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Insurance Hell All insurance-related matters are here: Medicare, worker's compensation, appeals, denials, insights, wins, losses. PRICING is here too. Note: This forum has posts from 2006 forward. Older ones are in the Big File.


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Old 02-16-2014, 07:32 PM
femalepowerlifter310 femalepowerlifter310 is offline
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Join Date: Feb 2010
Posts: 100
Exclamation SUCCESS! Winning Class Action Suit against Anthem Blue Cross

Hi everyone,

A few years ago, after my ADR, I was contacted by a law group who asked if I wanted to be involved with a class action suit against Anthem for denying my claim and any hope of getting FDA approved Pro Disc surgery. I was just extremely lucky by going to the right doc at the right time who offered me one of the first spots in the Freedom Disc clinical trials, 4 years later I'm doing amazingly well. Anyway, I thought I might see a few hundred bucks but more importantly continue my work as a 'medical pioneer' to fight for the rights of back patients who'd come after me - and for me later too should anything else go awry G-d Forbid!!!

I then was alerted I'd receive one amount - beyond what I'd imagined - but that if I'd gone a head with any other surgeries I could write my case and it would be presented in order to get more than the predetermined amount. So, I did. In Dec 2013 it was closed and payments were made, it has helped the fact that I've had to give up my high paid work as an athlete / stunt actor a bit, and it was a huge win for patient rights.

I've been talking to an ADR friend in another state - I'm in CA - other patients should band together to fight for compensation and patient rights! This website would be the perfect place to start a group!

I've been extremely lucky in having an amazing doctor, getting in the trial, and then being sought out for this suit; so I hope I can pay this forward for others.

Interestingly enough, I've been denied another procedure (orthopaedic again) and my docs are working on it - they just do not learn, do they? But strapping my warrior armor on, and if all fails, I'll call these guys back and see if anyone else has been denied again. My abilities as an athlete and human are part of my career and lifestyle, how can we continue to get denied new procedures that are proven to work? It doesn't make any damn sense. Let's all fight, ADR warriors!
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-FPL310
Cervical problems beginning 1984 (age 12)
*Hypothyroidism also started age 12 (may be related)
L4-5 herniation 1989
Years of Chiropractic allowed me to become a world class athlete in spite of this.
Cedars Sinai / Dr. Rasouli opinion Jan 2010
Axiomed Freedom Disc *clinical trial* - Feb 22, 2010
7 years later, Dr. Rasouli (my savior) had predicted with great accuracy when I'd need 2 level cervical ADR
Sept 29, 2017, became owner of 2 Prestige LP discs C5/6 & 6/7.
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Old 02-17-2014, 01:05 AM
pittpete pittpete is offline
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Join Date: Jan 2008
Posts: 307
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Thank you for the update
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Born 1970/1995-Hurt at work/1996-Right disc fragment L4-L5 discectomy-On/off back pain,no serious leg pain until/2007-Right herniation L5-S1,recurrent small herniation at L4-L5 with unbearable leg pain/6/08 discectomy L5-S1/leg pain relieved/occaisional mechanical pain/2012-Cymblata 60 mg,occasional aleve/2014-LB pain not debilitating but chronic,Rhizotomy relieves facet pain on right side/2015-L4-S1 facets shot/4/15 PLIF L4-S1 with facectomy
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Old 02-17-2014, 09:42 AM
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jss jss is offline
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Join Date: Nov 2009
Posts: 1,411
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What great news! Congratulations!
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C4/5 - ACDF in 2000
C5/6 - ACDF in 2002
C3/4 & C6/7 - M6 ADR, Nov 2009, Barcelona
Conceded defeat to a manifestly disingenuous BCBS-TX in my quest for reimbursement, Jan 2011
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