Robert is faced with a lot of health problems, ranging from neurological to psychological, which are now also affecting him physically. One of these physical health problems is the upper back problem, which causes (shooting) pains during movement. Because of this, he has been visiting the physiotherapist on and off for more than 4 years. A recent physiotherapy session from 2021-10-06 till date happened to be with Sportbedrijf Rosinga in Elst and with Fysius in addition. Fysius specializes in back and shoulder problems.
From investigation by the physiotherapist, it has been diagnosed that his trapezius muscle is underdeveloped, running in a zigzag pattern from the right shoulder to the left part of his middle-back, ending at the right side of his underback when you are looking at his back. His health issues are causing him to lie flat to cope with the pain as a result of the underdeveloped trapezius muscle.
For the past 2 years, and in particular the past 7 months, he has been following up on daily physiotherapy exercises. Among them is the exercise of going for a daily swim. This has been advised because it specifically targets the muscles that require strengthening to make as well as keep the upper back problems at bay. However, Robert’s financial capacity cannot afford to go both to the gym and to the swimming pool. He is not able to also forgo one for the other because both are necessary. But on the other hand, he has to go swimming but is unable to afford to do so, and he would not do so if he did not have to.
He cannot afford the annual subscription of about 400 euros per year, and given that he has to comply with the advice of health experts in order to restore his health, he is in a predicament. He has reached out to his health insurance (Menzis), but they are only willing to reimburse when a physiotherapist is actually present during the swimming. However, Robert is more than capable of conducting the physiotherapy exercises on his own in the swimming pool (such as performing the chest crawl) without direct supervision from his physiotherapist.
Ultimately, Menzis did not want to budge because Robert's problem, as well as its remedy, did not fit within the policies of the healthcare insurance. Robert tried to get an exception for his case, but even this was shot down immediately by Menzis, as they were not even willing to consider an exception after looking at all the evidence. Instead, Menzis forwarded Robert to the Wijkteams of Arnhem for a solution.
What's more, the frequency of going to the physiotherapist could be cut in half if he could go for a swim every day if he were reimbursed for an annual subscription to the swimming pool. Doing so would be a cheaper solution with regard to healthcare costs than maintaining the current situation.
On approaching the Wijkteams, the team said Robert’s case could not be considered. Only swimming (even if it is for medical reasons) is not a mobility aid. Mobility aids are about transport, such as an AVAN pass, for example. So that someone can, for example, go to an activity or person once a week, the Wijkteam agent also claimed they have also submitted a question to the expertise team (which deals with this), but they also indicated that no compensation can be given from the WMO for the cost of the swimming pool, even if it is medically necessary. Here is evidence of their response.
The Wijkteam advised Robert of the following options:
Apply to the Dullers Foundation.
Contact Zorgbelang. They can support Robert with this question.
These 2 options are not favorable because
Duller Foundation offers usually one-off solutions, not recurring ones. At least for individuals.
Zorgbelang is so overwhelmed they had to put a client stop in. In addition, independent client supporters do not have the authorization to help people with these kinds of circumstances and / or requests.
Upon being denied financial reimbursement from the WMO under the mobility aid, Robert had to request special assistance from the municipality of Arnhem. A few weeks later, Robert received a negative response on the special assistance he applied for from the municipality of Arnhem, stating special assistance was not granted.
On the 13th of July 2022, Robert wrote to the Tax Office, requesting that his case be considered for reimbursement. The response he got from the Tax Office was that his reimbursement request was not considered reimbursable because the rules do not allow it to be.
It is unacceptable that situations like this are not reimburseable. Hence, Robert created two petitions on petities.nl to create awareness and build up to change. Please sign both of them:
Acknowledge swimming as medical solution under the 'mobility act'
Make swimming lanes on prescription of the physiotherapist on the reimburseable list
The goal is to cast enough petitions that it forces the political establishment to make the change fast, full, and retroactive.