Reflex Sympathetic Dystrophy (RSD and CRPS) Reflex Sympathetic Dystrophy (Complex Regional Pain Syndromes Type I) and Causalgia (Complex Regional Pain Syndromes Type II)(RSD and CRPS)


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Old 04-15-2010, 08:07 PM #1
Lisa in Ohio Lisa in Ohio is offline
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Well I don't have to worry about the SCS anymore. WC denied it entirely. Does anyone know of a good vet??
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Old 04-15-2010, 08:27 PM #2
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Quote:
Originally Posted by Lisa in Ohio View Post
Well I don't have to worry about the SCS anymore. WC denied it entirely. Does anyone know of a good vet??
From what I have seen on this board the SCS is about 50/50, so I wouldn't get too discouraged...WC sucks and I am so sorry you were denied
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Old 04-15-2010, 09:01 PM #3
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Heart Hi Lisa ...

Sorry to hear this......

Did your Pain Dr/Surgeon write a letter of medical necessity to the Insurer?
I was under the impression that if that letter is sent, that pretty much seals the deal......but i have no knowledge whatsoever on WC or all the factors involved.....

I hope things work out for you soon......for all we know maybe the SCS would have caused you more problems..... ? ....
Otherwise, if you feel in your heart it is something you truly want to pursue (at least the trial implant), is there a way to see if your primary insurer would cover?
I really do think it all boils down to that letter of medical intent from the Dr.

Caring
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Old 04-16-2010, 12:28 AM #4
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Hi Lisa,
Are you disappointed or somewhat relieved?
I am wondering what their rationale was for denying you the treatment that you requested? Do they think it is 'not medically necessary'?
The criteria used baffles me (well, not really....the criteria is cost..)....such as in my case, how can aqua therapy which reduces swelling and keeps mobility in the rsd affected limbs not be 'medically necessary'????? .....denied!
Did your WC insurance offer an alternative treatment??
I am sorry you were denied, Lisa, if you were really counting on this modality....
Perhaps a blessing in disguise?

p.s. my veterinarian used to make housecalls...........

Hugs from Hope4thebest
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Lisa in Ohio (04-16-2010)
Old 04-16-2010, 11:22 AM #5
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Quote:
Originally Posted by hope4thebest View Post
Hi Lisa,
Are you disappointed or somewhat relieved?
I am wondering what their rationale was for denying you the treatment that you requested? Do they think it is 'not medically necessary'?
The criteria used baffles me (well, not really....the criteria is cost..)....such as in my case, how can aqua therapy which reduces swelling and keeps mobility in the rsd affected limbs not be 'medically necessary'????? .....denied!
Did your WC insurance offer an alternative treatment??
I am sorry you were denied, Lisa, if you were really counting on this modality....
Perhaps a blessing in disguise?

p.s. my veterinarian used to make housecalls...........

Hugs from Hope4thebest
Lisa...
I am very sorry for your denial...I understand your dissappointment is in that we open our selves up for any intervention possible..and being denied takes it out of our deserving hands... allowing us the decision is one hting but for them to say.. No!! That is a horse of a different color..I have a SCS..I ma wired but did not get good results and had spread so honey..I hope this helps you.... Plus your comment about the vet made me roll..You brought a fun smile to my face..Hang in there..possibly the SCS was mean't to happen for you...Take care and have faith..

hugz, Kathy
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Old 04-16-2010, 11:43 AM #6
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WC is such a different thing to deal with not like pvt ins at all.

Have you posted /visited out wc forum?
you may find some tips to help deal with the wc issues, appeals etc.
http://neurotalk.psychcentral.com/forum30.html
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Lisa in Ohio (04-16-2010)
Old 04-16-2010, 10:39 PM #7
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I am sorry if you are saddened by this. But from what I have read this truly may be a blessing in disguise. Look for another door to open or if this is something that you really want to try then as will the rest of the best you will have to fight!!!! I too had a huge belly laugh about the vet. Sorry for your disappointment. God Bless

Jeanie
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Lisa in Ohio (04-16-2010)
Old 04-16-2010, 10:52 PM #8
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Did you get the Utilization Reveiw form back from them ? What reason did it give for the denial ?
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Old 04-18-2010, 09:30 PM #9
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Quote:
Originally Posted by keep smilin View Post
Lisa...
I am very sorry for your denial...I understand your dissappointment is in that we open our selves up for any intervention possible..and being denied takes it out of our deserving hands... allowing us the decision is one hting but for them to say.. No!! That is a horse of a different color..I have a SCS..I ma wired but did not get good results and had spread so honey..I hope this helps you.... Plus your comment about the vet made me roll..You brought a fun smile to my face..Hang in there..possibly the SCS was mean't to happen for you...Take care and have faith..

hugz, Kathy
hi, i just got approved for the trial. i'm type 2 and my pm told me that type stays in the injured area. i'm really very concerned about scs. can you please tell me a bit about your rsd before the scs and what happened? if that's ok...thanks!
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Old 04-18-2010, 09:55 PM #10
Lisa in Ohio Lisa in Ohio is offline
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Glad to share. I fell at work and sustained a severe distal radius fracture. After 8 surgeries the pain was still severe and that was when the ortho doc decided it was RSD.
I was referred to the PM doc associated with the ortho practice. She pushed increasing amounts of pain meds until I switched to another PM doc about a year ago. The new doc then did 3 nerve root injections and I had very short windows with some relief and harsh side affects. He then recommended a SCS. I have had the psych eval, and then Worker's comp denied the procedure. Since the first of the year my pain areas have spread from my entire left arm to my left shoulder, neck, head and ear. My blood pressure is beginning to be high, my heart is acting up and I am having some pretty ugly kidney pain. I also have severe depression. Currently unable to work. I do not know what plan F is going to be, I just know that I am too tired to fight the system anymore. The link here to SCS is very helpful for some real life experiences with this device and things to consider. I hope you have great success with this device and look forward to further postings from you. Blessings, Lisa
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