I have to write a appeal letter for reconstructive surgery....

This will be my second appeal for a panni, thigh/breast lift and arm reduction. I have Ohio Med, Medical Mutual, and in the benefits section it says that they cover the above procedures if its medically necessary. My question is i've submitted pictures, office notes and a letter from my surgeon and primary doctor and im still being denied for the services because they are saying its cosmetic. I been experience back pain/neck and shoulder pain as well as rashes between the flaps of skin, thighs, and bra areas. I called my insurance company yesterday and now they are sayin that i need a letter from my doctors saying that if i dont have the skin removed the problems will keep occuring. Has anyone else ever had to do this to get approved? I mean, i thought thats what the office notes were for...any insight would be appreciated... Thank you, Nicky

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