I'm building my appeal and gathering as much documentation as I can find. I have a lawyer & am waiting for Laurie's book to arrive. I'm pretty desperate for surgery as I'm a breath away from total disability (no pay, disaster for me). Original surgery was scheduled for October 2007 and things have deteriorated since then.
I have been told that if I self-pay for ADR my insurance company will not cover any future neck issues. How have those of you who self-paid handled the risk of future neck problems or complications?
The alternative of fusion now pretty much guarantees at least 2 additional surgeries in a 12-18 months, but my insurance won't consider that aspect.
Has anyone gotten approval from Principal Insurance Company?
Anyone who has had any insurance company approval that was paid on cervical ADR, if you've got a moment please reply with what you had done (level, prior surgeries), insurance co., and date. It can only help my appeal to have specific examples of coverage.
I appreciate any tips or information you can provide!
Jayne.
C5/C6/C7 fusion 9/11/2002;
DDD at C4 and C7, C3 injury with some arthritis.
C3/C4 and C7/T1 now recommended for ADR, C4/C5 also recommended for ADR if I can wait until adjacent level ADR is available.
Dr. tells me fusion on C3/C4 now (most symptomatic) will result in fusion on the two additional levels very likely within 18 months due to status of DDD.
That means C3-T1 all fused at the age of 45-46, extremely undesirable and so much missed work time I may well be laid off.
|