Thank You to everyone who said a lil' prayer for me! But,

I was denied for surgery!! Someone please help me, where do I go from here? I felt that if God wanted me to have it, he would approve it! Now I am full of anger, and wonder am I not worth it. I want this!! Where do I go from here, or just learn to accept that I am what I am.

Colleen, it all depends on what kind of insurance you have and if you have met the criteria that they set forth. Could you give us a little background on why you were denied? You should also have a written reason why from your insurance company and how to go about appealing the decision. Chris

Chris, Thank you for responding! My insurance is a local welfare fund, the union is self insured. In the letter they write I have no further rights to administative appeal, but I have a right to bring action under section 502a of the act. I sent in letters from 2 doctors, diabetic and neurosurgeon. Copies of going to w.w. for 9 months and pictures of myself thru different times. Also a letter of my life, what I have to go thru day to day, embarassing intimate things in my life. What more could I have done?

But, what I was asking was what did they say was the reason for not covering you for WLS? For example - too low of a BMI, no co-morbids, did not meet the preapproval of say for example a 6 months supervised diet. That is what I was referring to regarding a denial. They just cannot blanently deny on the person's whim that is doing the paperwork without giving a reason. I am with the other posters regarding getting professional help from an attorney. Chris

I am sorry Chris. The answer to your guestion is Gastric restrictive procedures are specifically excluded from coverage under the plan, so pretty much all the work I did is useless. I am going to get ahold of a lawyer tommorrow, but I kinda feel it will not be enough.Thanks for your replies.

Have you considered a lawyer to help with an appeal? Check out www.obesitylawyers.com Good luck

Dahlfan, Thank you very much! I will look into this. Has anyone ever won after the lawyer?

I am currently using Gary Viscio with Obesitylawyers.com. My insurance is currently reviewing my appeal sent by Gary. You should email him with your info. He has a high success rate at getting appeals turned over. Good luck Mike

Hi Colleen. I am sorry to hear that you were denied for WLS. I was denied as well, but decided to be a self-pay because I didn't want to wait any longer. I was in my early 50's without a lot of co-morbities except for hypertension and stress incontinence. I knew if I didn't do it then, I would start having problems. So I bit the bullet and paid for it myself. The insurance company did cover some of the testing and consults I had done though. If you can, I would go through the process of reconsideration as much as you legally can. It's terrible that the insurance company would rather pay out if you develop a co-morbidity and need $$$ hospitalization instead of preventative WLS. Good luck with your journey! I'll keep you in my thoughts and prayers. Hugs, Lucy

Do not give up, and if you have to file action under some statute, then do it. God works in funny ways, use every avenue you have, I see you had a letter from the diabetes Dr. There is a lot of research showing that diabetes is cured after WLS. Within one month, I was off all meds, and I was on 100 units of insulin twice daily as well as oral drugs, and my sugars were still over 200 (and sometimes 300). So don't give up, keep praying, and go through every door until you get this done, you will not regret it. I would have mortgaged my house for this, it would have been worth it! Sandy Faith is not believing that God can. It is knowing that God will.