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I have a neck condition given to me where I had my neck broken because of being rear ended in a car accident. I have already have two fusions in my neck over the last ten years. I never recovered from my last fusion. I have severe pain in my neck, shoulders and upper back. I addition, I have significant loss of motor function in my one arm. I have had multiple MRIs, bone scans and x-rays. All the tests keep coming back with "Can't find any significant problem, nothing to be done". I've lost my job, cannot work and have been denied LTD disability. The accident happen many years ago, so the statutes of limitations ran out before I started having neck problems.
My last neck fusion was two years ago. The surgeon made the comment after surgery that he didn't understand how I still had any motor function left in my arms or legs. Recovery went well for six months and then turned bad. At twelve months, things got so bad that I had another round of tests (MRI, bone scan and x-rays) and went on short term disability. From the bone scan, the broken facet joint at the level that had been fused twelve months earlier was still very inflamed, so a nerve oblation (RFA) was performed. I was able to get back to work for a few months, but my neck continued to deteriorate. I could no longer continue work and was fired from my job.
The last two paragraphs are all background to my up coming question. Recently, I was back in my surgeon's office showing him my increasing loss of motor function in my arm. He ordered a Cervical Discogram which was denied by the insurance authorization request, because the insurance companies "determine cervical discograms to be experimental". That is being fought on appeal for medical necessity. They will gladly do the cervical discogram, if I pay for it (if I only had the money). On the internet, I found one of the insurance companies policies published for discograms and they state only to be performed when, I quote "unremitting pain with significant functional impairment of at least twelve months duration". I asked the insurance company how these policies are determined and they claim they are developed based upon guidelines from the medical professional boards (aka AMA, etc).
Here is my question, are doctors hands being tied by "guidelines / medical policies"? This goes beyond what an insurance company determines what they will pay. To me, it smells like this doctor could have been accused of bad medicine if he had not followed medical guidelines and would have ordered a discogram a year ago. I am being told that this cervical discogram is the only remaining test that might identify the cause my neck issues. It is documented that some disc issues are known to NOT show up on MRIs, bone scans and x-rays. So it smells to me that I have been forced to suffer for an additional twelve months and lose my job because of medical policy!