Re: My appeal is ready!

[Guest guest]

,

Sounds like you have put a lot of time and effort into your appeal. I think

you have covered all your bases and should have a real good chance at getting

the denial overturned. Good luck and keep us posted.

Marci (Mom to )

Oklahoma

[Guest guest]

,

Good luck on your appeal- keeping my fingers crossed!! How is la

doing with the tort?

' Mom

[Guest guest]

-...thanks. la still has tort. as far as I am concerned.

When we took her to the PT,she told us she felt Gabby's problem was

more underdeveloped neck muscles and that bring her in for regular

therapy would just make her mad because she is too young to

understand,Hold your head up straight! It made no sense to me and the

OT we took her to said she needed therapy 2 to 3 times a week. When

we took her to the craniofacial surgeon, he said to ask them at

Cranial tech what they thought about her tort. She has pretty good

range of turning but still tilts. I swear every step of her treatment

has been a fight. I still can't get over having to help the

pediatrician diagnosis the tort and plagio in the first place!!! well

this was probably more then you wanted to hear LOL thanks for

asking :-)

-- In Plagiocephaly@y..., rella1234@a... wrote:

> ,

> Good luck on your appeal- keeping my fingers crossed!! How is

la

> doing with the tort?

>

> ' Mom

[Guest guest]

-- I replied before this but I don't see it on the board..sorry

if you get two replies. gabriella still has the tilt but when we took

her to PT, they said there was no need to bring her in because

stretching her would just make her mad and she is too young to learn

to hole her head up straight. The PT said she feels Gabby just has

underdeveloped neck muscles. The OT we took her to said la

would need PT 2 to 3 times a week.*sigh* The craniofacial surgeon

said to ask cranial tech. their opinion on the tort when we take

Gabby to be casted. This whole ordeal has been a fight.starting from

helping pediatrician to FINALLY diagnos her with tort. and plagio.

Thanks for asking!!! I hope hope hope my appeal works!!!~

- In Plagiocephaly@y..., rella1234@a... wrote:

> ,

> Good luck on your appeal- keeping my fingers crossed!! How is

la

> doing with the tort?

>

> ' Mom

[Guest guest]

-

I hope you all can see my replies! I am not seeing them after i post

them. Thank You Marci for your support and I will keep updating when

I hear anything!~-- In Plagiocephaly@y..., marcisch@a... wrote:

> ,

>

> Sounds like you have put a lot of time and effort into your appeal.

I think

> you have covered all your bases and should have a real good chance

at getting

> the denial overturned. Good luck and keep us posted.

>

> Marci (Mom to )

> Oklahoma

[Guest guest]

,

I got your post and I wanted to send you good luck vibes on your appeal!!

Marci

[Guest guest]

,

Unfortunately it is all too common on this board that the parents are having

to get a quick education on tort and plagio because Docs are failing to dx or

direct the parents on what to do. Although my doc spotted ' tort at

2 months- she never thought he needed a DOC band and felt his misaligned ears

were an optical illusion due to the head tilt. We decided to do it and now

she is always saying it was the best decision and his head looks great!!

Well, thanks but no thanks to you I always want to say- but try to remain

civil as I am grateful for the tort dx at 2 months.

I would highly recommend doing as much research as you can on torticollis-

the fact that the pt told you she was too young and it would make her mad is

a huge red flag to me. We started at 3 months with therapy- and would have

started sooner with stretches had we known. Tort is very much like plagio,

the quicker you start working on it, the faster and better the outcome. The

body at this young age is developing quickly, and the wrong posture can

create upper scoliosis with tort as the spine will shift to accomodate the

posture of the brain stem (tilted). Also, the muscle if left unstretched or

unworked, will only get tighter and stiffer through time, so it is very

important to work on this asap. We had days of therapy where I would blow

bubbles to distract him (or dance like a clown, or play with toys!) and we

would turn his head to the left and he would cry and cry. Other days he

could turn and do great. If we had given up because he didn't like it, he

probably would be unable to turn his head to the left today (or go midline as

this is all related, the muscle is tight so it is pulling that head down

towards the shoulder creating the tilt, once you have stretched it out, they

will be able to go midline normally and only revert back for comfort zone

when hitting milestones, etc). Having the pt say it makes her mad so lets

not do it, is not doing your child any favors. There is controversy over

whether to stretch while the child is crying or not- I feel that sometimes he

would cry because he didn't want us to mess with him and other times probably

because it was painful- but therapy is never easy and I knew it had to be

done to be where we are today (plenty of adults in pt will tell you its no

fun either- but know the importance of it). We went 2x per week and I would

stretch and massage every night without fail (with the help of my husband,

boy was that tough! We had great success with doing his stretches while he

was sleeping). Through time, it got easier, and he was able to turn his

head. The tilt is always the very last to go. We really didn't see it leave

" for good " ( I say that in quotes because it does come back with milestones,

teeting, etc.) until about 9 months old (that was 6 months of therapy, 2x per

week, everyday at night). Although it may take you less time to see resolve,

be prepared for the long haul as tort is not fixed overnight. You also need

to work on that non-tort muscle, and strenghten that side. Have your

daughter reach for things with both hands alternately. Make sure she is

using both sides of her body equally and don't let her pull her shoulder or

hip up on the tort side. I found massage very helpful. Well, good luck on

your appeal. Keep the faith. Through hard work you will find results, it

will just take time and dedication- something that I know you have because

your looking out for the well-being of your child like a great mom does.

