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Author Topic: Timing for Elective Surgery  (Read 1044 times)

RCD

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Timing for Elective Surgery
« on: Mar 04, 2006, 12:55:40 PM »
Hello soc,

BACKGROUND

Custody – Joint Legal with Primary physical to Plaintiff

Child had medical condition at birth that required multiple corrective surgeries from age 3 months to age 6.  Since that point annual follow-up has taken place with no surgical procedures necessary.  

From age 6 to present there has been acknowledgement that some fine tuning would be necessary by age 17.  Fine tuning includes some cosmetic scar reductions and realignment of the nose.  Also revision of the nose hole to improve air flow.

NONE of the tuning is necessary because of imminent health issues or concerns and can take place at a convenient time up to age 17.  In my discutions with the doctor, later is better because head growth will have finished.

Dependant Child will turn 15 in the next month.  Plaintiff scheduled annual follow-up appointment and scheduled this surgery to take place within the next months.  

This was done without consulting the Defendant

Defendant is in tenuous financial situation due to downsizing and job loss.  In short there is no possibility of covering Defendants portion of any uninsured / uncovered costs arising out of this procedure.

Child maintains regular visitation with defendant and both sees and lives with the necessary lifestyle changes resulting from job loss and change in family income.

When surgery was discussed between doctor and Plaintiff, and child was present (as should be the case). At that time, the child raised the issue of defendant’s ability to pay and expressed concerns.  Over how defendant might pay.

There is no possible way Defendant can afford these expenses at this point in time.

CHild has also stated to Defendant that he is not certain he want to proceed because he does not know what he will do if he doesn't like the way the surgery turns out.

If family were in tact, there is no way the procedure would be considered at this time because of financials. AND there is no medical reason for the procedure to be performed now.  There are up to 2 more years.

Plaintiff has stated affirmatively that this time was chosen because it was most convenient for Plaintiff’s work schedule and is adamant in the decision to move foreword NOW.

State of Jurisdiction is MI

This surgery is not considered routine medical care and as such case law supports the fact that both parents should have a say in the procedure.

Plaintiff stated that costs could be as high as $13,000.  


QUESTION

1) How do I proceed to delay the procedure?  

2) Can I write letters to the Medical Providers and state that I am unable to pay any costs associated with the procedures and I was not consulted in the decision process and will not be liable for any charges?

3) Any suggestions on how to deal with the loose-loose situation I am in?  I am bad for demanding a delay and I will get bad credit marks if I do not pay.  

4) It is possible for the Plaintiff to move foreword and pay all uncovered costs and then in turn demand repayment under the court order in place splitting all such costs.   By that I mean that the current order states “ All uncovered / uninsured costs shall be split between the parties with Plaintiff paying XX% and Defendant Paying YY%.  Reimbursement for such out of pocket expenses shall be rendered to the paying party within 28 days of written notification of same..”  How can I protect myself from Plaintiff proceeding in this manner?

5) What is your opinion on haveing an open dicsussion with the child regarding the reasons I am asking for a delay?  Will the court look unkindly on me for engaging the child in that type of discussion?


socrateaser

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RE: Timing for Elective Surgery
« Reply #1 on: Mar 05, 2006, 12:18:56 PM »
>QUESTION
>
>1) How do I proceed to delay the procedure?  

Your liabilty is controlled by state law and your court orders. I won't subscribe to your opinion that you have no obligation for non-medically necessary healthcare until I read your court orders re healthcare. So, if you want my opinion, you'll have to post the text of the orders.

>2) Can I write letters to the Medical Providers and state that
>I am unable to pay any costs associated with the procedures
>and I was not consulted in the decision process and will not
>be liable for any charges?

The fact that you weren't consulted is irrelevant, if you are obligated to pay by the court order or state law. If you aren't obligated to pay, then it won't matter whether or not you tell the Medical providers, because you're not obligated to pay.

The general rule is that absent court order or state law, parents are obligated for their children's "necessities of life" (food, clothes, shelter, medical). However, in some jurisdictions, state law requires that parents share the cost of all "reasonably necessary healthcare," and such language is interpreted to mean everything from an asprin to a boob job, if the child's self esteem may be affected.

