Why can't I get the treatment I need for my injured arm?

[Gertie2u]

Yes, this is yet another rant about stupid insurance companies. I could tell you the name of my company, but facts are most companies have similar stupid arbitrary rules. Physical Therapy has done wonders for my injured arm, and I've already seen a huge reduction in pain and a pretty good increase in mobility. I still have a good bit of pain and lack some motion. I will grant you, it is a big assumption, but assuming steady progress I estimate another 8-10 visits would do the trick nicely. Too bad, says insurance. Your injury was given a designation, and we've decided as much progress as can be made will be made in 20 visits. Guess we'd better buy stock in an ibuprofen manufacturer.

[CW&M Mom]

PT is definitely one of those things..insurance all suck big time at.

Is it something they can teach you? That is what my mom did when she broke her knee.

She had them teach her as much of the exercises as possible and she went to the pool every day to get her mobility back..and then, come January she went back and got as many more PT sessions as she could before she used her yearly allotment (since hers ran January to December).

Now 20 years later she still does those exercises every day.

another thing you could look at possible is to do occupational therapy for 20 visits...get a script for that, do as much PT on your own..and then start PT up again if you can in January if your "new year" starts in January.

[Gertie2u]

Yes, my physical therapist has taught me exercises and I do them religiously. Unfortunately, as I progress, the exercises I need to do and am able to do change, and there isn't really a way for her to predict what I need to do when in advance. Aside from that, there are several things she has been doing that have been very helpful with pain management. I guess I mostly fear without my weekly visits, the pain will come back and I will slowly loose the mobility I have gained without these treatments. Unfortunately for me, they either require expensive equipment or a trained therapist to know in what way to do them to my arm. I am trying very hard not to become depressed by all this, but having a very hard time. I will ask the doctor would occupational therapy be an option in this case, or if he has some other way I can continue to get the help I need.

[motherofmolly]

find out when your insurance will allow more. your doctor might have you wait 4 or 5 weeks and then he can order more pt for it and you might be able to get more.

funny your insurance wont allow it, but i tell you what my insurance just kept wanting to send me even when i didnt need it

[CW&M Mom]

Find out exactly when your year is up. Most go either jan to jan or sept to sept. If your Jan to jan..then you need to hold out to Jan..then they can get a hole new set of PT.

[Gertie2u]

My year goes Feb to Feb, that much I already know. I also already know because we've been tapering off my visits, after a few days I get a lot of stiffness and an increase in pain. The therapist has been doing some sort of sonic heat thing and some massage with each visit that really helps a lot. I'm going to just ask her what she would charge me per visit. I suspect what my insurance is paying, and I could maybe afford once per month. I just don't know if that will screw up the insurance paying for more come February or at a later date at doctor request. I was kind of hoping someone here might be aware of the appropriate trick...so to speak. I don't want to lie or anything like that, but I know sometimes it is sort of a game, if you will. Like they think if you really have the need, you'll be willing to jump through whatever hoops to get there.