Visitor Question

Knee injury in high school without Medicaid coverage?

Submitted By: Elijah (AL, USA)

I was receiving medicaid benefits under my mother’s income and disability in high-school, but when I turned 19, still attending high-school, medicaid removed my coverage (until they realized I was still in high-school). I suffered a knee injury playing football at my high-school during the time period that my coverage had been wrongly removed.

So, my head coach sent me to physical therapy with a local physical therapy group that was partnered with the football team. I then returned to practice the next week, but my injury was still evident to me.

I explained to my coach that I was still hurt, but he insisted that I only suffered from a lack of “heart.” So, not knowing the severity of my injury at the time, I decided to stop playing football because of the pain.

The knee pain only got worse. I finally got an MRI years later, despite not having insurance, and I was informed that my injury was a complete ACL tear. Consequently, my MCL and LCL are now torn slightly as well, caused by years of walking without an intact ACL.

Am I at loss for these injuries? Or, should Medicaid pay to fix them? This is complicated since the first injury occurred when I should have been receiving Medicaid benefits, but wasn’t. And the subsequent injuries occurred as a result of the first injury that went without treatment? Any information you can give would be much appreciated.

Disclaimer: Our response is not formal legal advice and does not create an attorney-client relationship. It is generic legal information based on the very limited information provided. Do not rely upon the information in our response, or anywhere else on this site, when deciding the proper course of a legal matter. Always get a personalized case review from a local attorney.

Answer

Dear Elijah,

The operative phrase in your description is, “I finally got an MRI years later.” From the facts you present, at the time you sent this question it can be reasonably presumed you are out of high school and probably an adult.

At this late date it would be virtually impossible for you to prove your ACL injury was directly related to your high school football injury. Even if you could, you can be sure your benefits under your mother’s Medicaid will not pay for the medical or chiropractic bills you may have incurred and continue to incur as a result of the knee injury.

Medicaid, or for that matter, any other insurance company, would never pay for your recent medical and/or chiropractic bills resulting from what you contend is an old high school football injury. This is because your injury may have been a result of an intervening incident.

Moreover, you will likely not be able to find a doctor who will state, with any degree of medical certainty, that your injury was a direct and proximate result of your high school football days.

The above is general information. Laws change frequently, and across jurisdictions. You should get a personalized case evaluation from a licensed attorney. Find a local attorney to give you a free case review here , or call (888) 647-2490.

Best of luck,

Published: October 7, 2014

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