Blind woman approved for assistance after challenging Tenncare

Investigations

KNOXVILLE, Tenn. (WATE) — There’s good news for a blind woman who challenged Tenncare: She’ll soon be receiving assistance from her new caregiver.

About half a year ago, she appealed a state decision that denied her home health assistance. That’s when she contacted WATE 6 On Your Side Investigator Don Dare who took on her case.

RELATED: Blind Knoxville woman requests in-home care services, TN says no

MORE: Blind woman seeking TennCare benefits gets nonprofit help, case hearing

Janet lives alone and has been blind since birth. No longer though will she have to do everything herself. She’s beaten the system.

She challenged Tenncare and its decision to deny her home health assistance after her mother moved to a nursing home more than a year ago.

Last fall, the state said Janet had no significant functional deficits and does not qualify for Tenncare’s Choices Program. So, she fought the decision.

Vanessa Zapata, Janet’s attorney, relayed good news the other day about their appeal.

“She said it looks like we won. I said, ‘what?’ She said, we won! I said, ‘we did?’ I was so excited.”

Janet

The contested case is summed up in a 22-page order.

The administrative judge reversing Tenncare’s decision to deny Janet’s care under the home-bound Choices Three Program.

“So this will allow her to get some services in the home so she can be as independent as she’d like to be.”

Vanessa Zapata

“I would love it if they would come by three or four times a week and just help me with the things I need.”

Janet

In early November, WATE first reported Janet’s situation. Her mother, diagnosed with dementia, moved an hour away in December 2018. Her father died 20 years ago. As a teen, Janet attended the School for the Blind where she learned braille.

Janet has Crohn’s disease and says it’s difficult to take care of herself. Without help, she has toileting issues and can’t do certain things alone.

Her aunt, Linda Bradley, is Janet’s only relative who lives nearby, but she has declining health.

As a result, she can’t visit Janet every day to tend to her needs.

To prepare for her appeal, in October of last year, Tenncare sent Janet a 90-page document, none of it in braille, for a hearing set before an administrative judge last November. At the time, Janet had no one representing her.

“I really need somebody here who can talk to this judge. I don’t know what I’m going to say to him.”

Janet

“Lots and lots of families are struggling to get this care.”

Katie Ann Twiggs – Tennessee Justice Center

WATE got in touch with the Tennessee Justice Center after our first story in early November. The nonprofit legal agency advocates for people like Janet.

Her case was accepted.

Two months ago, there was a conference call with Vanessa Zapata, an administrative judge and Tenncare representatives. Janet learned of the decision last week.

Details of her part-time home care will be worked out soon. Janet is grateful to both attorneys at the Tennessee Justice Center. Without them fighting for her, she wouldn’t be receiving home health aids.

In about a week, assistance from her new caregivers should start.

Now, Janet can do certain things at her home: wash her clothes, clean the dishes, prepare a simple meal, feed her dog, etc.

But with blindness and other medical conditions like Crohn’s disease, and depression, the administrative judge concluded Janet needed physical assistance.

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