Former Hays football player Shelby Sherman is able to walk again after a paralyzing injury. (Courtesy photo)
by JEN BIUNDO
When 16-year-old Hays High School football player Shelby Sherman was sacked by a defender during a 2008 junior varsity scrimmage game and landed on the crown of his head, he was too stunned to be afraid as he lay on the damp turf.
But when he saw his mother, sister and girlfriend crying on the sidelines, he worried. When he remained fully paralyzed five hours after the accident, he worried that he would spend the rest of his life as a paraplegic. When the feeling slowly began to return to his limbs during a three-hour MRI, he worried that one side of his body was still numb.
And when he slowly walked out the hospital the next day in a neck brace, he worried that he would never play football again.
Two years later, he’s worrying about how his parents will pay the medical bills.
“It finally hit me how much this is going to cost my family,” Shelby said.
Shelby’s parents, Mary Beth and David Sherman, say the school district wasn’t transparent about the limitations of the catastrophic insurance policy it carries for sports injuries.
“We were always told that if you do not have primary care and you need to fall back completely on the school’s insurance, it does not pay 100 percent, more like 80 percent,” said his mother, Mary Beth Sherman.
At the time of Shelby’s injury, his father had recently lost the family’s health insurance following an illness. Concerned about her son playing football without insurance, Mary Beth Sherman said she talked with coaches at the Gridiron dinner before the start of the 2008 school year, and was again told that the supplemental policy covered about 75 – 80 percent of bills for catastrophic injuries.
But after the accident, the Shermans learned that the policy actually had a $25,000 deductible per child per year, leaving them on the hook for about $22,000 in medical bills.
On Aug. 22, 2008, just after the start of the scrimmage game with Cedar Park, Shelby was going up to catch a pass on the one yard line. The defender jumped up at the same time, knocking Shelby’s feet from under him and sending him crown first into the turf.
Mary Beth Sherman had seen her son take a hit before, but she had never seen him laying so still.
“My daughter is the one who said ‘Mom, he’s not moving,’” Sherman recalled.
They were called out of the stands and found the trainer, Mark Winters, on the ground with her son.
“I could see Shelby’s eyes were open and Mark was talking to him very calmly and asking him lots of questions, but it was obvious that Shelby could not feel anything from the neck down,” Sherman said. “I had the thought that I’m not putting my son in a wheelchair today. I talked to God on that one.”
Shelby was taken by ambulance to Brackenridge Hospital, where his parents told hospital staff they would be relying solely on the school insurance. Hospital staff didn’t indicate that would be a problem, Sherman said.
Through CAT scans, MRIs and other tests, they kept him overnight in the ER. As the paralysis lifted, he was released the next afternoon wearing a brace and on restricted activity and with a diagnosis of a cervical spinal cord injury.
On the first day of school, she went in to fill out the paperwork. Coaches told her that as the bills came in, she should fax them to the insurance company to expedite the process, she said.
It sounded simple until the first Explanation of Benefits (EOB) paper came in mid-October.
The bills kept coming, adding up to $22,000, just shy of the $25,000 deductible. The insurance policy covered just $1,400.
In months of wrangling with the insurance agency and school officials, Sherman said she found it frustratingly difficult to get even simple information, such as a copy of the catastrophic policy.
“It almost feels like these policies are for show, because the process is so arduous,” Sherman said. “Most people couldn’t handle this. It would be way over their head.”
The Shermans say they’ve accepted the fact that they’re stuck with the $22,000 tab for the overnight hospital stay, but are still angry at what they feel was a lack of clear information coming from the district about the catastrophic plan. Sherman went before the school board earlier this year to express her frustration, but didn’t receive a response.
According to the Texas Department of Insurance, school districts are not required to carry sports insurance coverage for students, but may opt to do so.
School district officials did not issue a statement on the issue, but simply noted that the school is bound by the terms and conditions of the insurance coverage. Current athletic forms given to parents about the supplemental policy include language warning parents of its limitations.
“This is a limited benefit policy and any charges above the policy limit are YOUR RESPONSIBILITY,” the form states. “Please be aware that this is a limited benefit policy and by NO MEANS was intended to cover all medical bills for your child.”
Shelby, enrolled in the state Children’s Health Insurance Program (CHIP), was able to continue playing football, and the memories of his temporary paralysis are now the basis for college application essays.
“People take it for granted that they can get up out of bed and walk,” Shelby said. “Now, when I see paraplegics, I think ‘That could be me.’ It was the scariest moment of my life, but it was a life changing experience.”
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