War Amps four-year battle to assist Quebec amputee before tribunal
May 24, 2017 – The War Amps four-year battle to assist leg amputee François Lauzon is now before the Tribunal Administratif du Québec. Witnesses gave testimony in person on May 4, 2017, and closing arguments will be exchanged in writing in the coming weeks.
Mr. Lauzon, who lost his left leg above the knee in a 2011 motorcycle accident, has been repeatedly denied coverage for an essential artificial limb component by the Société de l’assurance automobile du Quebec (SAAQ) despite his doctors strongly advising that he be fitted with a microprocessor (computerized) knee unit in order to walk safely and be able to return to the workforce. These cost approximately $75 000.
In 2013, a frustrated Mr. Lauzon contacted The War Amps Advocacy Program, which has since battled to help him access the prosthesis he needs.
“Simple things such as climbing stairs or going for groceries are difficult with the leg I’m currently using. It’s upsetting and unacceptable that I’m being refused coverage for a component that will allow me to be as mobile and as safe as possible,” he says. “All my doctors say I need it, but it’s still such a long process”.
War Amps Advocacy representative Louis Bourassa is perplexed by the SAAQ’s position in refusing this prosthesis. “The only conclusion we can come to is that the SAAQ clearly does not understand the total disability of amputation and the role of prosthetic care. Even though it’s expensive up front, this prosthesis will protect his safety and security and reduce the cost of his medical care in the long-term.”
He adds that Mr. Lauzon’s situation is reflective of serious issues with provincial prosthetic coverage in Quebec and across Canada, including long response times, shocking amounts of red tape and a culture of “nickel and diming” for needed prosthetic treatment.
“We have been waiting four years to appeal this denial decision. During that time, Mr. Lauzon has been unable to receive the artificial leg he needs, which is causing him harm,” Mr. Bourassa says. “Essentially, the system is a bureaucratic obstacle course to the detriment of Quebec’s amputees, who are in desperate need and not getting the prosthetic devices essential to leading full and productive lives.”
The War Amps is hopeful that the Tribunal will follow the advice of Mr. Lauzon’s medical professionals, who all concur that this artificial limb is medically necessary, and decide that the SAAQ should cover the cost.
“The SAAQ’s mandate is to cover medically necessary items. By denying coverage for this prosthesis, it is failing to meet its obligations, which is setting a dangerous precedent for amputees in Quebec,” says Mr. Bourassa.
Since its founding at the end of the First World War, The War Amps has fought to protect the rights of amputee veterans and address the inequalities they face. As a natural evolution, the Association has over time expanded its advocacy work to provide a voice for all amputees in Canada.
“Through our Advocacy program, we navigate and address the bureaucratic barriers and misunderstandings often confronted by amputees in Canadian society,” says Brian Forbes, Chairman of The War Amps Executive Committee. He views Mr. Lauzon’s case as a classic example of why the program is needed.
“We’re certain that many Canadians would be shocked to know that those who suffer the loss of a limb are not adequately covered by their provincial government health plans.”
He adds, “Our years of experience with provincial agencies, government departments and insurance companies have revealed that they do not fully comprehend the impact of amputation. Through Advocacy, we identify the gaps in support for amputees and work to effect change in areas such as insufficient prosthetic coverage, insurance and legal issues, human rights and government benefits to improve their lives.”
The War Amps was founded in 1918 with a philosophy of “amputees helping amputees,” and continues this legacy in the modern-day association that exists today. A nation-wide registered charitable organization, it assists war amputees and all Canadian amputees, including children.
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