How far can charity money go to help Boston amputees?
It's a month since the Boston Marathon bombings, and many of the survivors are still coming to terms with not only the reality of the extent of their injuries, but also the prospect of a lifetime of medical bills, prosthetics and rehabilitation.
Dance teacher Adrianne Haslet-Davis, 32, was at the finish line of the marathon with her husband, Adam Davis, an Army airman who had just returned from Afghanistan.
"The next thing we knew we were in the air, we landed kind of landed tangled together ... and we sat up and I didn't think anything was wrong and then he looked at my foot and we knew we were in some pretty big trouble," Haslet-Davis said.
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"He didn't see a lot of bombings when he was over there [Afghanistan]; he's definitely seen more in Boston," she added.
Haslet-Davis' left foot was amputated, and her husband suffered broken bones and lacerations.
"The horrible characteristic of the marathon is the seriousness of the injuries, just horrific. Amputations and brain injuries and burns ... I've never seen physical injuries as pronounced and as diverse as in Boston," Kenneth Feinberg, the attorney handling compensation for victims of the Boston bombings, said in an interview with CBSNews.com this week.
In total, 15 victims of the Boston Marathon bombings suffered 17 amputations; two had double amputations.
Dr. David Crandell, Inpatient Medical Director of the Amputee Program at the Spaulding Rehabilitation Hospital in Boston, which is treating the victims who underwent amputations, said losing a limb is, "Almost akin to losing a loved one."
"Having an amputation is definitely a major, life-altering thing that sometimes would force an individual or their family to make some new changes," said Crandell, to CBSNews.com.
Facing a lifetime of medical bills adds enormous stress too, not to mention the expense of modifying homes and cars to better live with disabilities.
"We've heard of instances where people have had to dig into college savings and retirements plans to be able to afford the device to continue working or get back to being an active member of the community," said Dan Ignaszewski, director of Government Relations at the Amputee Coalition.
Money for marathon victims and their families is coming from The One Fund, a charity started by Boston Mayor Tom Menino and Massachusetts Gov. Deval Patrick.
There is currently over $30 million to allocate from the fund to victims, with $11 million donated by the public and $17 million from corporate donors.
"You have to sort of categorize the different nature of the eligible claims, and how much money you have and then you allocate the money available to those who died, those who have double amputations, single amputations, those who were hospitalized the longest, those who went to the emergency room and went home," said Feinberg, who also handled compensation for victims of September 11, 2001, the 2010 Gulf Coast oil spill, the 2011 Indiana stage collapse and the Aurora theater shootings, among other tragedies.
Claim forms are available from May 15 and are due back on June 15. Feinberg will then spend the rest of the month with his staff deciding on allocation before handing out the money by June 30. Any individual claimant may request an in-person or telephone meeting with Feinberg.
While people who suffered the most serious injuries are expected to receive more money, there are no guarantees that they'll receive enough to cover future medical costs. Mental trauma will not be covered either.
"How much do you have to distribute? How many lost loved ones are there? How many died? How many were physically injured? What are the nature of the physical injuries? How long were people in the hospital?" said Feinberg.
For example, money for victims of the Aurora theater rampage was distributed as such: those who had family members killed or suffered permanent injuries each received $220,000; those who were hospitalized for 20 days or more each received $160,000; those who were hospitalized for between 8 and 19 days each received $91,680; and those who were hospitalized for between 1 and 7 days each received $35,000.
A standard, below-the-knee prostheses runs between $10,000 to $12,000 and would typically need to be replaced every three to five years, Crandell said. Above-the-knee prostheses jump to $50,000 to $60,000; the big difference being the knee unit which costs more and requires more attention.
"If you have someone in their 20s or 30s, you're looking at about 40 to 50 years of prosthetic needs. Now of course they don't need a new prosthesis every year, early in their care there are a lot of changes and adjustments, but if you say a well-fitting prostheses has an average life of about three years ... you're looking at 50 years," said Crandell.
The Johns Hopkins Center for Injury Research and Policy estimates the total lifetime cost of amputation at $509,275.
This includes initial hospitalization, follow-up hospitalizations, inpatient rehabilitation, outpatient doctor visits, physical and occupational therapy and purchase and maintenance of prostheses.
"A lot of insurance companies throughout the country have put caps and restrictions on insurance coverage for prosthetic devices; some of the common caps and restrictions we see are caps of $1,000, or $2,500, or $5,000 per year, which really doesn't do a whole lot for the costs for some of these devices," said Ignaszewski.
"Part of my job is really to advocate, to make sure the patient will really get what they need to be as functional as possible. Sometimes the insurance company doesn't really see it in those terms, they see it as 'it's not in our policy' or 'we don't cover that' and sometimes the individual has to do with lesser technology because the funding's not there. For me ... that's got to be one of the most frustrating things, when you know there's something available that could really make a difference and you don't have a way to pay for it," said Crandell.
"In instances like Boston, where a lot of those folks may have been very active ... those kinds of athletic devices, the running legs, the swimming legs, typically aren't covered at all under the insurance plans. The insurance plans focus on medically necessary devices, so that tends to be whatever the most basic medically necessary device is," said Ignaszewski.
Individual fundraising by family or friends is also helping out the Boston victims.
A leading crowd funding website, GoFundMe.com, has several pages aimed at helping victims of the bombings. Adrianne's friend has started a page for her and Adam that's raised over $260,000 so far.
"It's certainly a wonderful thing because we have a lifetime of that to use ... it's a lot of money and of course getting apartments that can fit wheelchairs, and all of that if I don't want to be on my prosthetic, it's exhausting," said Adrianne.
A huge concert is planned in Boston on May 30, with all proceeds going to The One Fund. Acts including Aerosmith, Jimmy Buffett and James Taylor will be performing.
Feinberg said that money has not yet been calculated into the available proceeds.
"The One Fund Boston is going to stay in existence so there will be other funds that will go into it," said Feinberg.
"Never underestimate the charitable impulse of the American people, it is amazing, like no nation on Earth," he added.
Despite the closeness in timing of the Aurora shooting, Hurricane Sandy, the Newtown shooting and the Boston Marathon bombings, Feinberg said there does not seem to be any kind of donation fatigue among Americans.
"I see $5 million Aurora, $7 million Virginia Tech, $30 million Boston, $5 million Indiana, $11 million Newtown; it's an amazing thing to watch the American people react to their fellow citizens in need, it is something to behold," said Feinberg.
Adrianne plans to go back to work in the next few weeks, on a part-time basis; incredibly, she is also planning to run the Boston Marathon next year.
"I can't think of a better way than to thank the people of Boston who have reached out to Adam and I on so many occasions... not just from me but from all the victims, it's just nice to be able to say thank you in such a strong way," she said.
Not only will Adrianne be running the Boston Marathon, but she will also be appearing on TV's "Dancing with the Stars," a dream she had before she was injured.
"We're not going to settle until she's dancing and teaching her class, and not only being on 'Dancing with the Stars' but there's no reason why she can't be winning it," said Crandell.