Please keep me posted and if I can help you in anyway, please feel free to

email me! Hugs to la! Hoping your appeal turns a victory in your

favor!!!!

' Mom

[Guest guest]

---

thank you so much for taking the time to respond with so much

information Let me tell you what I was told by the PT. She said she

felt gabriella didn't really have tort but more just underdeveloped

neck muscles. She did list a few excersises to do with her to help.

Now the OT who said we needed PT said la had slight tort. She

does turn head pretty good both ways. You can tell it is more

difficult to turn to the left. I guess since she does have a pretty

good range the PT doesn't feel it is tort. When you look at Gabby

from the back you can tell something is not right. One side of her

neck literally looks shorter. Her tilt has improved since we started

excersises and in fact had improved somewhat since her birth on it's

own. of course we went against the pediatrician saying it was ok for

her head to flop onto and stay flat on her shoulder when she fell

asleep in the swing,,and we propped her head up straight always!!!!!

I am now supposed to ask cranial tech when we finally do get casted

what they think about her tilt. The PT did say she was concerned if

la did have to wear a helmet or band because she said it would

add more strain to her neck. I honestly felt she did not know much

about tort. She actually told me to limit tummy time??????? Hello I

thought tummy time was important to help tort!!!!I tell you this

whole process has given me a different view of doctors. I always have

listened to what a doctor said thinking they went to medical school

so who am I to question them. Not anymore!! This site is so wonderful

for new parents trying to fight insurance or find out what to expect.

I hope we do win the appeal so I can help someone else fight their

insurance company!!!Thanks again!!!

In Plagiocephaly@y..., rella1234@a... wrote:

> ,

> Unfortunately it is all too common on this board that the parents

are having

> to get a quick education on tort and plagio because Docs are

failing to dx or

> direct the parents on what to do. Although my doc spotted

' tort at

> 2 months- she never thought he needed a DOC band and felt his

misaligned ears

> were an optical illusion due to the head tilt. We decided to do it

and now

> she is always saying it was the best decision and his head looks

great!!

> Well, thanks but no thanks to you I always want to say- but try to

remain

> civil as I am grateful for the tort dx at 2 months.

>

> I would highly recommend doing as much research as you can on

torticollis-

> the fact that the pt told you she was too young and it would make

her mad is

> a huge red flag to me. We started at 3 months with therapy- and

would have

> started sooner with stretches had we known. Tort is very much like

plagio,

> the quicker you start working on it, the faster and better the

outcome. The

> body at this young age is developing quickly, and the wrong posture

can

> create upper scoliosis with tort as the spine will shift to

accomodate the

> posture of the brain stem (tilted). Also, the muscle if left

unstretched or

> unworked, will only get tighter and stiffer through time, so it is

very

> important to work on this asap. We had days of therapy where I

would blow

> bubbles to distract him (or dance like a clown, or play with toys!)

and we

> would turn his head to the left and he would cry and cry. Other

days he

> could turn and do great. If we had given up because he didn't like

it, he

> probably would be unable to turn his head to the left today (or go

midline as

> this is all related, the muscle is tight so it is pulling that head

down

> towards the shoulder creating the tilt, once you have stretched it

out, they

> will be able to go midline normally and only revert back for

comfort zone

> when hitting milestones, etc). Having the pt say it makes her mad

so lets

> not do it, is not doing your child any favors. There is

controversy over

> whether to stretch while the child is crying or not- I feel that

sometimes he

> would cry because he didn't want us to mess with him and other

times probably

> because it was painful- but therapy is never easy and I knew it had

to be

> done to be where we are today (plenty of adults in pt will tell you

its no

> fun either- but know the importance of it). We went 2x per week

and I would

> stretch and massage every night without fail (with the help of my

husband,

> boy was that tough! We had great success with doing his stretches

while he

> was sleeping). Through time, it got easier, and he was able to

turn his

> head. The tilt is always the very last to go. We really didn't

see it leave

> " for good " ( I say that in quotes because it does come back with

milestones,

> teeting, etc.) until about 9 months old (that was 6 months of

therapy, 2x per

> week, everyday at night). Although it may take you less time to

see resolve,

> be prepared for the long haul as tort is not fixed overnight. You

also need

> to work on that non-tort muscle, and strenghten that side. Have

your

> daughter reach for things with both hands alternately. Make sure

she is

> using both sides of her body equally and don't let her pull her

shoulder or

> hip up on the tort side. I found massage very helpful. Well, good

luck on

> your appeal. Keep the faith. Through hard work you will find

results, it

> will just take time and dedication- something that I know you have

because

> your looking out for the well-being of your child like a great mom

does.

