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My husband has worked both sides of the aisle where insurance is concerned, but still has a negative view of the industry. He had something to add to the discussion after I told him about your post. He had to get a state license in property and casualty insurance, due to a specific position at one time and said if it is not specifically EXCLUDED, then it is debatedly INCLUDED and thus open for discussion. As Joy (I love that name) pointed out, have your attorney speak with the insurance coordianator. Just because she doesn't have power in the situation, she is fishing for info to be recorded on tape, to use in non-payment of the claim.
Stop being such a nice guy. Don't talk to these people, don't try to be HELPFUL and of course do not put anything in writing. You are a smart guy, there must be a reason you spoke to her on the phone. Did they claim this was the first step, did they catch you off guard or is it prohibitively expensive to get an attorney. All these possibilities come to mind.
I have had to deal with insurance companies, their attorneys and the others who become involved, who know which side their bread is buttered on, and can feel for you in this situation. I know your family means the world to you and the medical problems, the pain the bills and the professional situation has been stressful.
All of your friends here at this site, are with you and hope things will work out smoothly and quickly, without too much trouble from the insurance company. I have found attorney fees to be worth the money in most cases.
Take care, your friend A-R9View Thread

Family members do not get it! At least in my family, this has been the case. My mother had RA and felt her pain beat my pain. Her reasoning? RA is in THE JOINTS! She would yell at me. I am a critical care RN, by the way. Funny, I think the spinal cord, as part of the central nervous system and the vertebra, being movable=joint.
I feel sorry for you. You have much on your plate and without the help you were hoping for and many of us expect at a time of need. I am guessing, but I would imagine there was disfunction in your family before you had the medical problems. I think many of these execerbate during periods of stress and times of need from a family member. See if you can reason with the most logical/reliable family member. Even if you must try an aunt or grandparent. Have them go with you to see your physician and receive a medical necessity explaination for the opioids.
I came from a messed up family, so I understand the behavior you have described and feel for you.
Take care,
April-Rose9View Thread

People have little understanding of how an injury to the spine can have an imact on most, if not all areas of our lives. How is it the rest of the world forgets what they learned at a young age in school? It is called a CENTRAL NERVOUS SYSTEM for a reason. Why do people understand the importance of the brain in your health, but think the spine is inconsequential in the picture.
If we don't walk in a physicians office with our abdomen split open, dragging our intestines behind us through the door, we are deemed to be healthy. Even if we are fortunate to find a knowledgable and caring health care provider, we then must deal with family and friends and their perception of us post injury. One thing I learned from a wise psychologist, our family and the role we had in the family prior to the struggle with chronic pain, does not change after the injury. They always tend to see us the same way.
The people on this site are very kind and caring. It has been extremely helpful to me the last couple of months. Many of the monitors (I am clearly not one of them), have extensive knowledge and can point you in a good direction.
My sister is a psychologist who did a two year post doctoral fellowship in health psychology and she feels finding a good cognitive therapist is as difficult as it is to find a good physician. Dealing with pain, financial worry, grieving the loss of your profession, isolation, loneliness and the change in relationships is a very huge loss many of us have had to face after we have had an injury. I understand your reticence to have to make it to someones office. Maybe, check to see if someone will have a phone or skype appointment, once you have explained your situation.
I don't know how old you are and what kind of support system you have, but I would encourage you to take your mother to your doctors appointments, in the hope she will gain a greater understanding of the complex nature of your spine injury. Many feel surgery is a "cure all". I have heard many rude comments about my chronic pain over the years.
I feel for you and your situation. I have had three spine surgeries and a SCS placed without much success. I wanted desperately to return to work and had far too many surgeries for my own good. I have been in pain every day since my injury. I am the anti surgery person on this site, due to my personal poor experience with the outcome of surgical intervention. I believe in trying consevative measures first and only trying surgery as a last resort. Of course, some injuries must be tx surgically or risk paralysis. I do not like the non reversal nature of surgery. The scar tissue can take time to occur, the nerves change and the anatomy of the spine is different post op.
Well, as always for someone who claims they do not have much to add to the discussion, I end up rambling on and on.
Take care, and remember to reach out to the kind people on this site.
Aprilrose9View Thread

