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Replacing SCS
#31
Wife and I both had to see a psych before getting ours. They want to make sure your okay with it and will not have a problem with something inside your body like this. Could be a little to make sure there is nothing they can do to help with pain as well
 
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#32

It has become fairly common here in California that a psych eval is done before the spinal cord stimulator. A friend of mine who is a MD also had to have a psych eval before he had a spinal cord stimulator, and he is private insurance.

They also have psych evaluations for things like spinal fusions, but apparently not for everyone.

Dolphins, AME and QME's no longer have input with treatment requests or denials. It is all UR and IMR. Let me know if you get a UR denial, and need any assistance appealing it. It sounds like your requests are getting approved, which is a good thing that you have not had to deal with UR/IMR.

I am not an attorney.Anything I write should not be considered legal advice.I am writing from my own personal experiences,which is not from any sort of legal background. You should consult with an attorney over legal issues. In California, if you cannot get an attorney you can consult with an I&A officer.
 
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#33
NY here and it's required... no psych eval, no SCS.... My lawyer and my back surgeon both said it's required.
 
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#34
Things must have changed since I had mine installed back in 2006. My ptp asked for it, the ic denied, went to ame, he said yes, had it every since. No psych. I've only been seeing a psych for a couple years, and only for depression.

I have had numerous revisions, am getting ready to have wires moved up in 2 weeks to control spread. still don't have to see my psych.

Yes, I do get everything approved, the reason why, I refuse to take no as an answer. I have been told may, many times, no you can't have that, you can't get that, yet I always prevail. I'm the one with rsd, so I should decide what I need, and what I don't, and if they want a fight, they always get one.

I've been told at least 3 times, no you can't get ANOTHER PQME, yet I have had numerous pqme's. If I don't like what they say, I go to court, and ask the judge to make them prove what he is saying is true. I haven't lost once.

I have had numerous attorney's who acted like they didn't care, and I would get noyhing. now that I rep myself, I get everything I want, and fast.

Lust recently, they said I had to return to their ame, i said no, I want another panel. We went to court, and the judge agreed with me. They then said my upper extremities are not covered, I then used their ame report to prove the upper extremities are covered. And 2 weeks ago, I asked for a new scooter, they said I can't get the same one, it cost too much, and they wanted their vendor to come out for an eval. They came last week, and said I do need the scooter I am asking for. Had they said no, I would have argued that they do not spend their life in a wheelchair/scooter and who are they to decide what I should have or not. I would have taken them to court and argued, If you go buy a new car, you don't want the car dealer telling you what you should buy, and what you shouldn't. That's B.S. How can an able body person have any knowledge of what it's like having to spend my life in these things. That is how I always get what I want.
 
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#35
Whatever you are doing I am glad to read you are receiving the treatment you need.

This song is for you, Dolphins. I send it to those who "won't back down" to IC BS.

https://www.youtube.com/watch?v=k2h9HPZhqHE
I am not an attorney.Anything I write should not be considered legal advice.I am writing from my own personal experiences,which is not from any sort of legal background. You should consult with an attorney over legal issues. In California, if you cannot get an attorney you can consult with an I&A officer.
 
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#36
Thank you my friend. That's exactly how I feel.
 
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#37
Have a question that I can't find on the web... When I go in for the trial, my PM doctor told me that if it works, they will just cut the wires off and leave the leads in place in the canal.. then when I go for the permanent one, they will remove the old wires and put in the new ones... Couldn't I just request to have the wires removed altogether?? I was told it could take up to a month or more to be scheduled for the second... all depends on my back surgeon's case load... And since my husband and I are planning a well needed vacation in May, I don't want to have wires just in my spine doing nothing or having them get fused in before I can have the perm. one put in....

And the count down is going.... Ins. Carrier has until March 23rd to approve or not....
 
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#38
you can request it but worker's comp doesn't have to approve it especially since your doctor is not recommending it.
Reminder :
........Each state has their own comp system; POST YOUR STATE to get accurate information. Use the search feature to find information from similar questions.
THANKS FOR POSTING.
 
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#39
No.. approval is for the trial one... not for removing the wires/leads... I just don't want them fusing in place before they can put the permanent one in.

My lawyer has already checked and no one has heard a peep from the Carrier YET....
 
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#40
The wife and myself both have SCS. They didn't leave the leads in when we had the trials and I'm not sure why they would want to. I don't think it would be for placement because they would never get them back in the exact same spot. Now maybe they would so I'd hate to say they never would leave them in. Same doc that did my trial did the implant so I don't know if that has anything to do with it. When he removed my trial I asked and they gave me the lead to keep. Still have it out up
 
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