Assistance for a Lee County woman…
A sample of cases handled by Legal Aid of North Carolina
Note: This is an actual case submitted by an attorney from the Legal Aid of North Carolina office in Raleigh, NC
The client is a 63-year-old, Lee County woman with diabetes who had
not seen a doctor or taken medication in recent months prior to coming
to the Legal Aid Office. Simply put, she had no medical insurance
and could not afford to pay for treatment.
Also, the client did not have a good understanding of her medical condition
or its seriousness. She had been hospitalized in December 1998 because
of diabetic ulcers in the tissue and bone of her foot. While in the
hospital, she had had an incident of cardiac arrest, and had been diagnosed
with a heart valve defect.
The client had been released after three weeks in the hospital and had
applied for Medicaid, but her application was denied on the grounds
that she was not disabled. The Disability Determination unit in Raleigh
had determined that the client was capable of medium work, which means
that she should have been able to occasionally lift up to 50 pounds,
and frequently lift 25 pounds.
The client had worked for many years at textile mills, which had been
closed down. In the months prior to her hospitalization, she had been
working at Burger King. She was experiencing pain while walking or standing,
could not lift more than 10 pounds, and needed to take frequent breaks.
After her hospitalization, the pain became worse, and she was unable
to stand or walk for more than 20-30 minutes at a time.
The staff contacted the physician who had treated the client and
obtained medical records and a physician statement, which documented
that the client had severe diabetic neuropathy. This condition resulted
in inability to stand or walk for long periods, affected her gait and
station, and caused her a great deal of pain. Her heart condition also
limited her ability to work.
An attorney represented the client in an administrative appeal
hearing at the Department of Social Services. The hearing officer determined
that the client was disabled, and granted Medicaid retroactive to December
1998.
Now that the client has been granted Medicaid, she is seeing her doctor
regularly, undergoing additional tests and treatment, and obtaining
the proper medications. Her condition appeared to have stabilized and
the pain lessened somewhat at the time of the closing of her case in
August 1999.
The estimated financial benefit of the treatment and medication paid
by Medicaid from December 1998 until client turns 65 is at least $38,740.
"Without Medicaid, the client could not have afforded to see her doctor
or obtain medication for her diabetes, which was the cause of her medical
problems," noted the Legal Aid attorney. "Without proper treatment,
her condition would have worsened, probably leading to amputation of
the feet or legs, and additional nerve and organ damage. Fortunately,
Legal Aid was available to advise her and help her establish eligibility
for medical benefits."
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Mission Statement
Legal Aid of North Carolina is a statewide, nonprofit law firm that
provides free legal services in civil matters to low-income people in
order to ensure equal access to justice and to remove legal barriers
to economic opportunity.