CHICAGO (CBS) — A viewer reached out to the CBS 2 Morning Insiders with a plea that sounds hard to believe.
She wrote, “Please help me, I’m relying on your assistance.”
The 60-year-old Chicago resident has lived for more than 15 years as a quadruple amputee. A motorized wheelchair – her lifeline to independence – is now in need of repair, and her insurance company has advised that she should try to walk or use a manual wheelchair.
For the woman, Abla Gharib, challenges are nothing new. She lost her lower legs and much of her hands to toxic shock syndrome back in 2001.
“As you see, the amputations,” Gharib said, “and also I ended up with graft skin for most of my body.”
Meanwhile, Gharib said about a year and a half ago, her motorized wheelchair broke down. And she has another challenge now – this time from an insurance company.
“They refuse to pay for repair and a new wheelchair,” Gharib said.
As CBS 2’s Tim McNicholas reported, Gharib said since 2003, Blue Cross Blue Shield of Illinois had covered her wheelchair repairs and even a couple of replacements under the Illinois Comprehensive Health Insurance Plan.
But Gharib said they are now denying her claim, even though she still pays the $1,700 premium every month.
“Really frustrated really depressed about it,” Gharib said.
For now, the wheelchair company is generously loaning Gharib a motorized chair while she fights with Blue Cross.
But even that motorized wheelchair is wearing down, with a backrest that will not adjust and a broken armrest.
“It’s making noise, but it doesn’t work,” Gharib said.
And damaged or not, she does not know how much longer she will get to keep it.
“If I didn’t have it, I wouldn’t be able to do anything on my own and I wouldn’t be independent,” Gharib said. “I would be just bound to the bed and not able to go anywhere.”
Blue Cross denied the claim and the wheelchair company appealed. But Blue Cross shot it down again, writing, “The patient is able to walk a little,” and, “The patient might be able to move a wheelchair with their arms.”
“You can see my fingers,” Gharib said. “I wouldn’t be able to propel a manual wheelchair.”
And as for walking a little, Gharib pointed out that she has prosthetic lower legs, which she cannot use often because they damage her sensitive skin and it can take weeks to heal.
When Gharib read the letter from Blue Cross, she cried.
“Because I felt like my life would be over, to be honest with you, Tim,” she told McNicholas, “and I’m really upset about it.”
Blue Cross wrote in the letter: “It is not medically necessary. Please call your doctor with any questions.”
But her doctor said it is absolutely necessary.
“This is a unique case. It’s very rare scenario when you find a person that has amputations involving all four limbs,” said Dr. Mark Huang. “It’s really critical, because if she’s not able to propel a wheelchair on her own that’s not motorized, then basically she’s going to be stuck in the wheelchair and can only propel at very short distances if at all.”
Gharib said the motorized chair would cost her thousands of dollars on her own – another challenge she does not want to face.
We reached out to Blue Cross Blue Shield of Illinois repeatedly. They refused to discuss this case, citing patient privacy.
Blue Cross did tell us that patients can appeal, something that Gharib has already done. We checked back with her and she told us Blue Cross has now promised an update by Friday – but there is no word on what that might entail. We’ll keep you posted.
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August 06, 2020 at 06:03PM
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Woman Who Lost Much Of Her Legs, Hands Is Now Being Refused A New Motorized Wheelchair By Insurance Company - CBS Chicago
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