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  #1  
Old 09-02-2006, 08:19 AM
Eddie_G's Avatar
Eddie_G Eddie_G is offline
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I called my adjuster Mr. Schn#%$ from Liberty Mutual on Friday and he told me that Liberty Mutual considers the Prodisc experimental. He wants my surgeon Dr. Goldstein to write him ANOTHER letter stating WHY he thinks the Prodisc is better than the "Sherreat" (Thats how this uninformed DOLT pronounces it) My surgeon already wrote him a letter!!! This is the same idiot adjuster that approved two NJ surgeons that had done ONE ADR and ZERO ADR procedures. HA! I obviously refused those surgeons and fought to get the good Dr. Goldstein at NYU by having my company's medical director call Liberty Mutual's medical director. Well of course NOW my company's medical director left the company so I have to ask my VP (who would help me in any way possible)to write a letter to the new medical director. He in turn would have to talk to Liberty Mutual to get me approved.

This moronic adjuster has EVERYONE jumping through hoops for him. This little punk would have me be a labratory rat by being the first "Sherreat" surgery for some doctor, but won't approve what my experienced surgeon (who does both Charite and Prodisc) AND my PM doctor thinks is best for me. Jerkface told me he could find doctors to dispute my surgeon. I'm not sure his doctors would even know what a "Sherreat" is. What a JOKE this kid is! Did I mention pencil-neck and worm? Yeah THAT too!

How much longer do I have to suffer before it's not experimental....1 month....2 months.....3? Who is he to question my surgeon and PM anyway? He has proven himself to me to be uneducated, yet he controls my LIFE right now. I have all the reports on the Prodisc and will burn out his fax machine with all the reports he will receive on Tuesday.

I force myself out of bed to go to work at least 3 days a week now. Maybe if I stop going to work altogether, they will understand the seriousness of my pain. I'm just not mentally ready to sit home yet although nobody would question it if I did.

I hope Dr. Goldstein can find time to write this letter soon.

In my Workers Comp settlement, can I now sue for mental anguish?
__________________
12/16/03 Work Accident
Herniation and DDD at L4-L5
4/1/05 Discectomy
Epidurals and facet injections
5/15/06 Discogram confirmed L4-L5 DDD also an asymptomatic L5-S1 tear
10/24/06 L4-L5 Prodisc surgery with Dr. Goldstein
CAT scans & X-Rays show ossification
Trigger Point Injections, Medial Branch Blocks, Acupuncture, Weekly Deep Tissue Massage
10/27/08 Discogram (positive L5-S1 tear)
11/25/08 L5-S1 fusion with Dr. Goldstein
FAILED BACK SYNDROME
Liberty Mutual WC
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  #2  
Old 09-02-2006, 08:39 AM
chasswen chasswen is offline
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eddie
i surely feel for you. someone quits and you have to start again from the get.

chuck
p/s you want this surgery before to much lost in height or recovery is god awefull distraction pain.
__________________
ddd 1990
2003 mri,xrays,shots,emg
2004 discogram ouch pos l4 l5
facet block neg
lost all appeals BCBS 5 months of that
3 surgeons later
surgery with dr. bertagnoli aug 2nd 2006 in Bogen Germany Successfully ProDisc-L L-4 L-5
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  #3  
Old 09-02-2006, 08:44 AM
Eddie_G's Avatar
Eddie_G Eddie_G is offline
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Posts: 238
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Exactly! My doctor said if this is not done soon "my prognosis is grim".

This weather sure is grim. My prognosis for this rainy weekend in NJ is alot more pain...
__________________
12/16/03 Work Accident
Herniation and DDD at L4-L5
4/1/05 Discectomy
Epidurals and facet injections
5/15/06 Discogram confirmed L4-L5 DDD also an asymptomatic L5-S1 tear
10/24/06 L4-L5 Prodisc surgery with Dr. Goldstein
CAT scans & X-Rays show ossification
Trigger Point Injections, Medial Branch Blocks, Acupuncture, Weekly Deep Tissue Massage
10/27/08 Discogram (positive L5-S1 tear)
11/25/08 L5-S1 fusion with Dr. Goldstein
FAILED BACK SYNDROME
Liberty Mutual WC
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  #4  
Old 09-02-2006, 09:08 AM
Mariaa Mariaa is offline
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Posts: 1,121
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Eddie,
I so feel for you in terms of your WC struggle considering what I've been through since Oct.'05 with the change in CA WC legislation and the rescinding offer to pay for my Prodisc 2 level ADR...

The 2nd opinion surgeon really surprised me with his decision (tho I've yet to see it on paper). After 6 RIDICULOUS UR Denials (non-certifications for treatment), he has reversed the tables I believe.

However, the planned surgery for me is hybrid using fusion at L5S1 and ADR at L5 (Charite by my OSS)... I too want Prodisc.

Can you believe at one time WC authorized a 3 level Global fusion and the hired docs for UR were even denying a fusion for me!!!!!

Well, I truly offer my sympathy and hope that you will get this surgery done with the Prodisc however, perhaps if it's going to mean Charite or nothing, you might want to reconsider...

At this point I cannot remember if you're getting one or 2 levels done so perhaps that statement is useless, just food for thought...

Hang in there, fighting the fight and the run arounds is probably the only way to get anywhere with these ridiculous renderings and hopefully your spine will hang in there with your~ take good care... don't give up! Maria
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  #5  
Old 09-02-2006, 09:50 AM
Eddie_G's Avatar
Eddie_G Eddie_G is offline
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Posts: 238
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I'm just need one level at L4-L5.

