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Running head: ROGERIAN LETTER 1

Rogerian Letter

Rachel Tregre

Louisiana State University

Author Note

The following Rogerian Letter was written for English 2001, taught by Ms. Jean Coco,

and addresses issues raised in the case study CASE STUDY, published in Health

Communication in Practice: A Case Study Approach.


4800 Rue Laurent Dr.

Metairie, La, 7002

April 30, 2017

Charlie White
4540 Highland Rd.
Baton Rouge, La, 70808

Dear Mr. Charlie,

I am a representative for Medicare and am emailing you in order for you to understand
our policies on physical therapy. First, Medicare is for adults of the ages 65 and older; it is for
the ones who have disabilities and end-stage renal disease. In order to be eligible to receive
Medicare, individuals need to have worked for at least ten years, in which taxes were paid, and a
citizen of the United States.

Medicare covers physical therapy only if the condition you have is able to improve or if
the condition you have would get worse if there is no physical therapy. If Medicare does not see
improvement over several weeks, then it is important that the physical therapist document it and
send it to us. If Medicare denies physical therapy sessions, an individual can make an appeal in
order to have longer sessions, if it can be proven that it is necessary for your health.

Mr. Charlie, you have qualified for Medicare since you suffered from a stroke, but we
had to cancel it since improvement was not shown over a period of weeks. The stroke you had
was very severe and created problems with your speech and made you paralyzed on one side of
your body, meaning that the right arm and leg is unable to move. The condition made it hard to
take on simple task, such as tying your shoelaces. The exercises given to you were supposed to
help you make progress, in which it did, but it had to end since the progress ended as well.

We, as Medicare, know that you are sixty-eight years old and understand the harm that a
stroke can do to your body. We understand that prior to the stroke, you were used to doing things
on your own and was a very strong man. We understand that it is going to be tough getting used
to the fact that your body might never be the same as it was before. We realize that you are
looking for great outcomes, but it is important to start with small successes first. To make
progress, it is important to complete the exercises given to you from your physical therapist,
however, we understand that you are not doing the exercises assigned to you at home, which
could not help you progress. From the voice of your physical therapist, we also understand that
going through physical therapy can hurt relationships, such as with your spouse. Since it has
been known that your wife has been getting irritated and wants you to try harder and do more
things for yourself, this can be a setback for physical therapy. We know that some progress could
have not happened because of these setbacks, however it was important that improvement was
shown to have these sessions continued. We know how important these sessions were to you and
how much you looked forward to going to them. We know that you feel that Medicare should
offer you more of them.

I understand that you want longer physical therapy sessions, since it is important that you
regain your strength. As Medicare, we provide the opportunity for many patients to attend
physical therapy with no cost. We understand how painful it is for patients to have this coverage
come to an end. If I personally was in this position, I would be upset too. I wish that you could
have the ability of having Medicare cover your sessions until you were fully recovered because I
believe that there is still a great chance that you can improve. Even if you do not regain all of
your strength back, you could still possibly regain some of it.

I believe that you should be given the ability to attend physical therapy without having
the cost come out of your own pay-check. I think that we should provide longer sessions for the
elderly and give them more time to progress than just a few weeks. Moreover, I want you to
make an appeal, in which you can ask for us, Medicare, to give you more physical therapy
sessions. If you win the appeal, then Medicare will grant you more time. An appeal is an action
you can take if you disagree with the coverage or payment decision from Medicare. If you still
want to make an appeal, then you would need to make a case and could ask your physical
therapist to help you if he was willing to. There are many steps needed to make an appeal. First,
you would need to get an MSN, which is a Medicare Summary Notice (Kortzeborn, 2016). This
shows what you would be appealing, which in your case, would be for more covered physical
therapy sessions from Medicare. Second, you would write about why you disagree with
Medicare canceling your sessions (Kortzeborn, 2016). Third, you would write your name, phone
number, and Medicare number and sign it (Kortzeborn, 2016). Fourth, you would send a copy of
the documents to Medicare or call them at (800)633-4227(Kortzeborn, 2016). If the appeal does
not work, then you can ask your physical therapist to give you exercises at home, in which you
can do on your own.

As a representative of Medicare, I am forced to listen and respect their policies. If a

patient does not show a physical therapist improvement over a period of weeks, then it is my job
to take their physical therapy sessions covered by Medicare away. However, I feel for you Mr.
Charlie and understand that you want to be able to have more sessions, to try and make a full-
recovery. Even if you did not improve, it could still give you hope. This is the reason why I want
you to make an appeal to us, to possibly be granted more sessions. From your point of view, I
know that this would mean a lot to you. It could not hurt to try, and would only be more helpful.
Good luck with everything.

Josh Brown
A representative at Medicare


Babrow, A.S. (2017). Problematic Discharge From Physical Therapy: Communicating About
Uncertainty and Profound Values. Health Communication, 3, 27-38.

(2012, September 12). Marci's Medicare Answers: Does Medicare cover outpatient physical
therapy?. Daily Review, The (Morgan City, LA). p. 3.

Kortzeborn, C. (2016, Oct 6). Know your rights on Medicare and appeals. San Diego Union
Tribune, The (CA), p. 15.. Retrieved from

Tierney, R. A. (2017). Medicare. MagillS Medical Guide (Online Edition)