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New Member Introductions If you just joined, please introduce yourself here. Please add a signature describing your spinal history (use the "User CP) and ask us how we can help you get started.


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  #1  
Old 05-21-2012, 02:41 PM
stinaBan93 stinaBan93 is offline
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Join Date: May 2012
Posts: 2
Default Newbie - Glad we found this site!!!

Hello,

I'm 18 years old and have needed ADR for over a year. I had microdiscectomy surgery summer of 2011 after United HealthCare denied ADR surgery at that time (and denied all our appeals). The disc started bulging again by October 2011 and was fully herniated by March 2012.

UHC has again denied coverage this year, and denied the peer-to-peer review.

I am scheduled for ADR surgery this Friday, May 25, and my family has pulled money out of college savings to pay for it.

We have contacted several media outlets and customer advocates, a lawyer's office specializing in insurance bad faith cases, and the Synthes ProDisc PAL office. We will be picketing the UHC office in Cypress, CA this Wednesday May 23 from 11 AM to 1 PM.

At this point we want UHC to not only cover my procedure, but also change their policy so others can have Lumbar ADR without having to go through this nightmare. We've really appreciated the great info we have found here from gymnast1981, the list of insurance companies that cover this procedure, and the ProDisc PAL info!

Thanks big time for having these bulletin boards. It's great to know we are not alone in this fight.
__________________
Christina (18 yrs old) from CA
Sophomore at NAU, Flagstaff AZ
ADR denied by UHC in May 2011
Microdiscetomy July 2011, disc failed within 3 months
ADR denied by UHC again April 2012
Peer to Peer Review denied May 2012
Paying for ADR surgery scheduled for May 25, 2012
Fighting UHC in media and multiple fronts.

http://www.facebook.com/BackMyBack
http://www.indiegogo.com/backmyback
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  #2  
Old 05-21-2012, 02:58 PM
gymnast1981 gymnast1981 is offline
Senior Member
 
Join Date: Sep 2011
Posts: 150
Default

18 is way toooo young to have to have major back surgery... I was 23 when i found out i needed soemthing but waited and waited and finally did it 8 years later.

Do whatever you can to overturn their decision. dont stop fighting!!! that is my best advice to you!

i fought for over 8 long and stressful months and finally had an independant organization overturn their decision (thank you Obama Care!!!)
__________________
Becky (30 yrs old) From Wisconsin.
2004 my back goes out for the first time.
MRI in 2004, 2009 & 2011 DDD L4-L5.
MRI in 2011 more DDD and disc starting to bulge.
Fought UHC for 8 months and WON
October 31, 2011 IRO overturned UHC denial!
November 22, 2011 my spine got an upgrade.
(ProDisc-L) Best medical decision I have ever made


http://www.facebook.com/rebeccabille
my story: http://youtu.be/hT1jKmcOV8Y
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  #3  
Old 03-10-2013, 11:17 PM
Justinr999 Justinr999 is offline
Junior Member
 
Join Date: Mar 2012
Posts: 9
Default

Quote:
(thank you Obama Care!!!)
Did the affordable care act change something that requires insurance companies to approve independent organization's reviews?
As a huge ObamaCare advocate, I was a bit perturbed to find that I waited until 2013 for surgery only to find the affordable care act made nothing more affordable. Actually, I have heard several stories of where people's healthcare costs skyrocketed.
__________________
2003 - Work injury -- 7mm herniation in L5/S1 and 2mm herniation in L4/L5. Also Diagnosed with 3-level DDD (L3-S1).
2003-2008 - natural doc had me well enough where I was wake boarding and skateboarding.
2008 - re-injured lifting a box moving
2008-2012 - Ever increasingly faster degradation
2012 - looking into surgery (prefer Physio-L, waiting for case study on CAdisc-L)

Natural remedies, including MJ for spasms occasionally, have helped me through 9 years and especially the last 4.
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  #4  
Old 03-10-2013, 11:26 PM
Lillyth's Avatar
Lillyth Lillyth is offline
Senior Member
 
Join Date: Nov 2012
Posts: 679
Default

Quote:
Originally Posted by gymnast1981 View Post
18 is way toooo young to have to have major back surgery... I was 23 when i found out i needed soemthing but waited and waited and finally did it 8 years later.
I completely disagree. I have needed my ADR since I was a teenager and am just now getting to it. 20 years is far too long to lose of your life due to pain. I wish to God I had done it long ago when I was first injured. I wouldn't have missed out on 20 years of my life, and most of my son's.
__________________
Multiple traumas to spine starting age 13.
1st American to have 6 ADR's in one surgery. C3-4 - C/7, & L5-S1 - L3-4.
Surgery w/ Dr. Clavel, 3/18/13, M6.
Before surgery: severe spinal stenosis C5/C6 (cord "flattened" per stateside doc), + for Hoffman's & Babinsky's.
At time of surgery: 5 yrs MAX before ending up in wheelchair.
Clavel found L5-S1 partially fused. Had to cut it apart to put in M6.
Please excuse brevity - SEVERE carpel tunnel.
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  #5  
Old 03-10-2013, 11:28 PM
Lillyth's Avatar
Lillyth Lillyth is offline
Senior Member
 
Join Date: Nov 2012
Posts: 679
Default

Stina,

You say your parents are tapping your college savings for surgery here with the ProDisc? The surgery is by far cheaper if you are paying out of pocket to go to Europe. Plus they have better devices and more experienced doctors.

You should look into the European docs before you spend that kind of money here.

How much is your surgery here?

Lilly
__________________
Multiple traumas to spine starting age 13.
1st American to have 6 ADR's in one surgery. C3-4 - C/7, & L5-S1 - L3-4.
Surgery w/ Dr. Clavel, 3/18/13, M6.
Before surgery: severe spinal stenosis C5/C6 (cord "flattened" per stateside doc), + for Hoffman's & Babinsky's.
At time of surgery: 5 yrs MAX before ending up in wheelchair.
Clavel found L5-S1 partially fused. Had to cut it apart to put in M6.
Please excuse brevity - SEVERE carpel tunnel.
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