In order to pay for the chair, which cost more than $5,000, however, the Frech's insurance company needed a diagnosis. With none forthcoming, Frech was overjoyed when her friends raised the money necessary for Ella's temporary wheelchair through an account on the crowdfunding website GoFundMe. In early June, Ella settled into her chair and sighed with relief, laughing at her friends' assertion that she was now “confined” to her wheelchair. “I was confined to the couch!” Ella would say.

But the Frech's struggle was far from over. By November, there was still no specialist who had any idea why Ella wasn't walking, and her condition hadn't improved. Moreover, the chair was uncomfortable. The tires, bald instead of treaded, were unsuitable for Ella's outdoor, active lifestyle. And the wheels, angled slightly inward to accommodate the previous owner, put stress on her shoulders, which already ached from arthritis. In November, realizing the need for a longer-term solution, the Frechs sent in a request to their insurance for a new, custom wheelchair. Within weeks, they were denied.

“None of our doctors had sent the insurance company the diagnostic code for not being able to walk,” Frech said, which was a procedural oversight on the doctor's part. So the Frechs tried again.

In December, Ella's neurologist sent in a request for a customized chair, a light-frame, aluminum model. “We needed the chair to be as light as possible,” because of Ella's arthritis, Frech said. “And the aluminum frame [we requested] made an 11-pound difference.” By this point, Ella was heavily involved in adaptive sports, so the Frechs requested a treaded wheelchair tire to accommodate her activeness. Again, they waited.

On New Year’s Eve, the Frechs got the news: Ella’s chair had been denied for a second time. The insurance company needed more specific information as to why the chair was medically necessary. So the Frechs sat down with their neurosurgeon and got specific.

“We had to justify every single piece [of the chair] in writing,” Frech said. “Like, ‘Why do you need the six-inch cushion and not the three-inch?’” The Frechs sent in another request, this time for either a sporty wheelchair called a Box chair or a standard wheelchair model called the Tilite, which they liked less but would happily accept. The medical supply company took Ella's measurements, and their doctor sent almost 40 pages of medical documentation to justify the parts they had requested.

At the end of January, the Frechs were denied for a third time. Their insurance would not pay for either chair.

* * *

The Frechs’ story is surprisingly common. Roughly 30.6 million Americans over the age of 15 have some sort of physical disability, according to figures from the 2010 U.S. Census (the most recent year for which data is available). A 2009 report from the National Council on Disability (NCD) found that people with disabilities “tend to be in poorer health and use health-care at a significantly higher rate” compared to those without disabilities. The same NCD report found that disabled people frequently lack coverage for assistive equipment and are more likely to be affected by barriers to health-care services. In other words, disabled individuals are both more likely to need health insurance and less likely to benefit from it.