Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: SUNDAY, May 9, 1993 TAG: 9305090255
SECTION: HORIZON PAGE: F1 EDITION: METRO
SOURCE: Carolyn Click
DATELINE: LENGTH: Long
That's when the Roanoke man learned that $350,000 worth of employee health insurance doesn't necessarily last a lifetime.
"I never ever dreamed I would run out of insurance," said Emery, who has worked a union job for ITT Corp. for the past 18 years. "I'm maxed out on everything. I've borrowed everything I could."
Except for a broken leg and cuts and bruises, David Emery appeared surprisingly unscathed by the accident that sent his body smashing into the driver's windshield and over the top of the car.
But the collision March 30, 1991, delivered an almost deadly blow to his brain, causing internal bleeding and swelling. The accident wiped his mind clean of memory and the childhood skills he had taken for granted.
"He's like a cassette tape that's been erased," said his father.
David Emery remained in a coma at Community Hospital of the Roanoke Valley for 38 days and in a semicoma for weeks afterward. After two months, he was transferred to the University of Virginia Hospital, where he spent another six months learning to walk and talk all over again.
In the two years since his accident, David Emery has made astonishing progress. Although he suffered some paralysis on his left side and requires a built-up shoe, he walks with only a slight limp.
With a baseball cap perched backward on his head, he is in many ways the picture of a typical 11-year-old - loud, boisterous, eager to show off his coin collection and other treasures to a visitor.
But he also suffers continuing symptoms of traumatic brain injury, including inability to concentrate, forgetfulness, mood swings and occasional aggression.
It is those characteristics that prevent his transition back into the classroom. Roanoke public schools have told Ralph Emery they cannot accommodate David in any of their special education programs, and are working with the family to try to find a suitable alternative.
By law, school districts must provide "a free and appropriate education in the least restrictive environment."
For more than a year, David was enrolled at special schools that concentrated on therapy as well as education. Until several weeks ago, David was at the Cumberland School outside Richmond, which initially cost $950 per day and later $500 per day.
But several weeks ago, the Hartford Insurance Co., which administers ITT's health-care program, informed Ralph Emery he had hit the maximum of his insurance policy. Now, Ralph Emery spends his free time researching residential schools that might be willing to take David - and figuring out how to pay for his education.
He still owes the University of Virginia about $76,000 and Community Hospital about $24,000.
If the Emerys were impoverished - if for instance, Ralph Emery quit his job - then David would qualify for Medicaid and other government benefits.
But because Ralph Emery earns $28,500 as a vacuum maintenance technician, he cannot obtain any kind of government assistance.
Jim Rothrock, director of the Department for the Rights of Virginians with Disabilities, said the Emery case is not an isolated one.
"In many instances, when you have a head injury that is traumatic, you have a whole lot of medical costs and the family has to spend down," he said. "There have been instances of selling homes and totally revamping your financial plan."
The Virginia Head Injury Foundation is a repository for such anecdotal information, but serves a larger function of guiding families to available resources.
But officials say there are many more programs that benefit adults than children.
"With a head injury, he kind of falls between the cracks," said Kathy Robertson, president of the Roanoke chapter of the foundation.
Although head-injury patients appear normal and can accomplish basic living tasks, "people don't understand a lot of the cognitive problems they have. These people can't be unsupervised."
Often, she said, insurance companies cease paying the costs of long-term rehabilitation.
"After a person is able to walk and dress themselves and do activities of daily living, then they are not paying for higher-level cognitive training," said Robertson.
Doctors have said David Emery will be in active recovery for another three years, which translates into hundreds of thousands more in health-care costs.
Ralph Emery isn't sure how he will pay for it. His union, Local 162 of the International Electrical and Electronics Workers, has contributed funds and hopes to set up a trust fund for David.
But the kindness of friends and co-workers isn't enough when families are hit by catastrophic illness.
For Ralph Emery, health-care reform is more than just a hypothetical question debated by policy analysts in Washington. It is what he lives every day.
There are hopeful signs that children will be among the first beneficiaries of the medical revolution, but when legislation actually will be passed remains anybody's guess. The prognosis remains mixed for coverage of long-term care.
Right now, Ralph Emery knows the questions. He just doesn't have any answers.
by CNB