User:Hero cop screwed by UHC in AZ

I had a dream. A rather simple dream really; to walk hand in hand with my beautiful wife of nearly twenty one years around our neighborhood. Simply walk around a few blocks. Most would say, “Wonderful dream” right? Well it was all brought to an abrupt and cruel end on August 19, 2013. Not by some criminal or government agency, but by United Healthcare, our health insurance provider. You see, after serving as a Marine Sergeant, living by the rules of society, and paying my taxes, bills, and the so called “dues” of our society, I decided to serve again as a Highway Patrol Officer for the State of Arizona. On April 28, 2008 I was on the side of the freeway issuing a citation to a motorcyclist who had been speeding. Enter a driver who did not feel the rules applied to her. She decided that watching me was more important to watching the road. She also decided that traveling the posted speed limit of 45 miles per hour in a construction zone was not reasonable. She subsequently lost control of her pick up, crossed sideways over two lanes of traffic, prompting me to tighten every muscle in my body anticipating the collision I thought was coming. She narrowly missed me by about a foot, crossed back over two lanes of traffic and into the median where her vehicle rolled several times before coming to a stop on its’ roof. I grabbed a small fire extinguisher and first aid kit from my car and ran to her vehicle where I found her screaming, flailing about, and scratching at the window of her truck. I saw she had some blood on her face and did not know the extent of her injuries, but I did know her truck was smoking. I emptied my extinguisher into the engine compartment, and moved to where she was trapped inside her overturned truck. I told her to cover her eyes, then kicked in the window and dragged her from the vehicle to safety. Unfortunately, during my efforts to extricate the woman to safety, I tore the medial meniscus in my left knee. I did not realize it at the time as adrenaline masked the pain, but I did notice it a few hours later and reported the injury to my department as required. Over the next two years, I underwent several surgeries to my knee, ultimately losing the meniscus as it was too badly damaged. I would be retired by the State because of my injuries in May of 2010. I receive a pension. No health care, no benefits, only a pension, from which I must pay for healthcare, which if my wife did not have a good job, would cost around $1200.00 per month. This does not include annual copays and deductibles. It does greatly outpace my pension. Several times, my orthopedic specialist recommended I have at least a partial replacement of my left knee in order to alleviate the immense pain I constantly felt due to the bones grinding upon each other. Every time, the state would send me to an “Independent” doctor, (none of which had even a stethoscope in their offices), to be evaluated. Each time these independent doctors evaluated me, their conclusion was be that I did not require the suggested procedure. So I waited. In the years to come, the damage to my leg caused my lower back to deteriorate. I ended up having four Titanium screws and rods installed in my lower back to fuse the disks which were damaged by my inability to walk normally. This was done by a surgeon outside the state system. I went through own health insurance. My orthopedic surgeon who performed the back fusion suggested I have my left knee evaluated again by a specialist to determine if a partial or full replacement should be performed. He suggested this because he could FEEL the grinding of the boned in my knee when I moved it. I went to see the specialist my back surgeon suggested, had the prescribed tests, x-rays, and MRI performed. The knee specialist concluded that since my ACL was still in relatively good shape, a partial knee replacement should be performed. I agreed, and began planning. My wife took a week off work to assist me at home, a CAT scan was performed which found bone fragments floating around in my knee due to the bone-on-bone contact. The surgery was scheduled for August 20, 2013. As I anxiously awaited this day, my spirits began to rise in anticipation of FINALLY being able to lead a semi normal life once again. This was not to happen. On August 19, my doctor’s office called and told me they had cancelled the surgery as United Healthcare had denied coverage. After a little more digging, I found the insurance company and my doctor had a “peer-to-peer” conference call that morning. My doctor stated he argued for half an hour with the Unite Healthcare doctor the surgery was needed. United Healthcare claims my doctor simply agreed I did not meet the “requirements” of the procedure. In the meantime, I am once again left in the cold, only to dream of holding my wife’s hand while walking around our block. All because I made the foolish decision to do the right thing, and not allow another human being to burn to death. So, the next time you see a police officer standing around while someone burns in a car or house fire. Do not blame that officer for not interceding. They are not required to do so under any law, regulation, or policy. Doing so is at their sole discretion. I for one have only respect for my brother and sister officers who are not willing to risk their lives when our society has sent the clear message that they will be left to fend for themselves with only a meager pension. No provided healthcare, no expectation of the kind of care that former Representative Gabriel Giffords is currently receiving. They are left with only dreams of a normal life. And the knowledge that they will be left in the cold by the society they put their lives on the line to protect.