Pursuing Health Insurance Reimbursements for Your Child’s Therapies

Advice from an Insurance Law Expert             

Today, the Skyer Law team participated in an in-house professional development seminar that focused on how our clients may be able to pursue their health insurance plans to obtain insurance payments for their child’s therapies and related services. 

The training was provided by leading insurance attorney, Jodi Bouer, the founding partner of Bouer Law LLC, a national insurance advocacy and litigation firm headquartered in Princeton, NJ.    

The major takeaway:  Although parents should primarily pursue services under the IDEA, they should also concurrently explore accessing health insurance reimbursements for supplemental services outside of an educational setting, which are deemed medically necessary. 

For more information and to seek guidance on whether to pursue reimbursements for your child’s therapies under your health insurance plan or to determine whether you should fight your insurer’s denial of your child’s therapeutic services, please visit www.bouerlaw.com.
  

 

2015-2016 Settlements Update

We are working diligently to effectuate tuition reimbursement payments for our clients for the 2015-2016 school year. Unfortunately, the New York City Comptroller, who is responsible for reviewing and approving all settlements, is not adhering to the Mayor’s policy to expedite settlements between parents and the NYC Department of Education (See our June 25, 2014 blog to learn more about the Mayor's Policy: de Blasio Policy Update).

This is resulting in a widespread delay in the settlement process. Despite the persistent follow-up undertaken by our staff, the Comptroller’s Office remains non-responsive to our requests to ascertain the status of settlements. 

In the hope of putting additional pressure on the city, we encourage you - the parent - to contact the Comptroller’s Office directly to request that the Comptroller expedite the review of your child’s settlement. Once you reach the Comptroller’s Office you will most likely be told that, since you have retained counsel, it is your counsel that must make contact with the Comptroller’s Office. We know this, but we also know that squeaky wheels get oiled. As a result, we believe that if enough parents make noise, the Comptroller’s Office will have no choice but to listen.

You can reach the Office of the Comptroller at (212) 669-3916. Please provide the Comptroller’s Office with your child’s nine-digit NYC ID Number and Date of Birth.

Augmentative Alternative Communication

Cocktails and Communication with AAC Connection  

Augmentative or alternative communication (AAC) devices are an invaluable tool for many children whose ASD or other neurological impairment impacts their ability to communicate.  If you are a family member or caregiver of a child who uses an AAC device, AAC Connection is hosting a “Talking AAC Happy Hour”:

Thursday, May 12
6:30 – 8 PM
460 West 34th Street
12th Floor
New York, NY 10001

Attendees will benefit from hands-on AAC instruction from experienced professionals and users in a fun, relaxed environment.   For more information on AAC Connection and to register, visit
http://www.aacconnection.com/events.html.

 

Parenting a Child with Asperger's

Love That Boy

In the book, Love That Boy, columnist Ron Fournier shares his personal story as a parent of a child with Asperger’s Syndrome.  His figurative journey coincides with a cross country road trip with his son, Tyler.  Their father-son bonding experience further informs Fournier’s understanding – and his appreciation – of Tyler’s uniqueness.   Read more about Ron’s story here.

Autistic Student Assaulted by His Paraprofessional

Autistic Student Assaulted by His Paraprofessional

Yesterday, a local NY newspaper reported on a pending civil case against a paraprofessional who allegedly struck a then 9-year-old autistic student in the lunchroom of PS 225, which is located in the Brighton Beach section of Brooklyn.  A video showing the incident was made public yesterday in the course of civil litigation against the paraprofessional and the city.  Read more about this disturbing case here.  

Autism Awareness Month

                April is Autism Awareness Month.  Depending upon a child’s specific Autism Spectrum Disorder (ASD), language development and the ability to communicate will likely be impacted.  Many children with an ASD diagnosis will have difficulty using language effectively, while others may be completely non-verbal. 
                Many of these children can benefit from Augmentative and Alternative Communication (AAC) methods.  In fact, children with a wide variety of communication and language deficiencies, in addition to those with an ASD diagnosis, can benefit from AAC technological applications.  In support of Autism Awareness Month, the Apple App Store is providing the following AAC app downloads at a discounted price:

How to Survive Turning 5 Seminar

How to Survive Turning 5
A FREE Seminar for NYC Parents of Children with Special Needs


Regina Skyer and attorneys from the Skyer Law team will guide parents through the complex process of entering the NYC special education system.  One-on-one question and answer session will follow the presentation.  Teachers, therapists and related service providers are welcome.  Spaces are limited.  Register today!