Thanks for the support. That's why I come here.

My situation + what I see my Grandmother, Aunt, and Mother go through with incompetant nurses and doctors really makes me worry about our country's health care system.

I have a friend who will not leave her mother's bedside in the hospital. She watches EVERY medication that is given and questions EVERYTHING because the nurses don't look at the chart and do things they're not supposed to.

I have an Aunt in a nursing home. My Mother popped in to see the aide SHOVELLING food into my Aunt's mouth. Her mouth was full of food but he kept shovelling more in so he could get to the next mouth. My Aunt has lost 30 lbs (she is skinny to begin with) and my Mom ALWAYS finds her in bed with a dirty diaper. They lost THREE hearing aids, they lose her clothes, and use my Aunt's personal supply of diapers for other patients. Mom has to write my Aunt's name on all her clothes with a permanant marker. My Mom has put in multiple complaints to the state.

(Add to that the post I put into the "Bitch Session" thread about my Testosterone Dr.)

But I digress....

How does a medical insurance adjuster not know to pronounce "Charite"?

Is this even America anymore? This is Third World stuff!!!

Thanks for the support and yes I will continue to fight. Even if it's from my bed!!!
__________________
12/16/03 Work Accident
Herniation and DDD at L4-L5
4/1/05 Discectomy
Epidurals and facet injections
5/15/06 Discogram confirmed L4-L5 DDD also an asymptomatic L5-S1 tear
10/24/06 L4-L5 Prodisc surgery with Dr. Goldstein
CAT scans & X-Rays show ossification
Trigger Point Injections, Medial Branch Blocks, Acupuncture, Weekly Deep Tissue Massage
10/27/08 Discogram (positive L5-S1 tear)
11/25/08 L5-S1 fusion with Dr. Goldstein
FAILED BACK SYNDROME
Liberty Mutual WC
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  #6  
Old 09-02-2006, 10:03 AM
chasswen chasswen is offline
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Join Date: Apr 2006
Posts: 627
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care in germany was clearly 1st rate im really glad i sought treatment there.
the care was second to none!!!
best wishes
chuck
ps now if i can get blue crap to pay on the out of network i would even at point be happy to recieve 80% return. pricks should have to pay for all of it including travel costs.
__________________
ddd 1990
2003 mri,xrays,shots,emg
2004 discogram ouch pos l4 l5
facet block neg
lost all appeals BCBS 5 months of that
3 surgeons later
surgery with dr. bertagnoli aug 2nd 2006 in Bogen Germany Successfully ProDisc-L L-4 L-5
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  #7  
Old 09-02-2006, 11:07 AM
Eddie_G's Avatar
Eddie_G Eddie_G is offline
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Posts: 238
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I did try to get over to Germany to see Dr. Bertagnoli but the insurance company was not hearing any of that. I even offered to pay my own airfare. DENIED!
The closest I came to Dr. B. was a handshake at the *** Symposium last year.

Prodisc is what Dr. B likes. Gee...Is he experimenting on people??? I would take his experiments over a "Sherreat" surgeon with no experience.
__________________
12/16/03 Work Accident
Herniation and DDD at L4-L5
4/1/05 Discectomy
Epidurals and facet injections
5/15/06 Discogram confirmed L4-L5 DDD also an asymptomatic L5-S1 tear
10/24/06 L4-L5 Prodisc surgery with Dr. Goldstein
CAT scans & X-Rays show ossification
Trigger Point Injections, Medial Branch Blocks, Acupuncture, Weekly Deep Tissue Massage
10/27/08 Discogram (positive L5-S1 tear)
11/25/08 L5-S1 fusion with Dr. Goldstein
FAILED BACK SYNDROME
Liberty Mutual WC
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  #8  
Old 09-02-2006, 11:15 AM
chasswen chasswen is offline
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Join Date: Apr 2006
Posts: 627
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eddie
rofl
for being experiment he sure does send alot of time over here in the states talking of them.
chuck
__________________
ddd 1990
2003 mri,xrays,shots,emg
2004 discogram ouch pos l4 l5
facet block neg
lost all appeals BCBS 5 months of that
3 surgeons later
surgery with dr. bertagnoli aug 2nd 2006 in Bogen Germany Successfully ProDisc-L L-4 L-5
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  #9  
Old 09-04-2006, 11:28 AM
Mariaa Mariaa is offline
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Posts: 1,121
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Eddie,
I believe Dr.B will use whatever he thinks is appropriate for the patient situation or individual case. Don't quote me on that tho I'm almost certain it's true. Since he doesn't have to deal with the FDA or the insurance situation here, likely he has whatever he wants at his disposal.
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  #10  
Old 09-04-2006, 12:38 PM
fiddle fiddle is offline
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Join Date: May 2005
Posts: 73
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Eddie,

I am gearing up for my own insurance appeal, so I'll be on the boards quite a bit over the next couple of weeks.

I went over to Munich for a one-level with Dr. Zeegers. First reason: Dr. Zeegers. Second reason: Reputation of outstanding patient care (which was the case). Third reason: Choice of discs.

I am so glad I went to Zeegers because he said that my surgery was one of his most difficult ever. I also had received a warning about the U.S. hospital I was considering. I was told to "have someone with me at all times". This made me nervous. I believe you can get a second opinion from Bertagnoli/Zeegers through the web/mail. I wanted the help and support, so I hired Mark ******* with Global Patient Network to help me with this.

I paid out of pocket and I am hoping to get reimbursed. Reason for denial given: The procedure is "experimental".

Good luck. Fiddle
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