Still trying to determine what to do.

Denied at final appeal with insurance for Charite at L5/S1.

Doctor feels I'd do well with ADR or Fusion.

Contemplating a law suit against insurance company for denial of ADR. Attorney is researching my information with outside doctors for expert witnesses if needed. Attorney feels it is most likely that the inscurance company would settle before going to court because a court case usually goes in favor of the individual and not the big insurance company. It would cost me about $5,000 to take it that far. More if it needs to go to court.

Considering fusion since they usually work out well at L5/S1 where not much mobility is affected. The posts from fusion patients have been helpful to me.

Brady

Hey Brady,

This has been a loong struggle with you. Best of luck, Allan

Brady good luck on what you decide. I have contacted an atty too and got much the same numbers and advice you did. My problem is I need a 2 level and the fusion is not so successful in that area plus I need more flexibility due to my profession.
Let me know if you decide to follow the litigation route. I would be interested to see what happens

Kim:

At this point, I really want to file the law suit. I have three very experienced ortho surgeons that have examined me multiple times and recommend ADR. Also, my attorney has two chiefs of surgery (one in Texas and one in Denver) that she had review my case and they both support ADR for me. I'd really like to know what the insurance company does when they see that in the law suit and know that all these docs would be expert witnesses if they choose not to settle out of court.

I will keep you posted.

Brady

Brady, thx for sharing your challenges. I say, GO GET THE BEANCOUNTERS! (Yes, I am shouting.)

They may not understand your case, your pain, your research, your journey towards a decision -- but they understand $.

Knock em dead in their boots.

Thank you Allan, Kim, and Harrison and everyone else.

Also, thank you Andrea. Andrea is on this forum. She is here in Colorado and is in the legal/attorney business and has provided extremely valuable insight to me.

The attorney plans to file the complaint next week. I think its worth the $5K investment. They have to turn around eventually.

Brady

OK, everyone else - Get up out of those painful chairs, walk over to the window, throw it open, stick your head out and shout, "WE'RE SICK AND TIRED AND WE'RE NOT GONNA TAKE IT ANY MORE!!!".

There, that felt better... http://adrsupport.org/groupee_common...icon_smile.gif

(Sometimes shouting's wicked appropriate. Huh, Rich?) ;-)

Brady, good luck w/this.

Hey, one day let's hike in Rocky Mtn. Nat. Park! Or hang on Larimer St. where Keruouac hung out (sorry, used to live there..).

Allan