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surgery denied...now what?
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| iSpine Discuss surgery denied...now what? in the Main forums forums; i got a letter of denial from work mans comp (of course) the said that the results from the disco ... |
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01-26-2009, 02:38 PM
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surgery denied...now what?
i got a letter of denial from work mans comp (of course) the said that the results from the disco gram were not in the guide lines for surgery, now if you ask me comp shouldn't have been able to use the results from the disco since the wouldnt pay for the test my private ins. paid for it. So now the surgen has to write a letter of appeal to comp to try to get it approved which we all know is going to be a waste of time, so after they deny it again i hope and pray my ins will cover the surgery cause i really need to get better so i can go back to work.. i've been out for over 3 yrs now so i have a feeling comp wont approve anything cause it would be cheeper to just keep paying me $200 a wk ($200 cause the idiot judge thinks i can do some sort of work) for the next 17 months and the kick me off comp than to pay for a surgery so i can return to work!
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01-26-2009, 05:48 PM
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Does anyone else have these same dark thoughts of putting all the claims adjusters on one big ship and sending them to Mars... just so they can deny each other's claims that they can't breathe?
I have no experience with worker's comp except as an employer when is was a very lenient system that cost me a huge chunk of money, which I suppose makes me part of the problem  Would obtaining legal counsel to represent your interests help at all? I would agree that a test which they denied was necessary should not be used in any of their arguments/reason for coverage denial. Perhaps an attorney could point this out to them? We're labels a suit happy country and certainly California is at the top but come on, maybe that's because we fight back!
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3 level Prodisc adr S1-L3, Oct 12, 2005 Dr. B in Bogen, Germany Severe nerve damage in left leg, still working on it
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01-27-2009, 03:46 AM
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What about being in a clinical trial? I feel for you on the denial, my insurance denied me to, which is why I am going to be in a clinical trial
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34 years old- 1/06- In wreck with 18 wheeler Numerous MRI's, PT, chiropractic, accupuncture, TENS therapy, massage therapy, facet injections, epidural injections, Nerve study, Discogram, confirms pain in L4/5, IDET, decompression, Bi-lateral neurotomy L3/4/5, denied by insurance twice, in Active L clinical trial, had surgery March 17, 2009 in Miami, FL- received Active L disc Had Baby #3 after ADR!
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01-27-2009, 04:35 AM
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I agree with dishobbies. Find a really good lawyer. It is so hard to do this yourself and be in pain. You need some help!
Phylly
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Cervical fusion C4-6 March 2002 Fall on tailbone causing sciatica and back pain April 05 Conservative Treatment and PM for 2 years Discogram concordant pain @L4-S1 Aug. 07 Prodisc ADR's at L4-S1 November 2007 Foraminotomy July 08 for Sciatica Continued problems and back pain worsened Prodiscs removed and discs fused at L4-S1 Feb. 09
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01-27-2009, 05:44 AM
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Quote:
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1997 MVA 2000 L4-5 Microdiscectomy/laminotomy 2001 L5-S1 Micro-d/lami 2002 L4-S1 Charite' ADR - SUCCESS! 2009 C3-C4, C5-C6-C7, T1-T2 ProDisc-C Nova Summer 2009, more bad thoracic discs! Life After Surgery Website President: Global Patient Network, Inc. Founder: www.iSpine.org
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