complicated

Gchandler · #1 02-09-2012, 10:01 PM

I have been fighting for over 16 months to get fixed with no luck. My story is kinda complex. I was in a car accident and as a part of the settlement was awarded PIP coverage through state farm. Well since they dont pre approve any surgery no DR with do the operation. My insurance will only pay for a fusion. If I Have the fusion then I would be medically discharged from the Air National Guard and I would lost my federal job. If that happens State Farm does have to pay 85% of my wages for 3 years but that is not what I want. Then I was involved in another accident that damaged my cervical spine leaving me in more constant pain everyday. So now I need cervical and lumbar disc replacement. I have actually considered going to India the pain is so bad.

srajan0929 · #2 02-09-2012, 11:45 PM

hey so how old are you? are you male/female? have you done any procedures prior to considering disc replacement?

laid up doc · #3 02-10-2012, 01:10 AM

I'll be Harrison for a minute and suggest you put together a signature of your history - what level(s) are involved, what you've had in the past, etc.

Why would the NG discharge you for a fusion, but not a disc replacement? If that is indeed the case, and your career is at stake... and your insurance absolutely will not cover ADR... I would highly advise you consider going overseas. The usual suspects mentioned with regularity here are Drs Boeree, Clavel, and Pimenta in the UK, Spain, and Brazil, respectively.

Some of us may be able to chime in with more useful info if you can post more specifics.

Welcome, but sorry you're here... though many of us have found significant help from this and other forums!!

Gchandler · #4 02-10-2012, 02:47 PM

I'm a 33yr old male. I've had a discectomy at L5-S1 for sciatica. Then a car accident reherniated my discs. Military has been using ADR since 2005 and believes fusion allows more pressure to build on the rest of the spine causing it to become weak. They believe ADR allows most of your mobility to remain intact. I'm not active duty or else it would have been paid for

laid up doc · #5 02-10-2012, 06:02 PM

at your age and 2 levels.... ADR or hybrid really is your best bet IF you are a candidate.

have you sought the opinion of an ADR surgeon? do you have the resources to pursue overseas surgery?

i had no good option here - due to metal issues, device concerns, unresolved question of an SI joint issue, and an insurance that would only cover US ADR, not fusion. i have a pending MVA suit, but i had to proceed w/o any assurance that i would get a dime from that. i borrowed $$ from family and went to Spain, and everything has worked out quite well so far. return to work on Wed...

Gchandler · #6 02-10-2012, 09:20 PM

I have a pending personal injury case as well. I want to get fixed now, my trial is not until November. My doctor specializes in ADR and hybrid is what I would like. I'm just fighting insurance and submitted an appeal yesterday. I could go overseas if necessary

Harrison · #7 02-10-2012, 10:15 PM

Hi GC, pls see:

http://www.adrsupport.org/forums/f58...-health-11053/

Let me know if you need help.

srajan0929 · #8 02-10-2012, 11:02 PM

you should go overseas...european surgeons have more experience...

laid up doc · #9 02-10-2012, 11:02 PM

my lawyer told me PI suits don't usually go to trial til the injured party is "better", or at least that's the best time... my MVA was last March and my lawyer is still in discovery, getting my old records and such.

he's been very sanguine with me that exacerbations of pre-existing conditions are tougher to win. i went ahead and had my surgery w/ no guarantee of getting any money - but i'm going back to work, which is even better

good luck!!!

Gchandler · #10 02-11-2012, 11:46 AM

They are tougher but the eggshell doctrine helps plus my c5-c6 disc herniation is new. Every case is different from state to state. Personal injury will go to court when insurance refuses to pay policy limits opening up their insured for a possible judgment.