By Gustavo Arellano
By R. Scott Moxley
By Alfonso Delgado
By Courtney Hamilton
By Joel Beers
By Peter Maguire
By Charles Lam
By Charles Lam
In November 2006, physical therapist Satomi Okamoto at HealthSouth in Tustin evaluated Takacs and recommended he receive a power wheelchair with a power tilt-and-recline system, according to documents. The therapist noted that as a quadriplegic, Takacs doesn't have the strength to manually operate a chair, and because of his pressure sores, he needs to reposition himself often.
"With the custom features described above," Okamoto wrote, "Richard will be able to safely relieve pressure as well as be properly supported for independence around his facility."
Currently, he cannot move without the assistance of caregivers.
Admittedly ornery, Takacs refused to be repositioned by caregivers at French Park 30 times in April, according to documents. For a man who spent the first 58 years of his life doing things for himself, he may never get used to a life of dependency.
In June 2003, Takacs, a truck driver, fell out of the passenger side of a semi-tractor trailer after the door unexpectedly popped open as the driver made a sharp left. He landed on his head. For the past three years, he has lived at French Park. His only regular visitors—his sister and her family—come once a month from Colorado to take him out.
"Mentally, it's just . . . you know, it's bad," Takacs says. "You feel hooked-up in here. It's like being in prison or jail."
Full-time caregivers can hoist the 220-pound man out of bed with the help of a mechanical lift and push him to the recreation room for lunch or some bingo. But with his own power chair, Takacs could get outside and feel the sunshine whenever he pleased, or get on a bus and go wherever.
"There's a museum down the street on Main Street over here," he says. "Oh, there's different places I'd like to go to. The park, or just go out to the shopping center down here and everything."
On Dec. 19, 2006, CalOptima denied Takacs' request, saying he didn't meet the criteria, "since he has a full-time caregiver."
Even with the therapist's recommendation, CalOptima only approved a manual wheelchair and required he go to a wheelchair outfitter 40 miles away in Inglewood, even though at least two authorized vendors are within 10 miles of French Park.
Monson says Takacs' case, which he helped appeal, will likely be denied by CalOptima again. His next step will be to have a hearing in front of a judge at the Orange County Department of Social Services in Santa Ana sometime in the next few months. He hopes the case will be his third successful appeal in front of a judge and the 10th time he's helped a patient get a previously denied wheelchair.
For a few years in the late 1990s, Monson worked as an independent wheelchair evaluator to CalOptima members for a company called Adaptive Technologies Group.
"I would evaluate what the person does, how often do they go out of the house and into the community, and then write a detailed report and submit it to the insurance company. They would either approve or deny—usually approve.
"Once the wheelchair was approved, we, in essence, were the watchdog over that vendor, making sure the order went into the company properly, that it was followed up, that as soon as it got in, it was taken out and the patient was fitted."
But as time went on, Monson says, his evaluations were challenged more and more often, mostly by administrators who were not particularly knowledgeable about disabilities and didn't know which modifications were necessary and which might just be padding the bill.
Whenever Monson's clients were denied, he says, he made sure they got what they needed.
"If it happened on one of our evals, I'd go into their office," he says. "I'd say, 'Listen, you can't deny this. This person needs this,' and I'd tell them why."
But in 1999, Monson's contract with CalOptima was canceled after a new hobby—one that made him feel free for the first time since he was paralyzed—almost turned deadly.
Monson began skydiving.
"There's an amazing transformation or breakthrough. You make the conscious decision to leave the airplane when all of your instincts say, 'Don't jump,'" he says. "Something changes in you forever, and it's a positive change. It's an empowering thing that says, 'Yeah, I can do this,' perhaps even more so for someone who has limited mobility like myself."
On Monson's third jump, he broke his hip. On his fifth, he broke both of his legs.
"When you have a spinal-cord injury and you haven't stood for a long time, they can't put a cast on your leg when you break it. They can't put pins in it. You're just the rolling wounded.
"The manifestation of pain below my level of injury was profuse sweating, so I would just sweat and be in horrible pain. That's the main reason I gave up. The break wasn't that big of a deal; it was the year it took out of my life to be put back together."
The worst part was yet to come. Monson's injured spinal cord blocked pain signals to his brain, overloading his nervous system and causing a condition called autonomic dysreflexia. It caused extremely painful headaches, which he dealt with by using prescription pain killers. One day, when in a fit of pain, he ran out of Vicodin and called the paramedics.