Home page

Text size

E-mail this page

SOMBA K'E/YELLOWKNIFE - Jeff Merrill's struggle to receive funding for a prosthetic leg has ended in a victory for the Yellowknife resident and his family but leaves them wondering just how they were approved for funding when they had been told all along they would not get it.

Jeff Merrill kneels on his new prosthetic leg with his two children Taya, three and Koby, one, at their home yesterday after a long battle with the government over health care funding. - Andrew Livingstone/NNSL photo

The territorial government approved funding to cover Merrill's $11,000 prosthetic leg on his last day in Edmonton, Friday, where he was undergoing rehabilitation. The leg is being paid for through the Indigent Health Benefit (IHB) plan offered by territorial health care.

Merrill returned home later that day on his own two feet.

"I'm very grateful to finally have gotten the funding," he said. "It's a big relief off our shoulders and our family and the stress we've been going through for about a month now."

"We're very relieved," said Yvonne Haward, Merrill's wife. "It's been a long and tiresome trip."

Merrill had his right leg amputated below the knee in early September after a motorcycle accident on Franklin Avenue. He was originally denied coverage for the prosthetic leg because territorial health care doesn't cover prostheses unless they are disease-related or a person falls under a certain specific category, such as low income or elderly. Merrill received coverage under the IHB program even though he had been told numerous times he wouldn't be able to get funding. Haward is grateful for the funding, but wants to know how he was able to get approval.

"We were told all along we wouldn't be approved under this plan," she said. "I was very honest about the money we make and based on that we shouldn't have gotten anything."

"I was surprised they approved it under the forms we had to fill out," Merrill said. "We'd already been told previous that we wouldn't qualify."

The IHB application requires potential applicants to declare all income. Applicants must provide their last two pay stubs for each member of the household and claimed expenses must be backed up with proper receipts and documentation. Failure to provide this information would prevent the health department from assessing the application.

Haward said they provided none of the supporting documents.

"I'd like to know how they approved the form," Haward said. "I was told I could provide the supporting documents as soon as I was able to do so."

Dana Heide, assistant deputy minister of Health and Social Services, said Merrill was approved for funding based on a standardized test the department uses for all applicants.

"It's a means test which looks at your overall income, reduced by expenses," he said. "It's a balance against ability to pay against income. If I'm a single guy with no living expenses, chances are I won't be eligible. If I'm a married guy with a home, regular debt, I maybe eligible.

"It varies by circumstance, income and client."

Robert Hawkins, MLA for Yellowknife Centre, who has been lobbying in support of Merrill, is pleased he received the prosthetic leg but wonders about the motive behind the approval.

"I believe it was a miracle they were all of a sudden covered," he said. "How that miracle happened, I don't know."

Merrill and Haward are happy things have worked out for the best, but still want to see changes to the Extended Health Benefits (EHB) program so those who might encounter a similar issue in the future won't have to go through the difficulties they had to.

"I'm going to continue to raise concern over the extended benefits program here in the NWT," she said.

"This is the only program we were told we would qualify for up until the last minute. I think you should only have to fill out that very simple straightforward form (EHB) in order to get a limb paid for, not get the run around. It should never be based on how much or how little you make. Everyone needs to get back to normal after a tragedy such as this."

"I'm very thankful," Merrill said, "but I just hope they look in to this and try to figure out this black hole we've come across.

"The worst part of this whole process was dealing with the government on this. There was more stress involved in that than actually losing the leg."

Hawkins intends to push for changes to EHB.

"It's an insensitive policy that doesn't take into account certain things," he said. "There is no common sense to this policy. All this fight could've been eliminated had there been a balance of common sense."