GALLOWAY TOWNSHIP — Dan Lash glided back and forth through the water in the deep end of the pool, walking about 20 feet one way before pivoting in the opposite direction.

He had come a long way since October, when he first started therapy, clinging to metal sidebars in the water to help support his body as he worked to regain mobility and strength lost after he had a West Nile virus infection.

Lash, 58, is among many patients who have fought insurance companies or employers to get rehabilitation at the place of their choosing for the length of stay they need. Health care experts say it’s time patients know more about their rights to rehabilitation so they can advocate for themselves.

“They really need to get into it, advocate for their family, ask questions and always try to push back and try to get services they think they’re deserving of,” said Richard Kathrins, Bacharach CEO and Board of Directors chairman at the American Medical Rehabilitation Provider Association.

Health care advocates say physical and occupational rehabilitation is unique in the medical field in that it is often long-term — sometimes lifelong — and recommended for a range of health care issues such as chronic and temporary illnesses and diseases, injuries and surgical interventions.

For the 36,750 New Jersey people who were injured or sickened on the job in 2016, about one in four required more than 30 days away from work to recover, according to the U.S. Bureau of Labor Statistics.

One of the greatest problems, Kathrins said, is health care providers often see patients who don’t know how rehabilitation is covered under their insurance and how much say they have in choosing their rehabilitation provider. Bacharach started a campaign this year called #RehabRights to increase awareness among patients.

Lash and his wife, Mary, of Hammonton, said they were shocked when Pennsylvania Hospital doctors told them West Nile, transmitted through a mosquito bite, had caused Lash’s near total paralysis and life-support services in August.

The retired Atlantic City police detective would need extensive physical and occupational rehabilitation to recover his abilities to talk, eat, walk and move, but Mary Lash said she had to fight to get her husband into Bacharach, a designated inpatient rehabilitation facility.

“They (the insurance company) gave us a list of places I could go and wanted to put me in a (skilled) nursing facility that had therapy,” Dan Lash said. “But I wanted to go to Bacharach because that’s where I thought I’d do better.”

After getting denied at first, Mary Lash said, she was able to get Dan into inpatient treatment at Bacharach, where he stayed for more than two months before another six months of outpatient therapy. He recently transitioned to independent therapy under the provider’s Wellness Program.

Throughout therapy, they had to prove to the insurance company Dan Lash’s continued needs and progress to continue to get coverage for rehabilitation, Mary Lash said.

“The first time he was in the pool, I was so excited, because it was one of the first times he stood upright in a long time,” she said in the waiting area outside Bacharach’s aquatics therapy room. “Had he not been there, with aggressive therapy, he may not be as strong as he is now.”

James Dunleavy, New Jersey doctor of physical therapy and spokesman at the American Physical Therapy Association, said that is a situation he sees all too often in the rehabilitation field.

Rehabilitation is crucial for many different injuries and illnesses, he said, and waiting can result in damage. Getting denied coverage for the full time it requires a person to recover or heal from something can also result in poorer long-term outcomes.

It’s why doctors have moved onto the front lines of advocating and fighting for patients who need extended care, Dunleavy said.

“I have a case right now that because we see this patient, they won’t lose their limb, they have sensation and strength back, but they need pressure garments to maintain that,” he said. “We’re about to discharge the patient, and I can’t get the insurance company to answer my calls about getting the garments covered.”

For patients who only get covered up to a certain amount, Dunleavy said he has had to alter the schedule and time of therapy sessions per week to get the most rehabilitation for the patient while adhering to coverage limits.

“You’ve got to have a good support system behind you, that’s important,” said Dan Lash, who today is able to walk with minor assistance from a cane. “And when you get there (rehabilitation), you’ve got to have perseverance and be determined to get better and have patience.”

Contact: 609-272-7022 NLeonard@pressofac.com Twitter @ACPressNLeonard

Load comments