What more can I do to get my arms approved for reconstructive surgery?

My insurance has approved me for reconstructive surgery for my breasts, stomach and knees. They denied my arms saying the photos did not show evidence of functional impairment, clinically significant redundant tissue or secondary yeast infection. The plastic surgeon's office said they already said everything they could. I've asked my dematologist to submit a letter regarding the rash under my arms. I don't know if he will do it or when. I am faxing a letter to the insurance co. saying the photos did show the rash. I have the same problem under my arms that I have under my breasts, stomach and bends of my legs. Soap burns it (as does plain water), it stinks no matter how often I cleanse it, it hurts from the infection, is very diifcult to shave due to the rash and my arms ache from the hanging skin. I have been treated for sensitive skin for years and break out easily. The rubbing hanging skin exacerbates the situation. The dermatologist has me using 2 different creams. If they had to carry around the extra hanging skin, it would seem like a significant amount of redundant tissue to them. What else can I say or do to be approved?

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