An interview with Linsey Porter, OTA — on denials, delays, and the cost of being told to “fail first.”
Where Insurance Falls Short
Insurance is one of the most frustrating parts of the limb loss journey — for patients, therapists, and prosthetists alike.
Linsey has seen the system from multiple angles: as a therapist, as a billing and coding specialist, and as a telehealth coordinator who has worked with thousands of patients across the country.
One of the most common problems she encounters is insurers refusing to approve the device a patient truly needs. Instead, patients are often required to “fail” a basic device first.
For example, someone who requires a microprocessor knee to walk safely may be told they must first attempt to use a simple hinge knee — even if it leaves them largely housebound or increases their risk of falling.
“It’s incredibly disheartening,” Linsey says. “You have patients who say, ‘I just want to hike again. I just want to get out of this chair and go for a walk.’ And insurance says they have to fail a basic device first.”
A Story That Shouldn’t Have Taken Four Months
One case Linsey recalls shows just how difficult the insurance process can become. A woman in Texas had lived with limb loss for more than 20 years and relied on a prosthetic hand that allowed her to type and work from home. When her employer switched insurance providers, the new insurer denied the device she had been using successfully for decades. Because she was considered a “new” patient to the plan, they insisted she first try a basic prosthetic hand whose fingers didn’t bend.
Without her usual device, everyday life suddenly became much harder. She couldn’t type, button her clothes, or manage daily tasks independently, and she lived alone. The loss of the prosthetic she depended on affected not only her work but also her ability to function normally at home.
To fight the denial, she had to collect nearly 20 years of medical records, submit documentation from previous providers, and work with her therapist to explain the impact the decision was having on her daily life and mental health. After four months of calls, paperwork, and emotional stress, the insurer finally approved the device.
“It should not take four months of someone’s life just to be able to live normally,” Linsey says.