Thread: Final appeal
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Old 08-01-2014, 01:44 AM
Iron Iron is offline
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Join Date: May 2014
Posts: 13
Exclamation Final appeal

Hi, just wanted to check to see if anyone had some input and/or advice for me in writing my last appeal with Blue Cross of Idaho to have an artificial disc surgery done.
First off, I am a healthy 44 year old gym owner and trainer. Never have had a surgery and have always kept in super shape. I am about 12 percent body fat. I have zero pain. I am just super weak on my right side...only in my deltoid, bicep, rotator cuff, and forearm (grip).
I have been diagnosed with C 5 Radiculopathy.
Here is where it gets interesting. MRI shows multi level issues. Iam oly symptomatic at the C 5 level.
They are denying me because they say that it is experimental because I have multi level degenerative disc disease.
On their page it clearly states that they cover the surgery for folks that have DDD and re symptomatic at only one level.
Thanks for any help at all.
__________________
Body Builder/Trainer
C5 Radiculopathy- with only major weakness in right bicep and deltoid, no pain. Unacceptable
Insurance denial of ADR
Grade 2+ spondylolesthesis at L5/S1 (I can deal with the pain as long as I am active)
May 8 2015----3 Level Cervical ADR @ C4-C5-C6
With Dr. Clavel
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