Legal Aid Helps Abandoned Teenager Get Necessary Dental Care

Tina (not her real name) is a 16 year old girl who has been abandoned by her parents and is in foster care with the Department of Children’s Services. Tina was in desperate need of a crown for one of her teeth and her dentist requested approval from TennCare to have the procedure done. TennCare initially denied the application saying it was not medically necessary.

Deborah Yeomans represented the child before an Administrative Law Judge with the dentist testifying that the crown was medically necessary for the child and that the child was in excruciating pain and that this procedure would provide her relief from the pain. The State’s witness requested another x-ray from her dentist to review and determine if the procedure was medically necessary. Several days later the State’s dentist reviewed the x-ray and continued to testify that the procedure was not medically necessary. The Administrative Law Judge issued an Order stating that dental services were denied. Staff attorney, Deborah Yeomans, filed a motion to reconsider the decision of the Administrative Law Judge citing legal authority that the Administrative Law Judge must give more weight to the treating physician than to the State’s physician.

The Administrative Law Judge agreed with that legal argument and reversed her original order and ordered that the services requested be paid for by TennCare. Tina is smiling now.