Tricare has my paperwork!!!!!!!!!!!!!

I just checked online and there it is! Has a P which I would assume means "pending" But this is a lot better than a while ago .. cross your fingers for me!!!!

Yipeeeeee!!! You are on your way! Susann

WONDERFUL!!! That is awesome news. I will talk to you later or see you tonight Mary

WE COULDN'T BE MORE PLEASED FOR YOU, MS KYLEE!!!!!!!! NOW, EVERYTHING WILL FALL INTO PLACE PERFECTLY!

GO KYLEE, GO KYLEE!!!! We are cheering you on right down to the finish line!! Merlon

and if tri care does go for it yu can get it from the VA, , Im on my 2nd appeal for a DS via my congress man, since I am service connected retired,tricare de****d tostop covering the DS in april, but medicare,medicaid, and the va does. the va does in bermingham, but only for south eastern vets, **** mr rumsfeld inthe 70's took my young butt, and had no problem send me to a southeast place of hell, now they cant send me to the swamps of south east of america to get fixed, I should sign up, my son. ****ttttttttttttttt.

WHAT IS THE EXACT REASON THEY DENIED YOU, MASTER WALTER? OTHER THAN YOUR CASE (THAT I'VE HEARD OF), TRI CARE HAS BEEN THE ABSOLUTE BEST AT APPROVING WLS, EVEN FOR LIGHTWEIGHTS WITHOUT CO-MORBS. MS KYLEE WASN'T REALLY DENIED ... THE LADY IN THE SURGEON'S OFFICE DIDN'T EVEN SUBMIT THE PAPERWORK ... SO THAT'S NOT TRI CARE'S FAULT. THE ONLY "EASY" THING TO CHECK ON ... DID YOUR PCM SEND YOU TO YOUR SURGEON WITH AN "EVAL & TREAT" REFERRAL? THAT IS A MUST. IF YOUR PCM SENT YOU WITH ONLY AN "EVAL" REFERRAL, TRI CARE WON'T APPROVE SURGERY BECAUSE YOUR PCM DIDN'T OK YOU TO HAVE THE TREATMENT, JUST THE EVALUATION. THE OTHER THING IS ... GET TRI CARE'S DENIAL IN WRITING MAILED/FAXED TO YOU ... THE BIGGEST PROBLEMS I'VE SEEN ARE THAT MEDICAL DATA IS MISSING OR, WAS SUBMITTED IN ERROR ... LIKE PUTTING YOUR BMI AT 35 INSTEAD OF 45. I'D ALSO GO ONLINE & COPY THE "CRITERIA" FOR BEING APPROVED FOR WLS. AFTER GETTING THE ACTUAL WRITTEN DENIAL & EXPLANATION ... & THE CRITERIA FOR APPROVAL ... I'D GO DOWN TO MY SURGEON'S OFFICE & DEMAND A COPY OF EVERYTHING THEY SENT TO TRI CARE. TAKE IT HOME & CHECK IT DOCUMENT BY DOCUMENT TO MAKE SURE EVERYTHING IS CORRECT ... & EVERYTHING TRI CARE REQUIRES IS PRESENT. IF YOU HAVEN'T GOTTEN A LETTER OF MEDICAL NECESSITY FROM YOUR PCM, DO IT. IF YOU HAVE OTHER DOCTORS WHO TREAT YOU FOR OBESITY-RELATED MEDICAL ISSUES, SUCH AS JOINT DETERIORATION OR SLEEP APNEA ... GET LETTERS OF MEDICAL NECESSITY FROM THEM AS WELL. IF YOU HAVEN'T PERSONALLY WRITTEN A DOCUMENT STATING & EXPLAINING ALL THE OBESITY-RELATED MEDICAL ISSUES YOU SUFFER FROM, DO IT. IF YOU HAVEN'T PERSONALLY WRITTEN A DOCUMENT STATING & EXPLAINING HOW OBESITY & THE RELATED CONDITIONS NEGATIVELY IMPACT YOUR LIFESTYLE, DO IT. I UNDERSTAND YOUR RAGE; WE ALL DO ... &, OF COURSE I DON'T KNOW HOW MUCH OF THIS YOU'VE ALREADY TRIED ... BUT, RAGE NEVER SOLVES ANY PROBLEM ... CHANNEL ALL THAT ENERGY INTO PROVING YOUR CASE ... THERE IS NO ONE BETTER WHO CAN DO THAT THAN YOU!! GOD BLESS YOU & SENDING PRAYERS DAWN & NICK

