This is an excellent question. Does anyone have access to Westlaw to do a little legal research on this issue. I know with my denials, the problem was "no proven long term success" meaning US published studies more than 2 years...but I don't know how many years it takes before they cant make that agrument...Technically I think the FEHB (feds ins) policy is the way to argue....once it's FDA approved you cant call it experimental and investigation.
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Injured 9/01
Annular tears L4/5 & L5/S1
denied adr by insurance for 2 level charite as well as hybrid fusion at L5/S1 with Charite at L4/5.
New ins paid for 2 level lumbar prodisc surgery on 4/7/08 (at age 39) with Dr. Westerlund, at Core Orthop
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