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Old 11-09-2008, 07:52 PM
GaryC GaryC is offline
Junior Member
 
Join Date: May 2008
Posts: 2
Angry Thanks for NOTHING, TRICARE!

As I write this, it is 7 months + 1 day that TRICARE first denied ADR for my herniated L5-S1 disc, claiming it to be unproven technology.

I appealed the first denial and - guess what - I was denied again.

I appealed the second denial and requested a policy review. It took roughly 5 months for them to perform this review and - big surprise - they denied it again.

Not only did they deny coverage again - they said I could not appeal the denial because it was based on a factual examination of the case and the medical literature. In addition to taking away the only option that is acceptable to me (ADR) they refused to tell me of any other options.

They (TRICARE) claim they are acting in the benefit of service members and retirees to provide them with quality care, yet deny the one option that will give me optimum quality of life. As of now, I have no quality of life. I go to bed every night wondering if I'll be able to walk in the morning, but they don't care.

I provided them with more than enough evidence to support my case, including cost analyses, yet they were unconvinced.

Now what do I do? I can't hobble around for the rest of my life. This is insane. I put my life on the line for this country for nearly 20 years and this is the thanks I get - sorry, we won't help you, even though this was probably caused by your military service. Your only options are spinal fusion and physical therapy. PT hasn't worked, and fusion is unacceptable.
__________________
Gary Christopher
Retired Navy (1995) Submarine Force
2 bicycle accidents 1 car accident
LBP 2003 - MRI herniated L5-S1
Microdiscectomy/Laminotomy 2003
2008 pain returned
PT didn't help
L5-S1 totally dessicated
Vicodin PRN

Last edited by GaryC; 11-10-2008 at 12:31 PM. Reason: Insert Signature
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