That a combination Fusion (at L5S1) and ADR at L4 with Charite implant would be authorized by UR.
I have to have a BMD DEXA scan done first, then a discogram w/CT by my current OSS who wants to do this procedure.
I have to decide whether to go with this or fight for at least a 2 level ADR (pending next discogram results).
In order to continue my quest for all ADR vs. fusion, I have to find a new PTP ( Primary Treating Physician) which I believe would be Dr.Bae at The Spine Center since I've already seen him.
I'd have to first, get transportation there and back (yes I drive tho am limited in distance in terms of sitting and numbness in right foot/leg so also stay off freeway..). I'm going to check out my local Disabled Rescources Center and see if that's something I might be able to acquire for a price that isn't as "pricey" as a taxi from my city to Santa Monica.
I'd have to transfer care to new Dr.(WC has to authorize). I have to get new Dr. to agree to build case for me in terms of rebutting WC UR decision when rendered that it won't authorize multiple level ADR.
I have to hang in there thru appeals and probably get a WC attorney if it goes to arbitration, then hope that the ruling would be in my favor with penalties attached for not treating (would get surgery done plus some $ and that'd be nice tho would settle for just the surgery)..
** I'm wondering how much difference it would make to have the fusion at L5S1 now, vs. the ADR..
I'm not sure if the issues I'm concerned with in terms of fusion are as valid as I think they are... like potential for more nerve root scar tissue, potential for SIJ problems, potential for difficulty with bone growth, potential for more surgery in terms of hardware removal, potential for longer recovery period due to fusion involved in surgery... less mobility at L5S1 (how much do I really even have now and can is that measureable other than being able to bend over?)..
I would hope an ADR above the L5S1 level would prevent adjacent disc problems with L3 (as I have an annular tear there)...
My OSS also is treating me for my knee and my cervical spine so to leave him is to lose care of a fair amount of my body.. however, striving to seek best possible option and still work w/i WC means.
Still, every conversation I have with NCM, I bring up option of going to Germany with Dr.B and having surgery done at multiple levels at much less cost and possible vertebroplasty to boot, and the many successes he's having with multiple level surgeries.
I have to wonder about the individual WC companies and how limited they truly are in terms of paying for these surgeries if tossing the UR decision to the wind..
Am going to check out book from nolo.com in terms of type of settlement I might expect with my duration (lifer) with WC claim. The NCM says "don't settle..loss of lifetime future med benefits is irreplaceable"....
Just have to put my thoughts out there. Now even Cervie Queen has left me in the dust with her recent surgery...
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