I don't know about specific MI law in this area.

>3) Any suggestions on how to deal with the loose-loose
>situation I am in?  I am bad for demanding a delay and I will
>get bad credit marks if I do not pay.  

If you want a definitive ruling on this issue, then you need to file a motion for clarification of the parents obligations concerning the child in this area. Otherwise, I can practically guarantee, that if the procedure is performed, that the court will order you to reimburse the medical providers for the value of the services rendered, whether you agreed or not.

>4) It is possible for the Plaintiff to move foreword and pay
>all uncovered costs and then in turn demand repayment under
>the court order in place splitting all such costs.

Yes.

>   By that I mean that the current order states “ All uncovered / >uninsured costs shall be split between the parties with Plaintiff paying
>XX% and Defendant Paying YY%.  Reimbursement for such out of
>pocket expenses shall be rendered to the paying party within
>28 days of written notification of same..”  How can I protect
>myself from Plaintiff proceeding in this manner?

Ah, part of the order text! The above states "ALL UNCOVERED COSTS SHALL BE SPLIT." There is nothing in the above wording that suggests that you are only responsible for medically necessary healthcare costs.

There may be other wording in your order or state law that increases/limits your obligation, but if the above is all that there is, then I'd say you're on the hook for any reasonably necessary healthcare costs, and that includes this surgery.

>5) What is your opinion on haveing an open dicsussion with the
>child regarding the reasons I am asking for a delay?  Will the
>court look unkindly on me for engaging the child in that type
>of discussion?

It seems fairly obvious that the child is in need of cosmetic surgery, and that you will be obligated to share the uninsured costs. The only question is timing.

I suggest that you get a second opinion as to the best time for the surgery and then start saving your money because, one way or the other, you will be sharing the cost for this procedure -- unless a court rules otherwise in advance.

RCD

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RE: Timing for Elective Surgery
« Reply #2 on: Mar 05, 2006, 02:27:10 PM »
Thank you for the input - Based on your response it appears that I was not clear in my presentation.

I never intended to imply that the procedures were not necessary, or that I was attempting to avoid paying my lawful share.

My situation is that if I am required to come up with my percentage of the bill NOW, I WILL lose my house.  I do not have the resources at this point.  My financial situation changes significantly when a new 3 year govenment contract launches, but that is 12 to 16 weeks from now.  

The Plaintiff refuses to cooperate with obtaining a second opinion by refusing to provide me with medical card information she carries for the child (in this matter the court ruled that because the coverage is provided theough Plaintiff's new spouse's employer they do not need to give me a card  -  In fact, in court and on the record, Plaintiff's spouse stated affiramitively that if the court ordered that I was to be given a card, the insurance would be cancelled).  The only appointments I have been able to make  to obtain a second opinion are after the currently scheduled surgery date so there is no help there.  Further, we are blessed in that the doctor providing service is probably the best in the world, so any second opinion will pale in comparison.

It appears that my only alternative is to contact the medical providers and give them a copy of the court order and insist that they bill me directly for my portion of any uncovered costs.  Of course, I will need to make arrangements with the providers for a payment plan.  

I realize that there are no questions, but any comments you have will be appreciated.

socrateaser

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RE: Timing for Elective Surgery
« Reply #3 on: Mar 05, 2006, 03:24:55 PM »
>I realize that there are no questions, but any comments you
>have will be appreciated.

Ask the court to restrain the other parent from scheduling the procedure for the next 4 months. If you don't, then you're SOL.

You say that you will lose your house. You'll lose your house if you don't make the payments timely. If you have a house, then you can borrow against the equity. If there's no equity and you have no other sources of borrowing power, then that may influence the court's decision to restrain the other parent from scheduling the procedure.

You say that you must come up with the money now. I doubt that the medical provider will refuse to enter into a payment plan of some sort, but if not, then I doubt that the service provider will do the procedure, if he/she knows that you will not pay. So, tell the provider that you can't afford it. But don't count on this as a solution, because the only place where you can count on a complete solution in in a courtroom.

RCD

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Thank You (NM)
« Reply #4 on: Mar 05, 2006, 08:26:31 PM »
.  


 

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