[redsoxfan]

NYS-carrier approved SCS trial for lumbar pain last June and I had the trial in July. I got 60% relief so I decided to go with the permanent implant. The carrier approved surgery without prejudice and I had surgery in March. The carrier denied all the bills associated with the surgery because the leads were placed in the thoracic region which wasn’t an established body part. I went to court in May and the judge ruled in my favor that all bills were to be paid by the carrier. It’s getting close to the 30 days from that ruling and I have noticed on my ecase file they have not paid the bills and are disputing all of them again. Does anyone know what the next step would be for me? Will they ask for depositions from my doctors ? The last 2 IME’s I went to stated in their report that they agreed with my doctor in the placement of the SCS and the leads to be in the thoracic spine.

Thank you for any help

[1171]

It's really between the medical providers and the carrier; you shouldn't have to do anything until it directly affects you and your benefits.
The doctors and hospital have great access to their own lawyers and are pretty good at finding ways to get paid.

[tbear6410]

When I had my SCS, the battery pack was placed in my left rear area... and the leads and wires were put in just above my mid back with the wires pointing down... Was told this is the normal placement for the lower back pain..