Child with Erb's palsy or OBPI injury at birth - PR Medical exam

[dakin0580]

Hi,
We have a 2.5 year old with erb's palsy or OBPI at birth to right hand.
She can do most of the tasks. She cannot lift her hand above 90 degrees and few other movements not available. She can hold things, scribble, push and pull , eat, hold her knees. There is no elbow contracture as well, the elbow is good
We do regular PT and stretching at home to keep the hand active and hopefully she will gain other functions soon.
What are the chances that we will pass the PR medical testing with this condition.
How are progressive conditions like this calculated w.r.t costs on medicare.

Please ,can some respond. as its urgent..

Thanks

 

[canuck78]

Hi,
We have a 2.5 year old with erb's palsy or OBPI at birth to right hand.
She can do most of the tasks. She cannot lift her hand above 90 degrees and few other movements not available. She can hold things, scribble, push and pull , eat, hold her knees. There is no elbow contracture as well, the elbow is good
We do regular PT and stretching at home to keep the hand active and hopefully she will gain other functions soon.
What are the chances that we will pass the PR medical testing with this condition.
How are progressive conditions like this calculated w.r.t costs on medicare.

Please ,can some respond. as its urgent..

Thanks

Will surgery be needed or at least attempted?

 

[dakin0580]

Will surgery be needed or at least attempted?

Thanks for responding..

No , She didn't have any surgery till now.. only PT at home and botox injection once when she was 14 months for elbow (hand to mouth)..

She passed the phase of nerve surgery. She passed towel on face test and hand in mouth test and so they said nerve surgery is not needed.



W.r.t muscle surgery our doctor suggested that no one can predict muscle surgery, it all depends on babies improvement over the next few years.

But our specialist is happy to give us a letter that surgery is not needed and the baby is showing good improvement.

He thinks this is a progressive condition. He is also going to mention in the letter that that kid doesn't need any help with school and at home and is as independent as any other healthy kid..



If I submit a letter from our specialist that no surgery is needed at this point, do you think we can pass our PR medicals??

 

[canuck78]

Likely but there are never guaranteed. Botox injections also may not be covered. Having had them in my muscles over 5 years ago I paid $500 a vile.

 

[dakin0580]

Likely but there are never guaranteed. Botox injections also may not be covered. Having had them in my muscles over 5 years ago I paid $500 a vile.

So, if they are not covered, it should not be accounted in the costs towards medicare right?? It's anyways going out of our pocket.
Also are OBPI muscle surgeries covered as part of medicare , just asking?? , because our specialist seems to think they are categorised under plastic surgery and not mandatory every time??

When you say likely is it likely - high / likely - low

 

[canuck78]

So, if they are not covered, it should not be accounted in the costs towards medicare right?? It's anyways going out of our pocket.
Also are OBPI muscle surgeries covered as part of medicare , just asking?? , because our specialist seems to think they are categorised under plastic surgery and not mandatory every time??

When you say likely is it likely - high / likely - low

Botox is only covered for certain conditions like CP. Costs towards Medicare is taxes. Canada doesn’t have a fully funded Medicare system and healthcare varies between provinces. It is more like 70%. In most places you will be paying for physio out of pocket and OT out of pocket but may get partially reimbursed by your extended health insurance if offered by your employer. Same thing as any for a brace or any medical device. All out of pocket unless you have extended medical coverage. There are some income based programs that may pay for high cost medical devices depending on income but those vary by province and won’t be necessary in your case. Should mention dental care is not covered and many Canadians can’t afford dental care. When it comes to things like Botox injections they are only indicated for certain conditions when the drug applied to be covered in Canada. It is complicated. Same as other Rx drugs it varies by province and depends on your extended healthcare coverage. It is unlikely that most surgeries that Canadian surgeons can do given their equipment and and that are based on scientific literature as medically necessary (not cosmetic) will be covered. So you do know that surgery may be needed. I would be very reluctant to have your surgeon misrepresent your child’s condition. Lying to CIC is taken very seriously.

Given that you have a child with medical needs it would be really important to find a job with healthcare coverage before the child moves to Canada depending what his/her needs are. I feel lucky to have access to healthcare if needed but there are long wait times and you do have to pay for some things yourself. Some people are expecting to arrive in Canada and get the same speed and level of care that they were getting through a private hospital in their own country. You often get paid more but the costs for things are significantly more.

 

[dakin0580]

Botox is only covered for certain conditions like CP. Costs towards Medicare is taxes. Canada doesn’t have a fully funded Medicare system and healthcare varies between provinces. It is more like 70%. In most places you will be paying for physio out of pocket and OT out of pocket but may get partially reimbursed by your extended health insurance if offered by your employer. Same thing as any for a brace or any medical device. All out of pocket unless you have extended medical coverage. There are some income based programs that may pay for high cost medical devices depending on income but those vary by province and won’t be necessary in your case. Should mention dental care is not covered and many Canadians can’t afford dental care. When it comes to things like Botox injections they are only indicated for certain conditions when the drug applied to be covered in Canada. It is complicated. Same as other Rx drugs it varies by province and depends on your extended healthcare coverage. It is unlikely that most surgeries that Canadian surgeons can do given their equipment and and that are based on scientific literature as medically necessary (not cosmetic) will be covered. So you do know that surgery may be needed. I would be very reluctant to have your surgeon misrepresent your child’s condition. Lying to CIC is taken very seriously.

Given that you have a child with medical needs it would be really important to find a job with healthcare coverage before the child moves to Canada depending what his/her needs are. I feel lucky to have access to healthcare if needed but there are long wait times and you do have to pay for some things yourself. Some people are expecting to arrive in Canada and get the same speed and level of care that they were getting through a private hospital in their own country. You often get paid more but the costs for things are significantly more.

Thank you for such detail. No, we don't know if the surgery is needed at this point of time and the surgeon would give the same in his letter.
My only concern is how would a cost for progressive conditions like this are estimated / calculated. I mean any person might need a surgery for any condition not exisiting now. A person with Psoriasis / diabetes might need higher medical intervention in the future because his condition changed. So, All we can do is show its under control now..!! Any cases you have seen who passed medical with such conditions. Would that apply same for our condition too.


All I wanted to know is what % chance we stand with this .. Apologise if I am asking the same thing again, but can't get over with this question..

 

[canuck78]

Thank you for such detail. No, we don't know if the surgery is needed at this point of time and the surgeon would give the same in his letter.
My only concern is how would a cost for progressive conditions like this are estimated / calculated. I mean any person might need a surgery for any condition not exisiting now. A person with Psoriasis / diabetes might need higher medical intervention in the future because his condition changed. So, All we can do is show its under control now..!! Any cases you have seen who passed medical with such conditions. Would that apply same for our condition too.


All I wanted to know is what % chance we stand with this .. Apologise if I am asking the same thing again, but can't get over with this question..

Nobody could guarantee a percentage. Really is dependent o. The Canadian doctor reviewing the file. Psoriasis could be a big issue as well because of the cost of biologicals. Diabetes is less of an issue but diabetes supplies are rarely covered by the government and things like testing strips are extremely expensive. Insulin isn’t cheap either if the diabetes requires insulin. Kidney function will have to be checked for the diabetes patient. Given all your medical conditions I would really move with one parent first to try to secure a job with extended medical benefits. Many Canadians don’t have a medical plan through their employer.