Question:
I was denied, and got several ideas, but should I use a lawyer first??

I have an appeal letter, just about ready, but I am afraid I am going to screw this up, has someone else gone through this?? I have an HMO, should I try myself first, or work with Obesitylaw.com before I mail my appeal??? Please help... thank you    — Leah G. (posted on May 13, 2002)

May 13, 2002
Before you send off an appeal letter, make sure you have every comorbid condition identified and how it is affecting you life. Request any additional testing from you PCP and get scheduled appointments for testing. Review your state's law regarding healthcare regulation and contact any state agency directed to assist "consumers" for any information availible. A detailed appeal letter outlining your health and your knowledge of your rights is the only way to go. Also you might also consider paying out of pocket for consultations from non-plan doctors supporting your WLS to include with you appeal letter. email me and I will go into specifics of what I did to force my HMO to provide WLS. Remember also to tell them you are not going to take "NO" for an answer. Good luck. Erick
   — ERICK B.

May 14, 2002
Your best chance of getting approved on your own is going to be focusing on your co-morbidities. Do you have: Sleep apnea? diabetes? High cholesterol, triglycerides or blood pressure? Joint problems related to weight? Etc. but even on my own, my insurance denied my own level 1 appeal even though I documented that I had 6 of the 7 comorbidities that the NIH says qualifies you for surgery. I then hired Walter Lindstrom and got approved within 3 days of him sending in his 28 page appeal letter on the Level 2 appeal. If you don't want the run around, it may be worth just going with Walter from the outset, I wish I had. Good luck.
   — Dell H.