Dollywood ride inspector fights insurance company over prosthetic leg

(Courtesy: WATE)

SEVIERVILLE, Tenn. (WATE) – A disabled man in East Tennessee defied the odds when he went back to work just months after his leg was amputated, but he and his family are now fighting their insurance company because they don’t want to pay for his prosthesis.

Pete Delangis says he’s been working since he was a teenager. The father-of-five says he wants to continue to work despite losing his leg earlier this year.

That deep desire has been put in jeopardy.

He returned to work in mid-spring at Dollywood where he’s a roller coaster inspector and mechanic. No one expected him back so quickly after his left leg was amputated in January, but by early May he was checking the rails.

He credits the flexibility of his new foot to his vacuum pump prosthesis. He says the vacuum doesn’t let the leg slip.

“I’m a little slower and careful right now, but I’m getting back to where I can walk with no problem,” said Delangis.

However, there is now a problem. A letter sent in June from Delangis’s insurance company, United Healthcare, regarding the prosthesis was devastating.

They said the vacuum pump prosthesis, its lithium battery charger, and the sleeve that covers the stump to his leg are not medically necessary.

Delangis received the prosthesis from Prosthetics Orthotics in Sevierville. He says the high-tech leg cost around $40,000.

He and his wife are confused.

“They’re saying that they won’t pay for it and if he doesn’t have that leg, it’s going to fall off when he’s doing his job. That’s the leg he has to have in order to do his job,” said Carolyn Delangis.

“Originally they pre-approved everything before the prosthetics place even purchased anything or had taken any measurements,” said Pete Delangis.

“He doesn’t want to sit around; he wants to work. He’s happy at his job and his family needs him like that,” his wife told WATE.

Delangis has compiled an extensive file disputing his insurance company’s findings. A note from one of his doctors to the insurance company is to the point.

“It says if this insurance issue is not resolved quickly allowing me to heal and have more mobility, that I may require further surgery,” he said.

Delangis lost his leg due to complications from diabetes. He’s now on light duty at work because he needs adjustments to the prosthesis but they’ve been delayed since the insurance company won’t pay it.

“I want to hear that’s its paid for because I don’t want him to lose more of his leg,” said Carolyn Delangis.

Pete Delangis (Courtesy: WATE)
Pete Delangis (Courtesy: WATE)

WATE gathered all of Delangis’s paperwork last week and sent it off to United Healthcare asking for their side of the story.
The company responded quickly, saying, “Mr. Delangis has been approved for a technically advanced prosthetic leg” and that they “been in touch with Mr. Delangis and his provider to ensure that he is fitted for a new socket.”

“The doctor from United Healthcare, he apologized for all the confusion,” said Delangis.

He said he was told by the insurance company’s doctor the prosthesis is medically necessary. He says the doctor explained what went wrong.

“He said that it had to have been a billing error, but that they would take care of,” Delangis noted.

With his insurance reinstated, he plans on getting the socket to his leg refitted quickly.

“It’s good news that it’s being taken care of – that I can get back to work and back to doing things I need to do,” said Delangis.

Delangis also says he’s been told that his insurance company’s billing department will pay the bill for his prosthesis within three weeks

He still has to wait another 10 days for the blisters to heal on his leg. By then, he expects to be back to work and back on his feet.

Comments are closed.