Physical Therapy II

So after we took Aaron to physical therapy a few weeks ago, the physical therapist recommended we come in once a week for 4-6 weeks. But first they had to submit to the insurance company for approval. Once that happened, they would call us to schedule his next appointment.

Week after week went by with no call. I was starting to wonder, and then today we got something in the mail from his medical group. The insurance company denied coverage. They went into great detail about the situation, making it clear they understood we had a 1 year-old with a developmental delay, but that the diagnosis submitted by his doctor did not provide evidence that it was "caused by a specified illness, injury, disease, trauma, or surgery". So basically, they don't cover physical therapy except in those circumstances. They also state that our plan doesn't cover "physical therapy services that are primarily oriented towards treating a social, developmental or learning problem rather than a medical condition."

Well, OK. From what I've read, crawling is unpredictable and is not considered a standard milestone like sitting and walking, since some babies skip crawling and go straight to walking or just scoot around on their behinds. So maybe it's not a big deal, right? But at some point, if my kid is not crawling or walking, shouldn't the insurance company pay for physical therapy even if it is just a developmental problem and not caused by trauma or a "medical condition"?

At 10 months, I wasn't really worried. The doctor told us she wasn't really worried, she was just being cautious. But at 12 months, with him still not crawling, I'm starting to get concerned. Thom has been working with him on getting him to sit up on his own and he's starting to get the hang of it, but he's not getting up on his knees to crawl and although he's showing some interest in pulling himself up on the coffee table to reach something on top, he doesn't support himself well on his legs. He almost seems to have regressed when it comes to supporting himself on his feet since we stopped using the Jumperoo 3 months ago (which we did out of concern it was affecting his development).

I'm still not as concerned as I would be if he was slow in other areas. But he's doing great on the social level and his motor skills continue to improve. In fact, lately, he's been learning to stack his blocks. He has successfully stacked up to 4 of his alphabet blocks, which takes a steady hand. I don't think I've ever seen a one year old who stacks blocks instead of knocking them down. And although he is still not talking, he babbles quite a bit and it seems like only a matter of time before he utters his first real word (we don't count the time he said "Dada" a couple of weeks ago since even though it sounded different than his other dadadada's, we don't think there was any meaning behind it.)

So we'll keep working on our own to get him to crawl and to pull himself up. If we can't get him crawling, though, we'll consider paying for physical therapy out of pocket. There are instructions with the letter we got on how to appeal the denial, but I've been down that road with my old insurance company over a disputed claim, and don't have high hopes for them to change their minds. Hopefully he is just slow and will figure out it, though.

Although he doesn't crawl, Aaron gets around pretty well by rolling, pivoting around and doing sort of an army crawl with his knees out to the side (but he gets one arm caught under him, so he can't get very far this way). He likes to try to get into the kitchen (from his carpeted play area in the dining room), which we don't like since the floor is usually dirty and he likes to go straight for the trash can. But I think he especially likes the hardwood floors because he can slide backwards on them. Here's a video of him doing just that.