Getting my insurance co. to pay
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| Sat, 12-02-2006 - 7:55pm |
A couple of years ago I took my son to a Neuro-Pyscologist for tests to determine Dysgraphia. My son did have an IEP (in second grade, he is in 5th now) but they said his test scores were too high for them to see a sign of a disablity. The only thing he got out of the IEP was Speech Therapy.
The insurance co first said yes they would pay for me to take my son to this NP. They said this over the phone. But after a few consultants and a Conners form from his teacher, myself and my husband, the insurance co stopped dead cold and wasn't going to cover anymore testing that the doctor wanted to give.
I should of fought it, but I was so tired of fighting. The school year was ending and I hand picked his next teacher. It was such a better year with her, that I could take some type of break and relax a bit. He still had problems, but the teacher was so supportive and really did wonders for Christopher.
This year is completely different. At 6 weeks the Principle and his new teacher has labeled him Lazy, and said I am too lenient of a parent. He has completely given up on doing anything in class, he is stessed out to the extreme and I can't get anything out of him regarding homework.
During the conference where they labeled him and I, I asked for another IEP. The principle refused. She just looked down in his file and said (I have heard this so many times, I could say it in my sleep) Its impossible for him to have a disablity blah blah blah. (I thought once you had an IEP you were supposed to get a review every year? We have never had a review.....) I said well could I have an OT (its obvious to everyone he has small motor skill problems) She said they don't have enough for the school district for her to even be able to write one in an IEP. ( I was told later by a special ed teacher that that was a lie, she could do it, and she thought the principle just didn't want to help me). Then she and the Teacher started telling me his problem was.... the labels started coming...
The teacher has over-stepped her boundaries, constantly telling me I need to be stricter etc... that he can do this stuff, its easy but he won't. Chris told me she gets frustrated with him, say UGHHH and bangs her fists on the table when she can't get him to do his work... She was mad and made a snarky comment because I decided to let my son stay home the whole day the other day when he went to the dentist. Well I had followed the dentists advice on keeping him home if I needed too. She said it was a very deep cavity, and to keep him home until the novacaine wore off, (she was worried about him eating and hurting the insides of his cheeks.) and that his tooth may be very sore when it wares off because of the depth of the cavity. To just keep him home if that happened. So I did. It was only a difference of two hours left of the school day anyway...
I'm having panic attacks over this and my doctor put me on lexapro.
Anyway, now he's back at the NP but both of us suspect something more like Aspergers along with Dysgraphia. I don't dare tell the teacher because with the way she and the principle see him/us at this point, they will just think I am trying to find something wrong with him.
So, does anyone think since things have changed with including the testing for Aspergers that I can legally get the insurance co to now pay? Or even getting a lawyer to help with this? Can the school system legally refuse a IEP? It wasn't in writing tho, it was verbal. And at this point I feel like the teacher is harrassing me and my son. I have to wonder if she is a teacher that just doesn't like him? I talked to my son and he wants another teacher, so I plan to do something about that monday morning.
Anyway, since you guys have so much more knowledge and experience on this subject I was hoping to see if anyone could give me any suggestions.
If I can't get the insurance co to pay I still plan to pay for it. But its 3600 and I would rather put that aside for braces. This is more of a last min effort to see if my legal rights have been violated. But no matter what, I plan to pay, because he is worth that and so much more.
Thank you for any advice you can give me. I really appreciate it.
Elaine

Elaine,
First off, HUGS HUGS and more HUGS.
I don't have any advice but I know someone here will have tons of advice to offer.
Our insurance no longer pays for a learning disability dx, that is up to the school system, or so I've been told. CJ, 10 AS, was diagnosed 4 months bwfore Tricare stopped covering. I hate Tricare, but that's a different story.
As for the principal and the teacher, good Lord! They are both useless. I'd try to get him out of that classroom, also. Document everything. Every conversation, every meeting, every note sent home, everything. You may need it.
I hope this blows over and you get what you need.
Hugs,
Crystal
Elaine,
Welcome to the board, BTW. I have been out-of action a little bit, and I don't think I welcomed you properly.
It sounds like you have had many people putting you through the wringer
visit my blog at www.onesickmother.com
Right here's what I would recommend first and foremost.
Oh thank you thank you thank you everyone! The hugs felt wonderful! Your advice was wonderful and I plan to go look for steph thru that link. I'm just so mad at both the school and the insurance co, Its just unbelievable.
I just got up (I am not an early morning person hehehe) and will go get my coffee and come back and read everything again. I will try to go find Steph too.
Thank you, I knew you would all know what I am going thru.... and lead me in the right direction....
Elaine