I've also been denied fusion at my L5 S1. I'm only 35 and have sciatica running down both legs and severe lower back pain. I have the worst time sleeping and need to take ambien to fall asleep, and I struggle daily to take care of my 2 1/2 year old daughter and regular household activities. I've seen 6 surgeons who say I need the fusion or continue on the way I am. We provided more docs & the doctor requested a peer to peer and they denied me and never honored the peer to peer with the doctor. The doctor that works for BC that denied my claim was a "Dr. Marappa Gopinath". How is it that 1, paid by BC, doctor can deny something that 6 doctors think I need? I have talked to a few attorneys who seem really interested but was curious what you ended up doing or if you found other people like us or who did get approved.
Surgery was sched 12/20 - Denied Thursday Dec 16th and again the 17th
11/09 and 12/10 had two injections which gave bad side effects
Yoga, acupuncture, PT, Chiro, Pilates, Massage, Meds, all very little or no relief.
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