Hey Everyone, I am hoping that I can find some help here and get advice because I am lost.
I am 48 years old and have been battling back trouble for going on five years now. I have severe DDD, and have exhausted all conservative options that could have helped my problem. I am in severe pain at all times and am not a great candidate for pain meds, being that they make me ill. I was told by two Orthopedic surgeons that I need a lower lumbar spinal fusion. I have been denied stating not medically necessary. My doctor did a Peer to Peer and was denied also. I just completed my first level appeal and they are still stating that this is not medically necessary because my spine is not "Instable". Yet my doctors tell me that within a years time, I could be unable to walk and be forced to go on disability. I have grandkids and also a life to live. I just want my back fixed. Can anyone respond and let me know how I can maybe get this overturned????? I am in desperate need
P.S. I have Anthem Blue Cross