Category: Amputation

A class action lawsuit was filed late last summer against Anthem, one of the largest health insurance companies in the U.S. Anthem was accused of denying coverage for some lower limb prostheses because they were determined to be “not medically necessary”.  The lawsuit is seeking damages for the amputees as well as an injunction against the company, as well as attorney’s fees.

The lawsuit alleges that Anthem has developed a coverage guideline that it uses to deny claims for microprocessor controlled lower limb prostheses. According to the lawsuit, improvements in technology have allowed prostheses manufacturers to use microprocessors to power artificial knees and foot-ankle devices. Microprocessors controlled devices use technology to simulate the movements of a normal knee or a normal foot and ankle. These devices are considered as standard now and are routinely prescribed.

Anthem’s policy is that microprocessor controlled lower limb prostheses are not medically necessary. Anthem also labels the devices as “investigational”. According to the lawsuit, studies have concluded that microprocessor controlled lower limbs provide significant benefits and therefore are medically necessary. The lawsuit also alleges that there is more than sufficient evidence of the effectiveness of the devices, and that they therefore are not investigational.

If you are an amputee and you have been denied coverage for a lower limb prosthetic by Anthem, call me, Conal Doyle, California Amputation Attorney at 310-385-0567. I can help you join the class action lawsuit or help you to find other ways to be compensated for your device. Call today to learn more.

In September of 2017, Anthem was sued in a class action lawsuit in California for failing to provide coverage for microprocessor controlled lower limb prostheses for amputees who had lost a lower limb. The lawsuit alleges that Anthem has determined the devices are “not medically necessary” and are “investigational”. The lawsuit claims that the devices are effective and are also necessary for amputees who have lost a lower limb.

The two types of lower limb prostheses are above the knee prostheses and below the knee prostheses. Manufacturers of both devices now use microprocessors to power artificial knees as well as feet-ankles in those devices. According to the lawsuit, microprocessors have been standard in the devices for some time. Microprocessor controlled devices improve stability, decrease the number of falls, and improve ambulation on all surfaces.

However, Anthem alleges that microprocessor controlled lower limbs are not medically necessary and are investigational. Microprocessor controlled devices are more expensive than other types of limbs, but can provide huge benefits to an amputee. The lawsuit alleges that Anthem has denied coverage for the limbs using erroneous criteria.

If you are an amputee and were denied coverage of a microprocessor-controlled limb, you may be eligible to join the class action lawsuit. You may have other legal options as well. Call me, Conal Doyle, Los Angeles personal injury attorney at 310-385-0567. I can help you investigate your legal options.

Late last year, a group of Los Angeles attorneys sued United Healthcare, an insurance company, for failing to properly provide coverage for artificial limbs. The lawsuit alleges that the company systematically denies claims for prosthetic arms and legs without assessing or determining the amputee’s needs or how the device will meet those needs.

According to the lawsuit, United has a coverage determination guideline that it uses to deny claims for prosthetic arm and leg devices. The guideline states that if more than one prosthetic device can meet the amputee’s needs, benefits are only available for the device that meets the minimum specifications for the member’s needs. The lawsuit alleges that United has used this guideline to systematically deny coverage for prosthetic arm and leg devices without properly assessing or determining the amputee’s needs.

The lawsuit is asking that the plaintiffs receive compensation from United Healthcare for their claims. The lawsuit also asks that rights to future benefits under the insurance plan be clarified, and that any profits made by the improper denial of claims be retained.

If you are an amputee and you have been denied coverage for a prosthetic device by United Healthcare or by any other insurance company, call me, Conal Doyle, Los Angeles Amputation Attorney at 310-385-0567. I can help. Call today to learn more or to schedule a free consultation on your case.

A lawsuit that was filed late last year accuses Blue Shield of California of refusing to properly reimburse prosthetists for their prosthetic leg components. The lawsuit is seeking restitution and damages for the victims, as well as an injunction against Blue Shield’s business practices.

Under Blue Shield’s insurance contract with its customers, the insurance policy is designed for customers to obtain services from in-network medical professionals. If the customer chooses to get an out-of-network provider, the costs to the customer are usually higher. According to the lawsuit, implicit in the contract is the promise that Blue Shield will maintain a good network of providers. However, Blue Shield has failed to maintain an adequate network of prosthetists, which can result in customers being forced to obtain treatment from out-of-network prosthetists.

In the lawsuit, one amputee (who was a customer of Blue Shield of California) is alleged to have been unable to find an in-network prosthetist to create a below the knee artificial limb. The amputee was forced to use an out-of-network prosthetist. Blue Shield only paid 37 percent of the cost of the limb, which forced the amputee to pay about $18,000 out of pocket.

If you are an amputee and a customer of Blue Shield of California, and you have been forced to use an out-of-network prosthetist, which resulted in high expenses to you, call me, Conal Doyle, Los Angeles personal injury attorney at 310-385-0567. I can help you to join the class action lawsuit. Call today to learn more or to schedule a free consultation on your case.

First, I’m sorry to hear about your amputation. I am not only a personal injury attorney, I’m also an amputee. I understand all the emotional and physical issues that accompany most amputations.

Even the best prosthesis will never be the same as your limb. However, some great progress has been made in the field of prosthetics. They are more functional, comfortable, lightweight, and cosmetically appealing than ever before. Despite all the improvements, however, some prostheses are simply not useable.

Your options depend on the problems with the prosthesis. If it is too heavy or uncomfortable, talk with your prosthetist. There may be major or minor changes that can make a huge improvement in your comfort level. Also, keep in mind that your limb is designed with your activity level in mind, so discuss in great detail with your prosthetist your specific needs.

