They will try to wear you down with denials and BS excuses. Don't accept that. Don't give up! That's what they are counting on you to do.
My case was WC so I had more luck getting my company doctors to fight for me than I did having my lawyer write letters. I would think that the more ADR friendly doctors you have on your side the better. Send them a stack of letters from these doctors and if you do have to go to court, you have ammunition to fight these @$$holes. It's a shame we are just numbers to them and it's their job to save their company money, not to give you healthcare. Whatever you do, be diplomatic and keep good records.
My pain management doctor just ordered an MRI. It was just denied by my company nurse. She says I should still have pain and Dr. Goldstein would have to order it. WELL WE WANT TO SEE WHAT'S GOING ON IN MY SPINE AFTER IT WAS OPERATED ON! IS THAT SO MUCH TO ASK? The first word to pop into her head is ALWAYS "no". (I feel bad for her husband)
So I'll have to wait a few weeks to see my surgeon. Oh well, I'm used to it.
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12/16/03 Work Accident
Herniation and DDD at L4-L5
4/1/05 Discectomy
Epidurals and facet injections
5/15/06 Discogram confirmed L4-L5 DDD also an asymptomatic L5-S1 tear
10/24/06 L4-L5 Prodisc surgery with Dr. Goldstein
CAT scans & X-Rays show ossification
Trigger Point Injections, Medial Branch Blocks, Acupuncture, Weekly Deep Tissue Massage
10/27/08 Discogram (positive L5-S1)
11/25/08 L5-S1 fusion with Dr. Goldstein
FAILED BACK SYNDROME
Liberty Mutual WC
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