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The Big File All issues not easily categorized in the above forums are here. Comments on general health, diet, "getting comfortable," and more are here.

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Old 05-19-2005, 07:12 PM
JasonNYC JasonNYC is offline
Junior Member
Join Date: Apr 2005
Posts: 28

I have healthnet insurance and they denied my initial claim. I have seen an orthropedic surgeon and my doctor now who is a neurosurgeon who both say ADR is the best surgery for me.My neurosurgeon wrote a long letter to the medical director and as of now it looks like I will be denied again. I am supossed to be having surgery this monday may 23rd. I am ready to go to war.

I am starting a writing campaign to tv stations, attoney generals and I am going to get a lwyer who specializes in these situtations. I have been out of work for 5 months and this whole thing has been a fiasco. I
L5-S1 and L4-L5 Herniation
Medications - Neurontin and Darvocet
Charite Replacement surgery scheduled for whenever my damn insurance company will pay for it
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Old 05-19-2005, 08:49 PM
Dave Dave is offline
Junior Member
Join Date: Mar 2005
Posts: 10


Sorry to hear of your plight. I too have been denied, at intitial attempt and at first appeal, even though it is dreadfully obvious that ADR shows great hope for my situation and fusion appears more ridiculous by the day.

Welcome to the State of Healthcare in America. Oh no, there's no crisis here. Our politicians know best. Afterall, BigMed, BigInsurance, and BigPharma would not have bought and paid for them if they didn't.

Your spirit is inspiring, and hopefully contagious. In this case, war may be the answer. Please let me know what I can do to help. I'd gladly submit to interview, for a Midwest perspective on the story. Let's Roll.

Good Luck,

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Old 05-19-2005, 09:07 PM
Moe Moe is offline
Junior Member
Join Date: May 2005
Posts: 1

Dear JasonNYC...

I feel your pain in regards to denial, my insurance is with United Health Care, the afternoon before I was to have my surgery I was denied, I cried for a week and was in so much pain, due to having to be off my medication 8 days prior to surgery. I have appealed the denial actually twice next step is an attorney. I am looking for one that will work fast and be on my side. Since January I have actually had another disc to go bad, which might have been if surgery had taken place, this one could have been saved. Please advise me on what you find in regards to an attorney. Good luck and God Bless You.
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Old 05-19-2005, 09:19 PM
sfmcfar sfmcfar is offline
Join Date: Apr 2005
Posts: 61

It seems to me, as I may have mentioned before, that the thing to do is to get a law passed that prohibits carriers from claiming something that's been FDA approved is "experimental." It seems to me that it's at least within the realm of reasonableness (is that a word?) for a carrier to say that a 3- or 4-level ADR is experimental, and thus not cover it, but when I read of people like myself that meet the FDA guidelines perfectly and still hear "unproven" - it's enough to drive you to write your congressman, anyway.
L5-S1 DDD and herniation
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Old 05-22-2005, 11:04 AM
smc smc is offline
Join Date: Oct 2004
Posts: 94

Sorry things are not straight forward for you.

Good luck!!!
Sufferer of lower back pain since 1994.
Neck problem since 2004.
Also suffer from ME (CFS) and Chondromalacia Patellae
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