NEED FEEDBACK PLEASE/FOUND OUT WHY DENIED

Hi Everyone, I got the letter from my insurance carrier and they say I don't meet the criteria because I have not had a BMI of over 40 for 5 years. I think I am 1 years short. What I want to know is this, please excuse my grafficness here: Besides this do they take into consideration that I am in horrific pain due to osteoarthritis in my back. I have a bi-lateral fusion in my back 5 years ago which restrains my mobility and I am to a point where I almost cannot clean myself after going to the bathroom. I was in the ER last night in horrible pain due to my back because my PCP is on vacation. I can only be on my feet literally for 20 min max and can only walk at a normal/slow pace for 10 min at a time w/o getting completely out of breathe. 1 flight of stairs does me in as well. The final thing I am not sure of is this, my blood pressure used to be 107/77 last night at the ER my blood pressure was 146/98. It has never been that high in my life EVER. It really scared me. So I need imput, anyone with experience in this any suggestions please. The one thing I do know is that I Serve a Might Big and Awesome God that can open any closed door no matter how tightly shut. I have to keep telling myself that because I am so scared. The only other option aside of them taking these things into consideration and the fact because of them I may lose my job, is gaining 30 more lbs so my BMI goes over 50 then I don't need the 5 years history. I love you all for the prayers and support thank you for being here. In His Grip Always, Trish

Hi Trish, Once again let me tell you that I also believe that God is in control of your life and he will be there for you always. Now lets disect your posting. Lets first start with the last statement. Gaining weight - to lose weight? I am sorry - this really sounds like foolishness. I know the cry is desparation, but please lets not go down another road that God really does not want you to travel. Deep breaths. Deep breaths. Now it sounds to me like an appeal process is in order. Your doctor and you must sit down and list all the health risks you will face by waiting another year. You must carefully and without emotion (remember - these insurance guys are run by stats and health issues - not emotions - no amount of guilt trips or crying will ever move an underwriter - I know - this is what I do for a living - I sell health insurance). Your docotro must list all your co-mobidity factors - high blood pressure, pre-diabetes or diabets - sleep apnea - cholesteral - back issue (although this is usually not considered a co-mobidity factor) the risk of damage to the work done 5 years ago might help. I would certainly have my back surgeon writing a letter regarding the weight issues and the need for additional surgery to repair that damage if the surgery is not done soon. Now - the surgery is a great tool, but you will need to be able to move somewhat after the surgery for it to be really effective. Have you looked at a water-arobics class? When I could barely walk due to my weight I found tha****er excersise was a life saver (true statement!). Find a pool and just move in the pool if nothing else. Praying for your success in your quest. Keep your chin up and your eyes on the prize. Love Sally

I can't add anything more to what Sally has said, she covered it all. Just know we are all praying for you! Glad to see you are "going after the ins. co." sometimes they just want to see how dedicated you are to having the surgery. Hang in there. Karen

"The one thing I do know is that I Serve a Might Big and Awesome God that can open any closed door no matter how tightly shut. I have to keep telling myself that because I am so scared.' I just read a great devotional by Dr. Stanley that discusses how our trials help us build endurance in the Christian faith. "June 9 & 10, 2007 - Running With Endurance - James 1:2-3 Nobody wakes up on the morning of the Boston Marathon and suddenly decides, Hey, I think I'll run the race today! Long-distance running requires training, a LOT of training. The typical marathon runner spends months preparing for a race. He pulls himself out of bed every day and hits the street. Focusing on his goal, he pushes through physical and mental exhaustion. He watches his diet, gets plenty of sleep, and runs???every single day. The goal of all this training is to build endurance. The discipline isn't easy, but it's essential to running a marathon. The Bible often depicts the Christian life as a race. If this is true, then we can be sure endurance is critical to our success. What builds endurance in our spiritual lives? James 1:2-3 say, "Consider it all joy, my brethren, when you encounter various trials, knowing that the testing of your faith produces endurance." Endurance is an inner strength that enables us to face any difficulty without quitting. The runner needs endurance to finish the race. So he conditions his body for success, even though it hurts. As believers, we're called to do the exact same thing. Our "training" comes through trials. As we face different challenges, the Holy Spirit builds us up more and more. This is God's "training camp." If you're facing a hardship today, ask yourself this question: Am I willing to go through this intense workout today in order to win the race tomorrow?" Keep your eyes on the prize. Not just the weight loss, but the prize of a crown in heaven for your faithful obedience to the Lord. He is in control, and He will see to your needs. When I was going through a very difficult time in my life, a friend gave me Jeremiah 29:11. "For I know the plans I have for you," says the Lord. "Plans to prosper you, not to harm you. Plans to give you hope and a future." Memorize that, and keep praying it. God's plans for you are for good. Let Him do His work in the insurance company. He parted the Red Sea, and brought down Jericho. He had Jesus and Peter walk on water, and rose Lazarus and Jesus from the dead. Surely an insurance company is a piece of cake to our God. Trust Him. Hugs, Trish

Hi Trish, I just want to say that I agree with everything that has been said so far. Don't lose heart, don't give up, God is in control of your life! As far as the insurance, I was told that the letter of necessity from the PCP was the most important in the insurance approval process, so you may want to make sure that your pcp included all of your medical conditions and how your weight has affected your overall health. Go ahead with your appeal and wait and see what happens after that. I read here on OH that some people had to appeal several times before they got their approval. So buckle up and go along for the ride, being strong and courageos in the Lord. Peace & Blessings

Don't give up Trish....God will allow doors to open and shut according to His plan for your life. You need to appeal by reiiterating your co-morbidities. Somewhere I read that government guideline of the 40 BMI was for obese men....in actuality, for a woman the BMI obesity statis is closer to 35. Do some research....develop your strategy and write your appeal. luvitsunnyv