This time the hybrid surgery with ADR at L4 (charite) and fusion at L5S1 has been denied (non certified) and there was a 7 page attachment with it reasons it was denied.
It's gotten to the point of being a ridiculous matter because much of the denial was based around the fusion if you can believe it as in I'm not a candiate for fusion because I don't have instability.. and then of course the ADR was denied because it's just been recently FDA approved and there's not enough data to support it's use in my case in terms of being reasonable and necessary treatment (same was said for fusion).
So I am going to cash out with WC and take my business elsewhere.. finally.
I guess this is what they are aiming for, I just hope I get a fair settlement because this denial makes it sound like I'm not a candidate for anymore spine surgery based on my failed 2nd discectomy...
Wow, what a pain in the rear. Perhaps a sign, message, and so forth..
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