Help with appeal letter

Jann S.
on 2/18/05 2:41 pm - Toledo, OH
I have MedMutual of Ohio & I have been denied my request for Lap Band surgery stating that I did not have a high enough BMI for the last 5 years, and evidently my documented weight loss attempts didn't meet their criteria. Just for the record, I have been overweight since 4 or 5 years old!! I did lose a little over 100 lbs about 8 yrs ago (with the help of Redux and a lot of work) and managed to keep the weight off entirely for about 2 yrs before it started creeping back on. So during that brief time I didn't meet the BMI criteria for WLS (according to MMofOH), but definitely do now, and have for the last atleast 4 years, as, sadly, I have regained all but about 20 lbs of my weight loss. During the past 5-6 yrs, I was so embarassed about my weight gain, I avoided my doctor like the plague (she had been so proud of my success, I didn't want her to see how I had ended up re-gaining the weight). I didn't bother with any of my regular exams, including pap/pelvic, physical exams, etc, and only went to the doctors office when I was just too sick to ignore my illnesses. I wish "normal weight" people could realize how devestating it is for overweight people, who through some miracle, are able to lose weight, and pray they keep it off, only to regain it time & time again. How much it makes us feel like failures. Anyway....I had read an appeal letter on this MB a little while ago that listed all of the diets and weight loss attempts of the person and it sounded a lot like my life long struggle with obesity. If anyone has a sample of an appeal letter listing weight loss attempts and any other info that helped them gain approval for WLS, especially if it was thru Medical Mutual of Ohio, I would appreciate a copy of it so I can use it as an example for my own appeal letter. Thanks...and sorry for being soooo windy! Jann
Tabitha H.
on 2/20/05 11:26 am - Reno, OH
Hi Jann, I posted a sample letter right before you posted yours......its titled "Sample Appeal Letter" It under the OHio forum and about 3-5 posts under yours.......if you didn't see it. I found this letter when I typed "bariatric appeal letter" at Yahoo search........I got a bunch of hits when I typed it in, so you could always try it too Good Luck Tabitha
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