My heart goes out to you and to many of the people who visit this site due to the difficult struggles with chronic pain and how our lives are impacted in all areas. You know the old saying: if your body isn't taken care of, then where are you going to live. Our problem is post injury, we are stuck in bodies where we have nowhere to run and nowhere to hide.
All of us understand and have to deal with the strong emotions of isolation, loneliness, disappointment and the stress physically and mentally which comes with chronic pain. Then we go through the emotional roller coaster from day to day, depending on which facet of our injury is impacting a certain area of our lives.
I can really run on! I just want you to know, yesterday you were in my thoughts and prayers. Many of us understand the difficulties you are facing at this time. I hope you have a good support system with family and friends, but if not, there are many caring people at this site who will reach out to you.
Take care,
Aprilrose9View Thread

Hope you feel better, April-Rose9View Thread

Take Care, April-Rose9View Thread

I would see an attorney concerning your situation. Actually, I would see two attorneys. ASAP is important, due to time limits based on learning the possibility of incorrectly performed surgery. I am not an attorney, but believe you have one year from the time of "learning" something was done incorrectly in the surgical proceedure.
A good social security disability attorney can recommend a personal injury attorney. You can file for disability without an attorney, but I would not recommend this option. My mother worked in Human Resources, and recommended I file without an attorney. When I finally did get SSDI, I had lost out on 25K. I feel this should be left to the experts. A good attorney will work hard for you and earn every penny.
Good Luck, AprilRose9View Thread

You have an enormous amount of knowledge and may know every bit of this, and more.
1.SI joint was not designed to take much movement. There are 3 large nerves through the joint space. Due to your anterior fusion and the hardware you have, the solid vertebra (of course, no longer moving) transfer the movement to the joint (SI). Thus, the awful pain, you and I have at our SI joint.
2. The nerve root is the size of your baby finger. Sometimes, referred pain may be coming from the nerve root.
3.I also live in a colder climate. The winters 3-6 months are usually the worst time of the year for me. The cerebral spinal fluid, reacts to the fall in the barometric pressure. The pressure on the CSF, causes pressure (by this I mean PAIN) on the post op scar tissue, nerves trapped in the scar tissue and nerve damage from your injury.
4.When a nerve is damaged, or cut in surgery, the nerve ending does not heal in a linear pattern. Picture the nerve as a "braided wire". Like the multiple copper wires twisted together and encased in whatever that outer coating is! Clearly, I know absolutely nothing about electrical wire. Anyway, if the wire is cut, the ends fray. This is the way your nerve reacts to being cut, the post op scar tissue forms and will trap the tiny nerve endings. Scar tissue is inelastic, forms at various rates and degrees depending on your genetic make up and occurs when our soft tissue is exposed to air.
You probably know every bit of this and more. Was thinking of you and wanted you to know you have been in my thoughts. Hope things are getting better.
Take Care,
AprilRose9View Thread

It is difficult to do under the best of situations, and doubles in effort, to manage with chronic pain.
Keep up the good fight. I hope in the future a recent grad will set up practice in your area, bringing enthusiasm, new ideas and a fresh approach to care in your town.
Take Care,
AprilRose9
P.S. Thank you for the compliment! Took it from a one day old kitten I received from the local animal shelter. I worked as a volunteer in my home, bottle feeding orphan kittens and puppies. The kitten came with the name April, named by another volunteer who named numerous kittens born in April, the same name over and over. The kitten had an 18% chance of survival, according to my veterinarian. I thought she was special, so I added the Rose. Thus April-Rose!View Thread

Feel cut off from the group. Tried to send bj a couple of things without success.
I will check back to see if you have any suggestions. My husband thinks it is the site, but why are others able to post.
It is very cold and chilly here, inside and out. Snowing outside and more to come the next several days.
Take Care,
AprilRose9View Thread
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