Getting around his family's two-story home in Bensalem, Bucks County is a challenge for 14-year-old Tony Rodriguez. He's quadriplegic and suffers from severe cerebral palsy.
"I'm worried that if I fall down the steps someday something worse than what his condition already is could happen," said Tony's mother, Jackie Padua, who physically has to carry him up the stairs over her shoulder.
So Tony's doctor recommended a Scalamobile, a stair-climbing device for wheelchairs. But the family's insurance company, Keystone Mercy, denied the claim saying the device was not medically necessary.
"It's just always a problem," Jackie said.
Jackie said Keystone Mercy has denied claims for Tony in the past so this time she decided to fight back. She found free legal help through the Gittis Center at the University of Pennsylvania Law School.
"The students who come here are certified to practice law under supervision according to a law adopted by the Pennsylvania Supreme Court," said Alan Lerner of the Gittis Center.
Second year law student, Maggie Rosenberg worked on Tony's case.
"I just felt an immediate connection to them and I really wanted to help them," said Maggie.
To get a team at Gittis to take your case, you do have to meet financial eligibility requirements. For instance, the annual income of a family of four cannot exceed about $42,848.75.
And because Gittis is a law school clinic, it takes very, very few cases.
But Gittis is just one of many resources consumers can use to get free or discounted legal help and some agencies help people of any income level. For instance, every third Wednesday of the month anyone can call the Philadelphia Bar Association's legal line at 215-238-6333.
"And there will be lawyers there who will be there to answer your questions," said Michael Pratt, Philadelphia Bar Association.
The Bar Association's Chancellor said anyone of any income level can also participate in the Lawyer Referral and Information Service. Your initial half-hour consultation will cost you just $30.
The bar association also has a low-fee program. It's for low to medium-income families who can't afford a private lawyer but make too much money to take advantage of free services. A lawyer will handle your case for just $50 an hour as opposed to a typical fee of at least $200 an hour!
A lawyer will also handle a deed transfer for $50 and a power of attorney for $25.
Meantime, Tony now has his Scalamobile.
"It's working great, wonderful," Jackie said.
Keystone Mercy denied coverage of the Scalamobile twice but Rosenberg and her supervisor persisted and won their third appeal.
"We were really excited. Everyone was really excited," Maggie said.
"Thank you very much. I mean I never would have been able to do it without them," Jackie said.
Meantime, Keystone Mercy told us:
The appeals process is a standard and valuable process that allows health plans to obtain additional clinical information to make an appropriate decision our home medical equipment denial rate is low, less than 2%.
For more information:
More Pennsylvania Resources:
Philadelphia Bar Association
Find a Philadelphia Lawyer
Pennsylvania Bar Association
New Jersey:
NJ State Bar Association, Pro Bono Help
NJ State Bar Association, Military Legal Assistance
NJ State Bar Assoc., Lawyer Referral Services
Delaware:
Lawyer Referral
