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Back Problems Message Board


Back Problems Board Index


Hi Daubie, :wave:

Thank you so much for the reply, I'm glad I caught you, I was just about to sign off for the evening.
Geez,I didn't even realize that you were back to work already, I wonder if you returned too soon and that is why you are not getting much better ?

I'm glad the tens unit is helping you, I have one also, usually the docs have no problem writing the script, my PT place is the one who told me to get the script from the doc, so if PT tells you to get one, you shouldn't have any problems. Sometimes they like to bill the insurance company for a few weeks of rental before they submit the bill for you to own it, they like to make sure you are getting good relief from it. Have you tried all of the different settings to find the one that helps you most ? I thought that was so neat when I first got it. One of the settings feels like bugs crawling under my skin if I crank it up, it's a weird feeling for sure, especially since I hate bugs !!

I will try the butt cheek squeeze for sure, you and karen are correct, if it works, who cares ?

As far as the LTD, yes, I received a denial, so now I have to appeal again.
The DOL stands for Dept Of Labor, and the new regulations are ERISA protected, which gives the insurer the right to ask for a 45 day extension to make their decision, which I already had on the first appeal.
I finally did receive my claims file from Cigna, one of the key forms is missing, that I think caused the main denial to begin with. It was the physical assessment form which states my limitations and restrictions. They faxed it to my doctor twice back in Feb and March, but that witch that I wrote the letter about from my doctors must have also tossed the requests in the garbage as pay back to me for writing that letter about her shi* attitude.
The consulting Ortho doctor from Cigna tried to make phone contact with two of my doctors, but they only ended up playing phone tag. Their doctor claims that neither of my doctors even bothered to return his calls, that is total BS, because I have the phone logs from both doctors to support my appeal. They just kept missing each other. Cigna should have faxed a newer request to my doctor in May/June, rather than to keep playing phone tag. It was one of my doctors that told me that a Cigna doctor was trying to reach him to begin with, he was the one to tell me to ask the Cigna doctor to keep calling him back, as the Cigna doctor never returned his return calls.

The reason the consulting doctor (no, I was never seen by one of their IME's) quoted for the denial was that I should have had a 86 day maximum recovery period. I think he is blind, as he certainly wasn't reading about all of my post op problems, or even taking into account the possible hardware removal surgery that is pending once I'm fused enough.
My doctor said that the magnitude of my surgery requires a much longer recovery period, even if I had no post op problems.
My muscles are rubbing on the screws causing pain and total discomfort 24/7. I have a ton of swelling, as well as a bulging muscle at L5-S1 (L2-3 seems to be fine since the fusion, but L5-S1 is what is causing all of the problems) I had a two level fusion.
My legs, feet and butt go numb after sitting more than 10-15 minutes from nerve damage, and both of my legs ache terribly, like I have a vice tightened around them.
My job is sedentary, but even though I have very detailed medical records, as well as two doctors both refusing to release me to work, because they don't want me to endure the extra pressure and aggravation from sitting, the Cigna doctor (who has never seen me) says I can do sedentary work. How he can make such a determination is beyond me.

I'm sorry to be so long, as it stands, I'm fighting this with all that I have [img]http://www.healthboards.com/ubb/hammer.gif[/img] I have an attorney, as well as I retained that professional claims consultant/expert witness to assist me in this nightmare.
I think I will get approved this time around, but it will still take a month or two to get their final decision. We are still putting together the final appeal.

I will let you know how I make out.
In my eyes, insurance companies will do anything they can to avoid paying a LTD claim (STD is much easier) they try to force people back to work before they are able, not caring if they get worse. Well, my doctors don't want the liability resting on their heads if I get worse, so I will sit here with no income and keep fighting this, because it's my doctors that care aboout my best interests,not the insurance company, I'm just a claim number to them to begin with.
Their job is to get people to break, but it will never happen to me, I refuse to be looked at like I'm scamming the system for a crappy 60% of my pay, and get worse in the process.

Wow, sorry for that vent, but I feel much better now.
I guess it was bottled up inside me.

I hope that you can find some relief soon :angel:

Thank you for listening [img]http://www.healthboards.com/ubb/heart.gif[/img]

Be Well,
Baxter [img]http://www.healthboards.com/ubb/love2.gif[/img]

------------------
Two level laminectomy fusion L5-S1 & L2-3 done on 12/6/02.
I regret the day that I agreed to have this surgery.
Fifteen inch scar from the very top of butt crack (sorry), to the bra line.
BAK cages, rods & screws.(Titanium)
My pelvic bone was used for grafting.
Praying that the other two discs in between, won't have to be fused later, as I was told it was a possibility, due to the other two discs in between, not being in that great of shape.
Doc didn't want to fuse four levels, unless it is really necessary.
I would hate to repeat the surgery, as the recovery period, is so very painful.
I also have a free fragment in my T11-12 area, that I'm still refusing surgery for, at this point in time.
That surgery is way too dangerous for me to consider, until if affects my being able to walk.





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