Posted on April 23, 2011 · Posted in TBI Voices
This entry is part 14 of 14 in the series Gina

Brain Injury Advocate: Gina Concludes in Part Fourteen

Gina is in a unique position to discuss the issue of brain injury advocates, particularly self-advocacy. She not only is a TBI survivor who has a background in insurance, she is a survivor who went back to work in insurance, despite her brain injury deficits. While there are other battlegrounds, fighting back against insurance companies is one of the biggest challenges for the brain injury advocates and their community. On being a brain injury advocate, Gina had this advice:

If you don’t like what you hear from one doctor and you don’t agree with them, I guess find another doctor. If you don’t agree with what the insurance company refuses to pay or limits you on, you need to keep at them.

Get your policy. Look at it and just keep – I guess learn to be a little bit more – this is one of my problems. The word just left me. Learn how to advocate for yourself. That’s the biggest thing I notice with a lot of people in the group is just, you know, you could do this, you could try this, don’t give up.

Just the biggest thing I’ve learned is advocating and a lot of it is for myself and I guess I’m fortunate that I’m able to do that, that I, I’m pretty much independent. I will, I will fight for myself for something I want or I think I deserve or they’re screwing up on or they’re denying me things that I think I should get.

What are the processes, what are the things to remember when you do brain injury advocate for yourself?

Just writing everything down. Just, I guess with my insurance company I had major, major issues with them and I started documentation, everything, every phone call. I did homework. I had my policy. I guess that’s one thing I’m fortunate about. I don’t sell health insurance but I understand policies. I happen to have it on me and I kept calling them. You get your EOBs and if they’re denying something and you think it should be covered, sometimes it’s a doctor’s error and they coded it wrong so it’s a matter of – I documented. I kept one place where it was insurance issues.

Write down the date. Write down the time. Get the person’s name that you talked to and their extension and if you think they’re wrong, ask, call someone else. Call again.

Call the doctor’s office if the insurance company says well, no this is the way they coded it and you’re like I know I didn’t, that’s not what they did for me. So it’s, I guess like I said, I keep hounding them. They just got to the point where I think they – I guess people have got to understand especially there, they don’t, the people that are answering the phone don’t always know. They don’t even know what the policy involves. They, I’ve had to tell them a few times, no this is what it is.

As with being a brain injury advocate, self-advocacy, the key is never giving up. She says:

I don’t want to say things will get better. They don’t always get better. What you got to do is do what you can to adapt. Hopefully get people around you that are going to at least be empathetic, maybe not understand. Find where your weaknesses are and I guess do what you can. Try to do what you can to improve the situation.

Her husband concludes with a like sentiment about brain injury advocates:

Well a lot of it is time and be patient. It’s not going to be better over night and it is a life changing experience. You’re going to have to deal with things that change with your significant other as a result of an injury like this.

Gina has had a good result, a remarkable success in returning to a job that would derail most comparably injured people. But despite mistakes that were made in her early care, she got to where she is today because of commitment – her commitment to adapting, her husbands commitment to being patient. But key was the extraordinary commitment of her boss in believing that the Gina he knew, relied on, trusted – would return. I a way, you could call her boss a brain injury advocate.

Be patient; be committed; and believe in recovery, regardless of how long it takes.

Attorney Gordon Johnson

About the Author

Attorney Gordon S. Johnson, Jr.
Past Chair Traumatic Brain Injury Litigation Group, American Association of Justice :: 800-992-9447