Can you explain this...

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I agree with you in part but I take the letter to mean "The surgery team strongly advises you to lose 40-50 lbs prior to surgery to minimize your risk of complications" you would need to loose this amount prior to surgery.  That's not uncommon at all for most of us had to loose prior to surgery.  I doesn't sound to me like a total denial letter???  The VA is weird though.  Good luck...keep after them!!!

dont take it as an denial. start working on the weight loss that they requested and stay in thier faces. Do not give up. Many people on here have encouraged me to keep trying for the surgery and they wont let me give up so you cant either! Good luck and God Bless!
sherrie

Just from what you wrote, it sounds like they are giving you a conditional approval?  Most surgeons require a weight loss prior to surgery.  Weight Wise requires you lose 10% prior, some require a 2 week liquid fast prior, and according to the boards, most insurance companies require a 6 month supervised weight loss prior to surgery.  I would suggest getting a clarification of the weight loss and what their requirements of that weight loss would be.  Pin them down.  Good luck, Michael

Its not uncommon for doctors to require you to lose weight before the surgery for weight loss. It seems like its a little pointless but there are reasons behind it. WLS is a very serious surgery. Wouldn't you want to be in the best possible physical condition you can be in before you go in for the surgery??

Hi, Wayne.
I am the wife of a veteran, so I understand that the delays there can be even more frustrating than civilian insurance companies, which, at least, give a flat "No," usually the first time.
There is some validity to their risk factors. Age, weight, gender, etc. do make a difference. The older you are, the higher the risk of any surgery. Same with weight. The gender issue is probably linked to the hypertension, in their viewpoint.
What you need is a high-ranking military person or a politician (preferably one who is a veteran, as well) to go to bat for you. It's true that "the squeeky wheel gets the grease," and that's especially true for the veteran trying to utilize his/her benefits.
Good luck to you. Perhaps you may wish to opt for self-pay. I know it's hard and expensive. It's the route I've chosen, for I have no other option. I am using a credit company, and if I repay in 18 months, there will be no interest. It's something to consider, perhaps.
Blessings,
Mary

I wish you luck in your journey, Wayne. I'm sure that it's hard, but try to keep a positive attitude, that you WILL get WLS somehow. Medicare will pay for WLS, but not the VSG, at least not that I've heard of yet (most insurance companies consider it "experimental").
Something to keep in mind with Medicare is that they will only pay for WLS at a "center of excellence," so if the hospital (like Foundation Bariatric Center of Edmond) is NOT on their list, they won't pay. Since I wanted VSG surgery AND I wanted Dr. Walton for my surgeon, I chose self-pay.
It sounds like you've done all you can do. I will pray that doors will open for you, if you don't mind. Have you tried contacting Bob Dole?
Blessings,
Mary