Hearing Benefit/cochlear imlant
Lorene
request for Hearing Benefit under the ODSP. It is dated Feb 12. It has
my correct name and address including the ID member number. Read what
I typed the letter below:
Dear Lorene
Your request has not been approved because cochlear implants are not
covered by ODSP, but we will fax request to Discretionary Benefits at
151 Dundas Street, London to consider.
If you do not agree with this decision to deny your request for
Hearing Benefit, you can ask us to review this decision again. This is
called an internal review. You must ask for an internal review in
writing by March 18, 2010. If you miss this deadline, but you still
want to ask for an internal review, you should write to us explaining
why you were late. If you were late because of a reason that was
beyond your control, we may do an internal review even if the deadline
has passed.
If we do not change the decision after the internal review, you can
appeal to the Social benefits Tribunal. Please note that you must
request an internal review before you can appeal to the Social
Benefits Tribunal. If you do not ask for an internal review, you will
not be able to appeal to the Social Benefits Tribunal adn this
decision will be final.
Information about to ask for an internal review and how to make an
appeal to the Social Benefits Tribunal is included on the back of this
letter.
Sincerely,
Name of caseworker was included, but I decide not to include her name
Income Support Specialist for the Director of the ODSP
I have no idea what this is all about. I have never asked ODSP about
the hearing benefit at all. I have never requested anything from ODSP
at all, not even in the whole year of 2009 and the 1st month in 2010.
When I got the cochlear implant (CI) that was 7 years ago. Okay, just
over a year ago, 13 months ago, I got an upgraded CI. My audiologist
is the one who filled out the paperwork and send the bill to ODSP to
get them to pay for the difference of my old CI and the new CI. I just
signed the paperwork. Of course, I couldn't keep the old CI. It was
returned back to the CI headquarters in Toronto. The new upgraded CI
has more benefits than the old one had. In fact I like the new one
better than the old one. If the letter says it was about the cochlear
implant, why wait 13 months to make a decision about this before I got
the letter in today's mail. Does that make good sense? My audiologist
was the one who suggested having a new upgraded and the ODSP will pay
for the difference.
What should I do? I don't want to get stuck repaying ODSP back in
thousands and thousands of dollars back to them. I am looking at
around almost $10 grand. That is a lot of money.
Wait a minute. How often can a person get something under the ADP
funding program? Would that have something to do with that? Is there a
limit or strict rules for people who need ADP funding?
I have my TTY/TDD (telephone for the deaf) under the ADP program in
2001. My old CI was covered under the ADP funding in 2003 and the
ODSP paid the difference. My new CI was also covered under the ADP
funding in 2009 and the ODSP paid the difference, or so I thought.
That is 6 years in between the old and the new CI. I am requesting to
get a scooter just last week under the ADP funding program. The OT was
at my place last week and she filled the paperwork and I signed it. I
will not know if I get approved it or not in couple months or so.
I do know TTY/TDD can be replaced every 5 years to get a new one under
the ADP program. That was no problem as my old one was 10 years old. I
do know Hearing aids can be replaced every 5 years, except if it is 3
years old and having some problems that can't not be fixed or
something, you are allowed to get a new hearing aid under the ADP
funding with the audiologist's help explaining why a person needs a
new one. I am pretty sure the same thing for the CI, too. Sounds like
the Ontario Government are cracking down on ADP funding rules or
something. Something is screwing me around. I am getting a headache
and worried sick now.
Star
wrong person's desk or someone was going through your file at ODSP and
just started marking it at random for stuff for costs.
i'm sure that there will be plenty of these letters going out for no
reason in the near future that are completely unnecessary, cost more
money to right than the people filing them out actually doing their
jobs.
i'd take it to the media as well that you got singled out for
something like this completely unnecesarily and what it'll cost the
gov't to right the mistake that the person at ODSP doing their job
correctly would have saved taxpayers in the first place.
Sharol Caswell
> straighten out.
> Sharol
Brenda
from odsp using your ID and you are being informed of it.I don't think
you have anything to worry about.
Apparently there are two areas of budgeoning medical expenses for
odsp, hearing aids and mobility devices.
also of note.
February 15th was a new statutory holiday called Family Day. You got
end dated nasty mail delivered from odsp. hrumph
Correspendance that effects your eligibility for benefits requires a
signature from the director or regional manager.
Lorene
order the new upgrade CI. It was the other audiologist, whose name I
can't remember, ordered and did not send the request funding to ODSP.
ADP only pays up to 75% of the cost and the ODSP pays the rest. It is
the hospital's mistake, not the ODSP. So therefore, Kim told me not to
worry when this happens if I get stuck with the bill from ODSP, the
hospital will cover the bill for me, not me. Well, we will see when
that happens.
I am going down to ODSP right now. I am at the library checking my
audiologist's message before stopping in to ODSP office which is only
a block away. I will l find out what they had to say and let you's
know.
And Brenda, OHIP does not pay for the upgraded CI. They do pay for the
first one when you have the surgery. So the upgraded CI funds has to
come out of ADP and ODSP funding, not OHIP.
Lorene
Lorene
ADP paid $7200 plus and the remaining balance was $1600 plus.
I contacted my audiologist again by email. She told me the hospital
will pick up the tab for me as it was their mistake on their behalf
because the temporary audiologist didn't fill the correct medical
terminology in the paperwork.
Cochlear implant is when they insert behind your ear when they do the
surgery by opening part of your scalp by your ear to insert electrodes
into the cochlea and they stitched your scalp after inserting a magnet
inside to the other side of my scalp. When 4-6 weeks of healing time
is up after the surgery, you are fitted with a cochlear implant speech
processor and the coil that has a magnet that attaches onto the scalp.
ODSP does pay for speech processors, not cochlear implant. There is a
difference right there.
