Denied for Revision from Band to RNY

Hi,
I was notified by my doctor's office that my insurance (Federal BCBS) denied my request to revise from the lap band to a RNY. The denial is based on the fact that I have not been exercising and it hasn't been two years since my last WLS.  I do exercise however, its hard to work out 3 times a week when you weigh 286lbs and suffer from intense joint and hip pain.  The reason that I initally wanted WLS was to relieve my symptoms and improve my health  so that I could workout. I throw up every day because of the band and food constantly gets stuck.  Not sure if I should appeal because I'm not sure if it will make a difference.  I've spent most of the weekend in bed crying because I feel hopelessly stuck in lap band hell.  I would appreciate any appeal letters or other helpful advice.  Thanks

Might just be a blessing in disguse! Have you researched the DS?

Yes, but my insurance company does not cover the DS. 

research some of Diana Cox's posts, there is hope!

Before you do anything else get your band either totally or partially unfilled! If you are vomitting every day it's either too tight or you've set up a situation where it is continuing the irritation around the band. Then do liquids for a day or two, then mushies for a few days then try solids again but slowly, let your poor tummy rest and relax. It just makes things worse if it is constantly irritated. By the way around 2-3 years is when problems typically start cropping up. If you don't already frequent the band board, come on over and we'll be glad to try to help you.
As far as revision at least try to appeal once, sometimes they just deny the first one to see how serious you are about it. If you have joint and hip pain your doc should explain that as a reason you are unable to do alot of exercise. Never give up!!!

Thanks for the encouragement. I had the band emptiedon Wednesday and have no intentions of ever having it filled again.  I'm done with this worthless tool forever.  I'll contact the doctor's office on tomorrow and start the process.  Hopefully, it will work out. Thanks again.

I used the legal services of Walter and Kelly Lindstrom in 2001 to fight BC/BS National PPO when they denied my lapband surgery because it was deemed "experimental" and I didn't meat the BMI requirements.

I won!!!  And it was a pleasure working with this law firm.  Check out their website:

obesitylaw.com

I submitted a request to the law firm on Sunday but haven't gotten a response.  I wrote a letter of appeal to the insurance company for reconsideration.  I also found some research studies to support my request.  I just mailed the letter today but hopefully things will work out for me.  Thank you for your support

Appeal.  submit LOTS of documents, if you still have co morbidites, mention that, submit the ama low marks of band, explain about high rate of failure, tell them it will save them money when you don't have to keep going back to fix the issues with band, such as fills, unfills, etc.

I was denied too and i appealed and won.

Often than not, they think if they deny you, you will accept it and not try again, etc its a way of saving their money...

APPEAL APPEAL APPEAL!

Wow, that is very encouraging.  I hope that I'll have the same outcome.  The band is a completely wast of time and money.  Thanks for your support.