Blue Cross Fusion Denial
Hi everyone, I am new to the forum but not back issues! I really need some help. My wife has L2/L3 bulging and degenerating discs which are right above a previous fusion from 10 years ago. Unfortunately this happens as a consequence of back fusion but she had no other viable options available to her then. She has been scheduled for a two level fusion 8/23, and of course in true form BC came back yesterday and denied fusion because of "no signs of spinal instability". A discectomy / laminectomy is not an option because it won’t work. She is in agony and will be almost completely unable to move around within six months.
HELP - any suggestions? Attorneys?
We have sent it off to appeals but based on previous experience this won’t help. As a further note I have an L4/L5 herniation and very bad disc degeneration that needed fusion end last year. They did exactly the same to me – denial on same circumstance and refused in appeals. I ended up opting for a laminectomy and decompression which just like the surgeon said - has failed. Herniation is back, in pain 24/7, going on disability and will probably end up losing my house over this whole ordeal with BC. I will be next in line for the fusion I should have had earlier, right after we get my wife sorted out! Thanks everyone – any help would be appreciated. Have a wonderful day.