Blue Cross Denies Back Surgery For RN

Main Category: Back Pain
Also Included In: Health Insurance / Medical Insurance
Article Date: 09 Sep 2008 - 4:00 PDT

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"I am faced with an insurance hell. Six days before a planned surgery, Blue Cross denied surgery for an artificial disc implantation or disc arthroplasty. This was on Wednesday, Jan. 23, 2008. The lumbar artificial disc by Synthes Spine called Prodisc was approved by the FDA in August 2006. It is one of two FDA-approved lumbar discs available," said Kim Kutcher of Dana Point, Calif.

"It is disconcerting enough to prepare for this kind of surgery without being told a few days before that it is cancelled because Blue Cross deems it 'investigational'. I had already gone through pre-op testing, donated a unit of autologous blood, had appointments with four physicians, and arranged my schedule prior to the expected operation date.

"It is difficult to comprehend back pain unless you have gone through it; even as a nurse, I didn't understand it fully. It is with you all the time and it doesn't come and go; it is a 24/7 thing. I originally injured myself at home, or I thought so, by lifting sheet rock. The pain and muscle spasms started two days later. As a critical care nurse, I typically lift heavy weights during a shift. So when I woke up with back pain on May 24, 2007, I thought it was sore muscles. I had no idea this was a start of a nightmare that would put me out of work for months," Kim added. And the insurance fights threaten to cripple her spirit as well.

Read stories like this every day through Election Day at: http://www.GuaranteedHealthcare.org

Eighty-two percent of Americans think the U.S. healthcare system should be fundamentally changed or completely rebuilt (Commonwealth Fund, Aug. 7, 2008). America's nurses know that only single-payer, improved and expanded Medicare for all will fix our broken system and the tragedy of our devastated families. HR 676, by U.S. Rep John Conyers, is the most comprehensive, cost effective way to achieve guaranteed healthcare for all. Read prior stories in this series at http://www.GuaranteedHealthcare.org.

California Nurses Association