MAYBE THIS WILL HELP, MASTER WALTER ... HERE IS A LIST OF CO-MORBS I (WITH THE HELP OF OTHERS) PUT TOGETHER FOR SOME LIGHTWEIGHT WLS FRIENDS SO THEY COULD COME UP WITH CO-MORBS TO SUPPORT THEIR REQUEST FOR WLS. DO YOU HAVE ??? - DIEBETES - HIGH BLOOD PRESSURE - HIGH CHOLESTEROL - ACID REFLUX, HIATAL HERNIA, REGURD DISEASE, SEVERE HEARTBURN - FLUID RETENTION OR SWOLLEN JOINTS - ARTHRITIS, DEGENERAGIVE BONE DISEASE (ESPECIALLY IN THE LOWER BACK) - LARGE BREASTS = RUTS IN YOUR SHOULDERS (NERVE DAMAGE FROM THESE PRESSURE POINTS FROM THE BRA STRAPS) ... SHOULDER, NECK OR UPPER BACK PAIN ... HEADACHES OR SEVERE TENSION AT YOU NECK/SKULL - RASHES UNDER YOUR BREASTS OR STOMACH OR BETWEEN YOUR THIGHS, ETC. - CARPAL TUNNEL SYNDROME (SECONDARY CO-MORB) - HEAVY MENSTRUAL FLOW (SECONDARY CO-MORB) POOR BLADDER CONTROL ... DO YOU "SQUIRT" WHEN YOU LAUGH, COUGH, GET UP OUT OF A CHAIR, ETC - SLEEP APNEA ... SNORING, COUGHING, CHOKING, APNEA (STOPPING YOUR BREATHING) - SEVERE PAIN/DAMAGE IN ANKLES, KNEES & HIPS - EXHAUSTION ... TAKE NAPS DURING THE DAY OR NEED TO RECOUPERATE AFTER ANY PHYSICAL EFFORT ... NEED TO REST DURING LONG PERIODS WALKING LIKE WHEN SHOPPING LIFESTYLE LIMITATIONS ... - LITERAL HUFFING & PUFFING PERFORMING "NORMAL" DAILY ACTIVITIES - LIMITED OR UNABLE TO PERFORM NORMAL FAMILY ACTIVITIES - " " " " PERFORM SEXUALLY - " " " " PERFORM EMPLOYMENT DUTIES - NEEDING HELP BATHING, TYING YOUR SHOES, DRESSING, TAKING CARE OF YOURSELF ...... or CAN'T CARE FOR YOUR FEET, TOES & TOENAILS ... NOT BEING ABLE TO CLEANSE YOURSELF PROPERLY AFTER USING THE RESTROOM (MANY OBESE HAVE THIS PROBLEM) ... NOT BEING ABLE TO CARE FOR YOUR CHILDREN PROPERLY (CAN'T CARRY OR PICK UP A SMALL CHILD, FOR INSTANCE. RE: NOT ENOUGH CO-MORBs?????? Hi Dawn, That was a great list. The only other one I can think of is hyperlipidemia (I think that's it) high lipids. You always have great posts. Karen RE: NOT ENOUGH CO-MORBs?????? Here are a few more that I have thought of: Depression Pain in feet (Arthritis) gall bladder issues Asthma going 2 months or more between periods Fatty/Large/Diseased Liver & ... COPD & DEGENERATIVE BONE DISEASE, ESPECIALLY IN THE LOWER SPINE ARE ALSO CO-MORBs ... DON'T REMEMBER IF I PUT THIS ON THE LIST, BUT IF YOU HAVE A WEAK BLADDER IN WHICH YOU URINATE WHEN YOU LAUGH, SNEEZE OR STRAIN YOUR STOMACH MUSCLES ... THAT'S A CO-MORB. ~~~~~~~~~~~~

Actually they initially denied me for insufficient weight, I was 13 lbs under the 100lbs of the metro chart of 1983, but we got pass that with some chart from the VA clinic, they do not use bmi, the big problem that I am having is that my service connected co morbid condition of diabetes INSIPUDUS makes the rny incompatible to me, I can only have the ds, which they arbitrarily decide to stop /exclude covering 6 days after I applied for approval. another condition I have gerd, that required a fundus wrap, also precludes a rny, my diabetes 2, and severe apnea will be helped as well . I have been retired for 38 years and tricare has not spent a dime on me, and they are decline there first opportunity.