Health Insurance Issues
Posted on: Mon, 12/01/2008 - 09:26
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I was just denied
I applied for SSD in August and just got my denial letter. It kills me that even though my Doctors and their mental examiner say I am unable to work, they still denied me. But, most everyone has said they will the first go around so I will start the appeal process today.
Jeanette
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42 year old female with c4-c7 fusion, Have had 3 surgeries in the last 15 months.Had infection at the iliac crest sight and had to have surgery 1 month after neck surgery to debred and jackson prat tubes placed. I have tried spinal shots,PT, didn't help me.Medications for chronic pain: Percocet, Soma, Neurotin, (next step is a pain pump)I have bone spurring,DDD,spinal stenosis, ossification,at the 4-5 fusion there is almost complete loss of CSF.At T7-8 level I have protrusion that indents the thecal sac.New disc extrusion at c3-4 and bone spur c5-c6 fusion sight that is pushing on spinal cord and nerve roots.I have had to quit work, I loved my job....
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Jeanette:
That's so crappy! What was the reason they gave for denying you?
What a bummer.
Jeaux
'Only 2 defining forces have ever offered to die for you..... Jesus Christ and the American Soldier.
One died for your soul, the other for your freedom'
Broad-based midline posterior C5-6 herniation with cervical cord rotation counterclockwise, C6-7 herniation both with moderate degree thecal sac impingmnt; Milder C4-5 herniation (with mod. degree midine thecal sac encroachment); Mild midline C3-4 Left paracentral C2-3 disc bulges; Mild posterior T2-3 disc bulge; Suspected Adenoma of Left thyroid gland; S/P right hemilaminectomy (2/06) at L5-S1 with postsurgical changes, scar tissue around the S1 nerve root as well as circumferential osteophyte impingement of the foramen floor bilaterally; disc bulge at L4-5 and mild degenerative changes of the facet joints. Schnorl's node L1-2 (posterior endplate eccentric to the right). But this may all be because I am depressed....
I wanted to tell you to hang in there.....I was denied the first time and hired a lawyer. It took me 2 years to the date before I was awarded. It is a long battle and you will probably need a lawyer. It's crazy but you almost have to be on your death bed to get approved the first time....seriously, you have to be terminal.
Sharon
that but you actually got your first denial pretty quick. At least now you can move on with your appeal. I also had their docs and mine say I am 100% disabled but they did not expect that it would last 12 months or more. I got denied on my first appeal and am now awaiting a hearing with an ALJ. Good luck to you and don't give up!
I am in no way associated with the medical field. Anything that I post comes from personal experience only.
DDD, Facet Arthropathy, DJD, Sleep Apnea
PT, Epidurals, Facet Blocks,Medial Branch Block, Rhizotomy,Discogram,Annular Tare L3/L4 Endoscopic Microdiscectomy,Laser Surgery
Methadone, Percocet, Soma, Welbutrin
is that they say there is no proof that my disability will last a year or more. Okay, a fusion just doesn't go away, hello...Besides my surgeon wrote that I will always have a chronic pain issue. Oh well, I will keep fighting, my husband can't work 2 jobs 7 days a week forever...
Jeanette
42 year old female with c4-c7 fusion, Have had 3 surgeries in the last 15 months.Had infection at the iliac crest sight and had to have surgery 1 month after neck surgery to debred and jackson prat tubes placed. I have tried spinal shots,PT, didn't help me.Medications for chronic pain: Percocet, Soma, Neurotin, (next step is a pain pump)I have bone spurring,DDD,spinal stenosis, ossification,at the 4-5 fusion there is almost complete loss of CSF.At T7-8 level I have protrusion that indents the thecal sac.New disc extrusion at c3-4 and bone spur c5-c6 fusion sight that is pushing on spinal cord and nerve roots.I have had to quit work, I loved my job....
my denial said. You will be much better off once you are actually out 1 year. The fusion will not go away but they may think it is possible for you to get well before you are out of work for 1 year. It takes lots of patience to wait this out.
I am in no way associated with the medical field. Anything that I post comes from personal experience only.
DDD, Facet Arthropathy, DJD, Sleep Apnea
PT, Epidurals, Facet Blocks,Medial Branch Block, Rhizotomy,Discogram,Annular Tare L3/L4 Endoscopic Microdiscectomy,Laser Surgery
Methadone, Percocet, Soma, Welbutrin
Aren't you glad to know you will not be suffering a year from now? That's great! (I am being sarcastic here....)
Usually, what happens is that if someone has had surgery, policy dictates that SSA "ASSUME" the surgery will be successful within 12 months from the date of surgery. My Daddy always says that when you ASSuME something, you make an "A$$" out of "U" and "ME". Catchy ain't it?
In Louisiana, if you are denied, you request an Appeal. Used to be, you would request a RECONSIDERATION of that denial. That would entail another disability examiner looking at your file and if they agreed with the first decision, the decision was affirmed. If the 2nd reviewer could not agree with first decision, it would be a reversal. Louisiana has cut out that second step and gone straight to the Appeal Process. If this is the case in your state, you go ahead and appeal right now. Do not wait the 10 or 30 days' grace period. Chances are that the full 12 months from your surgery date will occur while you are waiting for a judge to review your file. And if you are still not better, you may be approved.
I said all that to say, move on to your next step. Today. Be sure to continue treatment; every 3 months or so, ask your doctors for a copy of your record from this point on - December 2008 to present, then March 2009 to present, then June 2009 to present, etc. Keep them all together, and when you are notified your hearing has been scheduled, send all the records to the Judge assigned to your claim. If your doctor charges you for the records, don't worry about getting them - SSA will request them and pay for them.
I sure hate to hear your claim was denied. That really bites. Good luck on your appeal process. Again, if you have any questions, you know where I am.
Jeaux
'Only 2 defining forces have ever offered to die for you..... Jesus Christ and the American Soldier.
One died for your soul, the other for your freedom'
Broad-based midline posterior C5-6 herniation with cervical cord rotation counterclockwise, C6-7 herniation both with moderate degree thecal sac impingmnt; Milder C4-5 herniation (with mod. degree midine thecal sac encroachment); Mild midline C3-4 Left paracentral C2-3 disc bulges; Mild posterior T2-3 disc bulge; Suspected Adenoma of Left thyroid gland; S/P right hemilaminectomy (2/06) at L5-S1 with postsurgical changes, scar tissue around the S1 nerve root as well as circumferential osteophyte impingement of the foramen floor bilaterally; disc bulge at L4-5 and mild degenerative changes of the facet joints. Schnorl's node L1-2 (posterior endplate eccentric to the right). But this may all be because I am depressed....