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Physical Therapy Declined after 2 months?

StacyAnnSStacyAnn Posts: 50
edited 06/11/2012 - 8:53 AM in Back Surgery and Neck Surgery
My insurance company says I have reached "maximum therapeutic benefit" after only 2 months of twice weekly PT. I am aghast. 9 months after second surgery in 2 years and only 2 months to rehab? Anybody else run into this? My therapist managed to squeeze 6 more visits from them Friday but then what? I haven't worked since this all started. I cant lift more than 10-15 pounds without pain. I cant walk upstairs or inclines/hills without pain. It is just so frustrating.



  • Sometimes you have to fight for it, sometimes you only get what you can and work on the rest on your own. I was in PT many times for months on end, but I can't walk on an incline at all, of course my problems are totally different.
    Hopefully you will slowly improve on your own even when you are finished with PT. There are probably a lot of excercises they can teach you to do at home. There were times when I couldn't go to therapy and I had no choice but to learn the excercises to take home like homework, and I know of others who have done the same.

    Are you in a pain management program, if so they can refer you out again, or for aqua therapy, massage therapy, etc.
  • I am guessing your insurance is per state participants? I am federal, so a different pool. Like Robin said you may have to fight for it. Or as I like to call it, "the squeaky hinge gets the oil" (or attention) of the insurance company, that too, it does at times come down to how your physician words his report to the insurance as to *why* you need to continue.

    Don't give up. Let your prescribing physician know what is going on (they might be able to fix), and or they might have guidance if you contact your insurance directly. I hope this gets resolved fast. *HUGZ*

    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • Ask if the PT place offers an 'after patient' type care. The place I went to offered 'after care' for this reason. It was like $40/month but I had unlimited access to the place and the physical therapists would give me general guidance as needed.

    I didn't do it because I just kept up the exercises at home but I did consider it b/c it was a good deal, cheaper than a gym membership AND I had access to my PT person.
  • Well, I guess calling and being persistent helps. I don't know what happens after 6. One day at a time right? My PT is great. They were ready to help one way or the other.

    I do the exercises at home but I don't have the gym equipment like they do and live in the middle of nowhere. Plus the huge ice pack at the end of the sessions feels great on my back!

    Thanks for all your support!

  • Good for you Stacy..... :)))
  • Each insurance company has fixed limits on PT. It is to stop abuse by both the PT group and/or the patient. 2 months and twice a week is no surprise. That sounds very typical.

    Your 6 extension will max the limit. I'll bet they will make you go back to the surgeon and get a new prescription for PT. With a very specific reasoning and time. They may just tell you that is all your policy is paying for and you can go on your dime for further PT.

    For your own sake. I'd suggest you get the PT to show you exercises and give you printouts. Ones you can do at home by yourself. Then get into a ritual of doing them. Most likely that will be how you do the rest of your PT.

    For lower back. Most of it really comes down to basic stretches and Pilates/Yoga type moves you can do at home. Other than a few stretches we used a machine for. The rest I did at home with no special equipment. Just a band or ball.

    Good luck.
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