Savannah Rucker: Injured on the Job and Unable to Afford the Fix

Savannah Rucker is 58 years old and lives in Waterloo, Iowa. She has worked in the school system for eight years, the last two doing special needs intervention, and gets her health coverage through the school’s plan, recently changed to Wellmark.

In 2024, Savannah had an accident at work. “I fell at work and broke my wrist. But when I fell, it was like my wrist and my elbow hit, and it jarred my shoulder.” She went through workers’ comp, and the hospital took x-rays. “They said, oh, everything is okay, nothing’s broken.” Thirty days later, her hand was still swollen and hurting, so she went back. This time, providers focused only on her hand even though she informed them about the pain in her shoulder. The scan showed her wrist actually was broken, and she was put in a cast.

Throughout the time she wore the cast, Savannah kept telling providers her shoulder hurt. She was told she’d be sent to physical therapy, but first needed an MRI, one that came with a $500 cash requirement upfront. “I said, I’m sorry, I don’t have $500 cash to pay.” The MRI was canceled.

Savannah returned to her doctor at the school, who told her they’d get her seen elsewhere. But by that visit, a mammogram she’d already had scheduled came back with a diagnosis. “My mammogram came back saying that I had triple negative breast cancer. So, she just called me into her office, and the shoulder was forgotten about. All of a sudden, we got to get you in emergency, get surgery, take care of the cancer.” The fall and shoulder injury happened at the end of 2024; the breast cancer diagnosis came in March 2025. Providers turned their focus to treating the cancer, and Savannah went through chemotherapy.

Once she completed chemo, Savannah raised the shoulder pain again. “My shoulder is at the point now that I can’t tolerate the pain anymore. Is there something we can do?” She was sent back to physical therapy, but the session made things worse. “He did whatever he did, made it hurt worse. By the time I went back, I said, hey, whatever you did, it is hurting. The pain never stopped.” The physical therapist told her he could no longer see her and sent her back to the specialist, who ordered another MRI — this one requiring $600 upfront. “I said, that’s why I haven’t had it. I don’t have that kind of money to pay up front.” Offered the chance to make a payment instead, she paid $100 toward it and finally, over a year later got her scan.

The MRI showed more than anyone had realized: a fracture in her collarbone, a slap tear in her bicep, and a torn rotator cuff. The specialist sent her straight to a surgeon, who set a surgery date. Savannah waited about a month for it to arrive.

On the day of surgery, Savannah was told she owed $7,789 upfront before the procedure could happen. “And I’m looking like, no, I don’t have that kind of money. Why didn’t you tell me that before I got here?” Staff pointed to a text message sent June 18th, which she pulled up on her phone. “It doesn’t even open and it doesn’t say anything about the doctors or anything like this. It just looks like a spam.” Asked why no one had called instead, staff told her, “we don’t call people because they don’t answer because it’s like a spam call.” No one had mentioned the payment the day before, either, when she’d spoken with the office about what time to arrive.

She was then told she had a $10,000 deductible, of which she’d already met close to $1,900, far more than she expected. “I said ten thousand dollars? My employer doesn’t even pay us like that. And I was told that our deductible was like three thousand.” Staff conceded, “Well, I think you’re right. It might actually be three thousand. But this is how much we need up front in order for you to have your surgery today.” Savannah couldn’t pay it. She was told the $7,789 was only a facility fee, separate from the doctor and the procedure itself. When she asked why she hadn’t been sent to the hospital instead, staff explained the surgical facility was its own entity, with no financial assistance or scholarships available, and that her doctor hadn’t even known it was separate from UnityPoint. Offered a chance to pay 25 percent instead, Savannah said, “I was like, no, I cannot.” The surgery never happened, and she’s still waiting for it.

Savannah went back to the doctor’s office and relayed what she’d been told about rescheduling at the hospital. When she reached out to the hospital about financial assistance, she was told she needed to provide three months of pay stubs from the previous year, tax forms, and bank statements.

She also went back to workers’ comp, since the original injury had happened on the job. She was told there was no paper trail to confirm it. “We don’t have a paper trail. This happened back in 2024, we can’t be sure that this is still the incident.” Savannah pointed out, “You don’t have a paper trail because you guys weren’t listening. Every time I kept telling you, it’s my shoulder, you were only concerned about my wrist because it was swollen.” She also noted that the original workers’ comp providers she’d been sent to had gone out of business, as had the Waterloo school doctor who saw her, and that the school secretary who had filled out her original workers’ comp paperwork was no longer employed there. She was asked to sign permission forms so her current doctor and surgeon could release records to workers’ comp. “What forms would they give you when they don’t have information either?”

Despite everything the MRI had revealed, chip bones in the shoulder joint that needed to be cleaned out along with the tears, Savannah says no one gave her a sling or told her to limit use of her arm. She has continued working through it. “I’ve just been going every single day trying to bear with the pain and not bump my arm or hold it in the wrong way or lay on it wrong.”

Savannah’s story shows how high health care costs, a lack of transparency, and poor communication become direct barriers to care. A $500 payment she could not afford forced her to cancel her MRI. An unexplained $7,789 facility fee forced her to cancel her surgery. A missing paper trail stalled her workers’ comp claim. More than a year later, she is still waiting for the surgery she needs, still working through the pain, and fighting for a better system. “I just believe that the things that I’ve been going through here lately is so that I can help advocate for somebody else.” Her question stands: what happens to people who can’t fight this hard just to be treated?