Injured Bethany Town Worker Faces Struggle With Insurance Company

Thursday morning, Keith Johnstone spent an exhausting hour working with his personal trainer and his nurse trying to learn how to stand and walk again.

Joe Martinez, the trainer, and nurse Christine Cohen helped Johnstone rise on his legs and then supported him as he kept his body weight on his paralyzed legs and back.

"I wasn’t able to stand before," Johnstone said, once Martinez and Cohen lowered him back into his wheelchair.

These days as Johnstone continues his three-year struggle against the spinal cord injury that left him helpless, he and his wife, Jo, must also struggle against an insurance company, PMA, which has refused to pay for any more physical therapy. The Johnstones must pay for Martinez out of their own pocket.

The insurance company claims that his recovery "plateaued" and further treatment won’t yield any significant results.

But Keith and Jo say they have videos that disprove that. They say he has made enormous progress from the special therapy he has received, and the interruption caused by the insurance company has stalled his recovery.

Keith was injured on Aug. 11, 2008 while working for the Bethany Public Works Department. He was part of a crew cutting down a tree to clear a parking lot for the firehouse on Route 63 when a large branch fell from above him and landed on his head.

First Selectman Derrylyn Gorski said the accident was especially tragic because if the branch had come down a few inches in any other direction Keith’s injuries would probably have been minor.

"It literally split his safety helmet," she said.

He spent two months in intensive care at Yale-New Haven Hospital and left at age 47 as a quadriplegic, paralyzed from the neck down. But from the start, Keith Johnstone has surprised his doctors. They thought he would spend the rest of his life on a ventilator, but he left intensive care breathing on his own.

That started lengthy rounds of treatment for the spinal cord injury. Jo Johnstone said a center cord injury is difficult to treat, but a great deal of progress has been made since actor Christopher Reeve was paralyzed in an equestrian accident in 1995.

Therapy for severe center cord injuries focuses on the lower extremities first, because that’s where the earliest recovery of muscle strength and control occurs.

The first treatment started at Craig Hospital in Denver, which specializes in spinal cord injuries. Keith spent several months there and Jo said when he left he could move his limbs and sit up by himself.

That enabled him to get a motorized "sip-and-puff" wheelchair, which he can steer by inhaling or exhaling through a straw.

Returning to Connecticut, Keith received treatment for a year at Gaylord Hospital in Wallingford, which also specializes in neurological rehabilitation. He progressed further from that treatment, so he could stand by himself for a few minutes.

"Last year on his birthday [in February 2010] he took his first steps," said Jo. With the assistance of two people, Keith walked across his own kitchen.

In August 2010, Keith relocated for nine months to the Shepherd Center in Atlanta, another top rehabilitation facility for spinal cord injuries. Jo said Keith continued to make progress at Shepherd, and the doctors there were very encouraging.

"A doctor in Atlanta told us he will walk, but he will need therapy all his life," she said.

But the insurance company had a different prognosis. The Johnstones say the company claimed that Keith’s progress had stopped and didn’t justify spending any more money.

Jo admitted that by this time the cost of Keith’s therapy was very high, she didn’t know how much. But she and Keith say he is entitled to it.

"They thought he’d be on a ventilator all his life. He’s proved them wrong all along," Jo said.

"He’s consistently attained a higher level of functionality than the medical people have predicted," noted Gorski, who is among the many people in Bethany who have followed Keith’s case and supported him.

"Everybody you talk to in town is very interested in how my husband is doing," said Jo Johnstone.

Unfortunately, the interruption in his intensive therapy has cost him. Jo said Keith has lost much of the progress he has made. "He can hardly stand up now," she said.

PMA offered to pay for a short return trip to the Shepherd Institute in Atlanta in return for an agreement that Keith isn’t entitled to any more therapy after that.

The Johnstones rejected that offer and are currently looking for a new lawyer, hoping to get their case back in front of the Workers Compensation Commissioner. If possible, they want to try new therapies available at the Burke Institute in White Plains, New York.

As Keith worked with Martinez and Cohen, a UPS truck pulled up to their door and delivered a new walker. Designed along the same idea as a baby walker, this adult version will allow Keith to strap himself in and use his own legs to move around the house.

"The insurance company said I’ve plateaued," said Keith. "When I can walk, then I’ll have plateaued."