I've had a Nurse Case Manager for quite some time now. I was originally told by WC back in 12/03 after seeing Dr.Bradford in SF that the 2 level ADR pro disc trial would be authorized. A surgery date was set, but they canceled as the trial shut down early. So then I saw Dr.Bae at The Spine Center who recommended the same thing. This time the surgery went thru UR and was denied by the State certified orthopedic surgeon.
My Nurse Case Manager is very much in my corner, however, there are some new players at this company in positions of power and I think in position to "clean up cases". I'm known as a "lifer" as my case dates back to 1982 and I have Lifetime Future Medical Benefits. Also I'm an RN,NP who has been out of work since 2000 so while I would like to go back to work, there is no push for WC to try and get me back to work...
One thing that was mentioned was if I was a single level ADR case this surgery could be approved but being multiple levels ...fusion was my option or "other"...
There's more, will write more tomm. Am very tired so need to sleep before writing anything else..
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