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New to this site
Hello everyone,
I was just introduced to this site by a friend on another site. I recognize a lot of the names on here, so I'm not new to all of you, just some. I have been married for 6 years and have two daughters, Emma 5 & 1/2 years and Ava 3 years. I have been living with debilitating back pain for 3 years. I was hit by an 18 wheeler when I was 2 weeks post partum with my second daughter. We were very fortunate to not have died in the wreck. Both of my daughters, 2 weeks and 2 & 1/2 years, at the time of the wreck, were physically unharmed. Myself, on the other hand, had back pain within an hour of the wreck. I think the adrenaline and momma bear in me had me worrying about my kids and the pain did not kick in until we were in the ER and the girls had been deemed ok. I was given a Rx for Vicodin and sent home, told I would feel better in a few days. Well, that came and went, many dr visits, MRI's, chiropractic, PT, accupuncture, IDET, facet injections, epidural injections, nerve conduction testing, massage therapy, TENS thearapy, decompression, 2 discograms (both 10/10 in L4/5), and a bi-lateral neurotomy L3-4-5 later, and I am still in pain. None of the treatment I have had has helped any of the pain. The only relief I get is from pain medication. I am a canidate for Pro-Disc L, have been denied by insurance and am waiting on answer to my appeal. If that doesn't work out, I plan on being in the Freedom Disc clinical trial. I see Dr. Zigler at TBI in Plano. I am looking forward to meeting all of you and getting and giving advice! Kathy |
Welcome
Hi Kathy
Welcome to the site;) Hope your feeling O.K. Gil:) |
Hi Kathy,
Welcome to the forum. Glad you found us but your circumstances, especially with two small children must make your life very difficult. What did the MRIs tell you? Is L4/5 your only pain generator? You've been dealing with this for 3 years and though the worlds of insurances wrangling turn too slow, I would have thought it would be settled by now. If you were hit by a semi, I would expect them to take care of the medical bills and not your own ins co., who by the way, will more than likely turn down your request for an ADR, but keep pushing. I have heard good things about TBI and even if your insurance should come through, you might want to consider staying with them. The doctor's skill and experience has a lot to do with your ultimate outcome. Is there any timeline yet for the clinical trials? Hang in there, I'm assuming help is on the way. Glad your children checked out OK. There's your blessing! Good luck, Dale |
welcome and don't give up on insurance
Hi Kathy,
Welcome to this group. Although I don't post much, I read what others have written and have found the information to be very useful. I am currently home recovering from a 3 level Prodisc C (C4-5, 5-6, 6-7). My surgery for ADR was initially denied by my insurance company as "experimental". I appealed and it was again denied....this was after FDA approval of single level Prodisc C procedures. I almost gave up on insurance and started making plans to spend our retiement money to go to Germany to have the surgery done there. However, I was extremely lucky to have a dr. that was willing to fight for me and my right to have the surgery that I needed. He wrote letters appealing the insurance companies decision. I also got my H.R. department involved, who got the broker for the insurance company involved. Eventually, we came to some agreements that at least allowed me to have the surgery done. The cost of two of the implants has not yet been resolved, but I will keep fighting to get them paid for! The insurance company did agree to pay for the surgeon, hospital costs and one implant. I'll try to keep this group undated as to how it all ends up. Basically, my message to you is don't give up! You have rights. I made dozens, maybe hundreds of phone calls to my State Insuance Commissioner and others who offered suggestions or information. Keep this group updated on your progress and how you are feeling! Best wishes, Melody |
Quote:
As far as the other insurance paying for me... They have been nothing but a pain in my a$$. I hired an attorney, because they didn't even want to pay my medical bills. I just settled with them a couple of months ago; but didn't end up with much, after everyone else got their share. Also, I was hit head on in a 35 mph crash in July of 2006. Because of the way the Texas laws are written, the 18 wheeler company is only responsible for my care from Jan 06 to July 06 (when the other wreck occured), this is called an intervening action. The second wreck I was in, the person does not have high limits, I believe they have 25K available for the other persons care. So, we are having to use my un-insured/underinsured insurance on my vehicle, to try and cover my care. But, the problem is, that I have to pay everything out of pocket; but I can use my health insurance. Then, when I decide to settle (which means that anything beyond that point will not be covered), then I get paid for all my care. The money then gets taken, the atty gets 40%, my health insurance gets paid everything they paid out of pocket, then I get what's left. It sucks. I will be having Dr. Zigler do my surgery, regardless if I have the Pro-Disc or if I am the clinical trial. I really like him and he comes highly referred. The clinical trial has been pushed back several times, due to paperwork. I think it will start by Feb or March. I won't be having surgery until March. I am going on a cruise with my family in Feb. and don't want to be in recovery then. Kathy |
Kathy, I hope you don't mind, I moved your thread to the main forum.
It sounds like you've done pretty much everything possible to avoid the ADR surgery. It's so outrageous that when we are injured AND have insurance, we still have to fight a system that seems to have everything stacked against us. The new guy gets to point at pre-existing conditions and say, "not me", the entity that was on the hook for the prior problem gets taken of the hook by the 'intervening event'. Keep up the good fight. All the best, Mark |
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