Tuesday, February 9
7:30 – 9:30pm

Brooklyn Conservatory of Music
58 Seventh Avenue
Brooklyn, NY 11217
REGISTER

NEW DATE ADDED:
Thursday, February 25
7 – 9pm

New York Open Center
22 East 30th Street
New York, NY 10016

REGISTER

How to Survive Turning 5: The handbook for NYC parents special needs children
   now available Amazon.  



Putting the Department of Education on Notice

 

While you and your children are enjoying the last unofficial weeks of summer, our attorneys have been busy working on your cases and getting ready for another successful year. If your child attends a private special education school/program and you are hoping to be reimbursed for this placement a 10 Day Notice of Intention is part of the required legal process for tuition reimbursement.

 

On Monday, August 24th our offices filed over 1000 of these individualized notices.This written notice is required by law to be filed with the school district ten days before a parent's removal of their child from the public school. This means 10 days before the child starts at his or her private school. The notices have to: (1)inform the school district of the specific reasons that the parent(s) disagree with the IEP and program recommendation made by the CSE; (2) as a result of these disagreements they intend to place their child at the XYZ private school; and (3) the parents intent to seek tuition reimbursement for this placement. The school district has ten business days to address these concerns. Starting last year, Mayor diBlasio initiated a policy whereby a district could recommend settlement based on the notice alone. We are told that the NYC DOE will continue to follow this policy and will inform us within 15 days of receipt of this notice whether they are going to settle the case based on the notice alone. The goal in our firm is to have the school district read this notice and be convinced that they should settled the case for tuition reimbursement. If the district does not agree to settle a case, we then have to file for an impartial hearing. Settlement can also happen once the full hearing request is filed. Our team does everything possible to avoid an impartial hearing. Check your email regularly; once we hear back from the DoE, your case manager or the paralegal assigned to your case will be reaching out with next steps.  Please note: If your child has a 12-month IEP, your notice was filed in June.

 

Exciting News: We are growing!

Hi Everyone,

On August 1st, our administrative operations will be moving to our new Brooklyn location, located at  142 Joralemon Street, Suite 11C. 

Our Manhattan offices will be undergoing renovations. We have temporary offices available for consultations in Manhattan. Our contact information remains the same. 

If you have any questions about this, please contact Ben Foley at BFOLEY@SKYERLAW.COM OR 212-532-9736. 

Join Us in Our Fight Against Breast Cancer

Hi Everyone,

 Join the Skyer Law team this Sunday, October 19th in Central Park as we participate in the American Cancer Society's Making Strides Against Breast Cancer Walk! Look for our team "Sky's The Limit" and visit our home page: Making Strides - Sky's The Limit

 We'd love you to walk with us, but if not we hope you support this worthwhile cause. 

Update on de Blasio's New Policy of Fast Tracking Tuition Reimbursement Cases

On August 20th our office filed notices in cases seeking tuition reimbursement for private school placement. As of today, the DOE has responded to 80 percent of these notices, recommending settlement in 60 percent of the cases. We are told that the remaining 20 percent where we have not had a response are still being reviewed by DOE lawyers. This is the first year since 1993 when the Supreme Court issued the landmark Carter decision that the city is recommending tuition reimbursement based solely on the required 10 day notices. We are calling this “fast tracking.” I refer you back to my Blog of August 20th which summarizes this new fast track policy: Follow up Re: Mayor's New Policy

 

In cases where settlement has been recommended, negotiations between our paralegals and the Department of Education paralegals are already underway. We have been in touch with all the private schools and we are also asking parents to provide us with documents.

 

On the cases where we are told that the DOE is not “fast tracking” settlements, we are now drafting and filing detailed Hearing Requests. Once these hearing requests are filed the Department of Education will review them and determine whether to recommend settlement or proceed to impartial hearing. Our hearing requests are extremely detailed and legally nuanced and we are optimistic that in most cases settlement will be recommended.

 

This is all good news and we are happy that the policy initiative put in place by Mayor de Blasio is actually being implemented. Stay tuned and we’ll continue to keep you posted.

 

Best,  

Regina