A series of recent lawsuits filed against insurance companies in California claim that insurance companies are wrongfully refusing to provide microprocessor-controlled prosthetic limbs. The insurance companies are claiming they are investigational or “not medically necessary”, among other claims.
According to the lawsuits, microprocessor technology has been used in prosthetics for decades and has become standard in the industry. Microprocessor-controlled lower limbs feature sensors, a microprocessor, software, a resistance system, and a battery. They use technology to monitor a person’s gait using sensors. The sensors detect and monitor changes in the environment, such as going up or down a slope or walking at a different speed. Based on the feedback, the microprocessor adjusts the limb, which can enhance stability for the user, and can reduce stumbles and falls.
The lawsuits claim that the primary advantage of microprocessor technology is safety and stability, not the ability to engage in athletic endeavors. They are primarily for everyday activities of daily living and can be beneficial for virtually all amputees.
However, the insurance companies that have been sued have written medical policies that do not authorize payment for microprocessor-controlled limbs. Instead, they only authorize payment for the less-expensive body-controlled limbs, which have a number of disadvantages when compared with microprocessor-controlled limbs.
If you have had a claim for a microprocessor-controlled limb denied, you should speak with an attorney. Call me, Conal Doyle, Los Angeles personal injury attorney at 310-385-0567. I am working on several of the lawsuits and can provide you with a consultation on your case. Call today to learn more.