 5 years and it was her decision alone as it should be!  I would like to know who made the "moron" at the transit authority a medical professional able to make life altering decisions on anyone's behalf!

I am behind you 100% here honey and I am sure all the other members will be equally appalled at this situation.  Perhaps another member can come up with a better idea to help you but I hope that this can be corrected soon.  Please don't get yourself too worked up about this until you have had a chance to speak with the doctor and the transit authority...with any luck it's just an oversight and it will be rectified with the smallest amount of trouble but if not...then you can get all upset and jump all over some heads because it wouldn't be hurting any brains over at the transit authority obviously...they don't have any!!!

Lots of Hugs,

Rena