If you are concerned about the cosmetic appearance of your prosthesis, discuss that with your prosthetist as well. Most prostheses today can have a very natural appearance. There are new covers and skins that can make your limb look very similar to your other limb. It’s very important to discuss your expectations about your limb’s appearance with your prosthetist.

Prostheses can not only be a challenge to adjust to, they can also be incredibly expensive. If you have lost your limb in an accident, you should discuss your legal options with an attorney as soon as possible after the accident. You may be able to recover compensation to offset your expenses. Call me, Conal Doyle, Amputation Attorney, at 310-385-0567 to learn more or to schedule a free consultation on your case.

I’m very sorry to hear about your ATV accident. I am not only a personal injury attorney, I am also an amputee, and I understand how an amputation can affect the rest of your life. If the accident occurred under certain circumstances, you may be able to recover compensation.

ATVs are popular among teens and adults. They are used not only for recreational purposes, but also for tasks on farms and at businesses. However, even then they are used correctly, they can lead to accidents and serious injuries. It’s been estimated that there are roughly 100,000 emergency room visits each year in the U.S. due to ATV accidents, and many of those are for children.

It can be very complicated to figure out who is responsible after an ATV accident. In some situations, the owner of the ATV is legally responsible, and to obtain compensation after your accident, you may need to file a claim against that person. If the ATV itself was defective or unsafe, and the defect led to your accident, you may be able to file a claim against the ATV’s manufacturer or retailer. If you were riding the ATV on private property that was somehow dangerous, you may be able to file a claim against the property owner, which may be paid by homeowner’s insurance.

Amputations can result in huge medical expenses over the course of an amputee’s lifetime. In addition, an amputation can seriously impact the amputee’s career and potential earnings. It’s important that if you have been injured in an accident and lost a limb because of someone else’s wrongdoing, you speak with an attorney. Call me, Conal Doyle, Amputation Attorney, at 310-385-0567. I can help. Call today to learn more or to schedule a free consultation.

I am also an amputee, as well as a personal injury attorney, so I understand how traumatic an amputation can be both physically as well as mentally. If you have suffered an amputation because of an accident at work, you should speak with an attorney.

In most cases, if you are injured on the job, you cannot sue your employer directly for your injuries, even if it was your employer’s negligence that caused your injuries. Instead, you are limited to workers’ compensation, which is a type of insurance program. Your employer pays into the workers’ compensation system, and when an employee is injured, the employee is limited to benefits from workers’ compensation insurance. Workers’ compensation pays for medical expenses and a portion of lost wages. If an employee is permanently disabled, the employee may receive a settlement.

Although you cannot in most cases sue your employer directly if you are injured on the job, you can sue any third party that contributed to your injury. For example, if you were harmed because the equipment that fell on you was unstable and poorly designed, you may be able to sue the equipment manufacturer. Typically, you will receive more compensation from a personal injury lawsuit than from workers’ compensation.

If you have suffered an amputation on the job, you should consult with an attorney to find out all legal options that are available to you. Call me, Conal Doyle, Amputation Attorney at 310-385-0567. I can help. Call today to learn more or to schedule a free consultation.

I’m sorry to hear about your amputation. As you have probably learned, prostheses and associated services and equipment are very expensive, and often need to be replaced fairly regularly. The good news is that there are a number of sources that can help to finance your prosthesis.

Your first step is to determine what you need, and to get a prescription for that device. Stay organized, and keep detailed medical records and information about your income, expenses, health insurance, and dependents – all of that information may be needed during the funding process.

Your first step is to talk to your insurance company, if you have one. If you did not receive the benefits to which you thought you were entitled, consider filing an appeal and above all, be persistent. There are also some government services to which you may be entitled that could pay for limbs, including Medicare, Medicaid, the Veterans Administration, and Tricare. If you do not have insurance, and you do not qualify for assistance from the government, you may want to talk to a non-profit organization, which may be able to help.

You may also consider a personal injury lawsuit, if your amputation occurred because of the wrongdoing of another party. If you were involved in an accident with a reckless driver and that caused your amputation, or you believe your amputation was caused by a doctor’s medical malpractice, you could be entitled to compensation. It’s critical that you speak with an attorney sooner rather than later – time limits apply, and typically the sooner a case begins, the easier it is to pursue.

Call me, Conal Doyle, Amputation Attorney, if you have suffered an amputation because of another party’s negligent actions, or if you believe that your insurance company is wrongfully denying your claim in bad faith. I am not only an amputee, I am also an attorney. Call my team today at 310-385-0567. We can help. Call today to learn more or to schedule a free consultation.

I am so sorry to hear about your amputation. As an amputee as well as a personal injury attorney, I can understand the physical and emotional issues that an amputation can cause.

In some cases, an amputee may be able to sue a doctor for medical malpractice for issues related to the amputation. Most medical malpractice cases hinge on whether or not a health care professional was negligent in treating or failing to treat a patient. Medical malpractice cases are always evaluated by the medical standard of care that is applied in the specific medical treatment setting in which the patient was treated. Therefore, in order to determine whether or not your doctor was negligent, you should look at the treatment that other doctors practicing in the same community and same medical field would have provided.

In your situation, to determine whether or not your doctor may have committed medical malpractice in failing to save your limb by using oxygen therapy, you will have to evaluate whether other doctors in your area would have used oxygen therapy to save your limb. It’s likely, although you will want to speak to an attorney, that oxygen therapy would be considered as an experimental treatment, and would not be part of a standard treatment for most doctors in the area.

If you have had an amputation, and you believe your doctor may have committed medical malpractice, you should speak to an attorney as soon as possible. Call me, Conal Doyle, Amputation Attorney, at 310-385-0567. I can help. Call today to learn more or to schedule your free consultation.