Insurance companies and cognitive therapy: the fight continues


Source: Libertas Academica

Source: Libertas Academica

Ellie Cizek, a 20 year old, experienced a traumatic brain injury on the ski slopes which resulted in a period of coma and a long road back. Her rehabilitation team believed that her recovery would require 18 months and her insurance company cut off funding after four months when she regained the skills to walk and talk. The decision of her insurance company was made in total neglect of her cognitive deficits arising from her severe brain injury. Their decision was based on their medical necessity criteria which did not include consideration of her thinking skills as part of her brain injury.

We are seeing a shift in the view of cognitive therapy as an integral part of brain injury rehabilitation in some sectors such as the U.S. Military, the VA and some recent state legislation which forces insurers to address the issue. Ellie’s story needs to become one of  “old news”. People with brain injuries need comprehensive rehabilitation services which include physical, psychological, cognitive and behavioral rehabilitation. The failure of insurance companies to recognize the role of the brain and its functions is a sad state of affairs.

Click here to read Ellie’s story.

About Rolf Gainer Ph.D.

Dr. Rolf Gainer is the founder of the Neurologic Rehabilitation Institute at Brookhaven Hospital in Tulsa, Oklahoma as well as the Neurological Rehabilitation Institute of Ontario, in Toronto, Canada. Dr. Gainer is a psychologist with more than twenty-five years of experience in the treatment and rehabilitation of individuals with brain injuries and a dual diagnosis. Dr. Gainer has designed and operated innovative rehabilitation programs in the United States and Canada for individuals who have been regarded as difficult to serve. He is currently involved in conducting two outcome studies related to the long-term issues faced by individuals with brain injuries and a dual diagnosis. He has presented papers throughout the United States and Canada in many professional conferences and educational forums.

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