What I got is a new upgraded brand new speech processor last January
2009. ODSP should have covered it except the temporary audiologist
didn't use the correct medical terminology in the paperwork requesting
ODSP funding. That is how come ODSP rejected it. I am still
flabberghasted it took them 13 months to let me know of their
decision.
Furthermore, the ODSP are confused the difference of cochlear implant
and cochlear implant speech processor. That is where the trouble
started. I think the temporary audiologist put in cochlear implant on
the paperwork and that is probably why ODSP will not pay for it. OHIP
pays for it - the whole thing - surgery including the first cochlear
implant speech processor and 5 year return visits back to the hospital
for adjustments and mapping. By mapping here I have copy a bit and
pasted what it means:
A cochlear implant user needs to have their MAP frequently updated.
This is because each MAP is individual to its user and is constantly
changing. Over time, MAPs may become weak, softer, or less clear. This
is the result of several factors including adaptation and tissue
growth. Fibrous tissue continues to grow over the internally implanted
device (electrodes and receiver) during the months following surgery.
These changes may change the amount of electrical stimulation needed
to stabilize the signal. The greater the tissue growth over the
implant device, the more power is required to stimulate it. If tissue
growth occurs without mapping, the signal will begin to fade.
When the MAPs are new, they tend to sound louder. With experience, the
user becomes accustomed to the stimulation and ‘adapts’ to it, finding
that over time, it may no longer be a loud enough signal. This is
called adaptation. This is similar to when one listens to music at a
set volume level for a long period of time. It sounds comfortably loud
at first, but as the minutes pass we find ourselves raising the
volume. Reprogramming the speech processor compensates for any changes
that occur due to adaptation.
That information came from their website at www.medel.com if anyone
like to take a look at it.
My audiologist told me to come in tomorrow morning to the hospital
with the letter I got in the mail yesterday as she wants to photocopy
it and her department will take care straightening the mess and paying
the bill for me. Whew!!! What a relief that is!!! I was ready and
itching for a fight!!! LOL All my relief and headache went away. Thank
heavens for that!!!
Lorene
Lorene
an internal review of the decision about your request for cochlear
implant (CI) under the ODSP. They have deny my request because CI are
not covered by ODSP. Their decision is completed and the original
decision has been reversed.
I can understand that. My audiologist, Kim at the University Hospital
said they (the hospital) will pay for what I supposedly owe to ODSP.
However, in the next paragraph, I am confused what it means, "This
means that we have changed our decision to deny your request for
hearing aid because teh ODSP policy directives allows for funding of
the portion of the cost for a hearing aid or hearing aid appliance not
covered by ADP and you will receive this benefit as of Feb 18, 2010. A
payment of $1669.93 will be issued to you."
Does that mean I will get a benefit cheque? But I never paid for the
CI. ADP and ODSP are supposed to cover the whole cost. ADP by 75% of
the cost and the rest is paid by ODSP. And yes ODSP will not covered
the cost of cochlear implant because it is paid for thru OHIP, which I
got it 7 years ago. Since then, I got a new and upgraded cochlear
implant speech processor just over a year ago. I was told by Kim that
ODSP does pay for speech processors and supplies and batteries, not
cochlear implants. So that letter is making me confused about the
paragraph about the benefit payment. I haven't gotten the benefit
cheque yet. I can't keep it right??? I would have to return to ODSP,
right??? I don't know if it will be a cheque or direct deposit to my
bank account. I kept checking my bank online and so far, there is no
payment.
Lorene
Star
member of CHS with you to help with translating that you can trust to
not give you misinformation to clear up the matter.
it could be a benefit for devices that you qualified for for years and
this is backpayment because YOU KNOW, ODSP hasn't known about your
hearing problem for the entire time you have been on ODSP... *eyeroll*
so you should have been getting extra money for item x,y,z or
something.
it kinda sounds like ODSP is covering their own.
i'd be at the office asap with help to clear it up or you can take the
money and if it gets deemed an overpayment pay it back over 20 years
in little sums and say YAY to nearly 2 grand?
Sharol Caswell
take the money and have paid out nothing, it will come back to haunt
you eventually and you will need to pay it back,
corrinna
needs from then on, or just at the whim of the office. Not
worth the after effects. If it were a retroactive payment, it
would not have been in response to an internal request
for this year. However, checking in with your worker is a
good idea.
--------------------------------------------------
From: "Star" <star...@gmail.com>
corrinna
if you keep it, they are going to ding you for it. You are
supposed to submit it to the audiologist or return it back
to ODSP.
--------------------------------------------------
From: "Lorene" <sym...@yahoo.com>
Sent: Tuesday, February 23, 2010 12:00 AM
To: "ODSP Fireside" <odspfi...@googlegroups.com>
Subject: [odspfireside: 26774 ] Re: Hearing Benefit/cochlear imlant
I can't keep it right??? I would have to return to ODSP,
right???
Lorene
bastetschylde
of it and OW paid for the remainder. I also had a cochlear implant
turn-in and money from that went towards the upgrade as well so ADP
and ODSP could pay less on it. My audiologist took care of everything
and I made sure to discuss it with my worker. No problems so far.
The cheque you got seems like it's for the audiologist to pay
Cochlear.
Lorene
me about the mistake and straighten the mess for me. That is okay and
a huge relief. Darn it, I could have use $1600 cheque. Oh well,
beggers can't be choosers.
What is the make of the cochlear implant you have, bastetschylde?
Lorene
bastetschylde
compatible with the Cochlear Nucleus 5. I am still adjusting to the
new processor (got it in January) and going in for finetuning.
Do you have difficulty on the phone still by any chance? Feels like
I'm getting worse and worse, although part of it may be because of my
anxiety issues and I'm less likely to use the phone and "practise"
listening.