> Please keep me posted and if I can help you in anyway, please feel

free to

> email me! Hugs to la! Hoping your appeal turns a victory

in your

> favor!!!!

>

> ' Mom

[Guest guest]

I felt the need to chime in here. From what I read in your post, it

appears to me that your PT isn't too experienced with tort. You can

have ROM and still have tort. Tummy time is a necessity and a band

doesn't interfere with it at all. How many children has she treated

and were they ever resolved? You might want to ask her for

references. Our first PT just told us to move his chin to his

shoulder 3 times a day. We wasted 2 months with this PT and saw

very limited improvement. I was appalled when we got a new PT and I

got so much more info. I never thought of asking a PT for

references or what her experience level is. I learned my lesson!

Dane's mom (DOC Band 2/14)

> > ,

> > Unfortunately it is all too common on this board that the

parents

> are having

> > to get a quick education on tort and plagio because Docs are

> failing to dx or

> > direct the parents on what to do. Although my doc spotted

> ' tort at

> > 2 months- she never thought he needed a DOC band and felt his

> misaligned ears

> > were an optical illusion due to the head tilt. We decided to do

it

> and now

> > she is always saying it was the best decision and his head looks

> great!!

> > Well, thanks but no thanks to you I always want to say- but try

to

> remain

> > civil as I am grateful for the tort dx at 2 months.

> >

> > I would highly recommend doing as much research as you can on

> torticollis-

> > the fact that the pt told you she was too young and it would

make

> her mad is

> > a huge red flag to me. We started at 3 months with therapy- and

> would have

> > started sooner with stretches had we known. Tort is very much

like

> plagio,

> > the quicker you start working on it, the faster and better the

> outcome. The

> > body at this young age is developing quickly, and the wrong

posture

> can

> > create upper scoliosis with tort as the spine will shift to

> accomodate the

> > posture of the brain stem (tilted). Also, the muscle if left

> unstretched or

> > unworked, will only get tighter and stiffer through time, so it

is

> very

> > important to work on this asap. We had days of therapy where I

> would blow

> > bubbles to distract him (or dance like a clown, or play with

toys!)

> and we

> > would turn his head to the left and he would cry and cry. Other

> days he

> > could turn and do great. If we had given up because he didn't

like

> it, he

> > probably would be unable to turn his head to the left today (or

go

> midline as

> > this is all related, the muscle is tight so it is pulling that

head

> down

> > towards the shoulder creating the tilt, once you have stretched

it

> out, they

> > will be able to go midline normally and only revert back for

> comfort zone

> > when hitting milestones, etc). Having the pt say it makes her

mad

> so lets

> > not do it, is not doing your child any favors. There is

> controversy over

> > whether to stretch while the child is crying or not- I feel that

> sometimes he

> > would cry because he didn't want us to mess with him and other

> times probably

> > because it was painful- but therapy is never easy and I knew it

had

> to be

> > done to be where we are today (plenty of adults in pt will tell

you

> its no

> > fun either- but know the importance of it). We went 2x per week

> and I would

> > stretch and massage every night without fail (with the help of

my

> husband,

> > boy was that tough! We had great success with doing his

stretches

> while he

> > was sleeping). Through time, it got easier, and he was able to

> turn his

> > head. The tilt is always the very last to go. We really didn't

> see it leave

> > " for good " ( I say that in quotes because it does come back with

> milestones,

> > teeting, etc.) until about 9 months old (that was 6 months of

> therapy, 2x per

> > week, everyday at night). Although it may take you less time to

> see resolve,

> > be prepared for the long haul as tort is not fixed overnight.

You

> also need

> > to work on that non-tort muscle, and strenghten that side. Have

> your

> > daughter reach for things with both hands alternately. Make

sure

> she is

> > using both sides of her body equally and don't let her pull her

> shoulder or

> > hip up on the tort side. I found massage very helpful. Well,

good

> luck on

> > your appeal. Keep the faith. Through hard work you will find

> results, it

> > will just take time and dedication- something that I know you

have

> because

> > your looking out for the well-being of your child like a great

mom

> does.

> > Please keep me posted and if I can help you in anyway, please

feel

> free to

> > email me! Hugs to la! Hoping your appeal turns a

victory

> in your

> > favor!!!!

> >

> > ' Mom

[Guest guest]

--

, Thank you for your input. I thought it sounded really strange

about limiting the tummy time. I am going to ask when I take her to

Cranial Tech to look at her and recommend a PT if they think she

still needs it. I notice her tilt still sometimes but what I notice

the most is when I look at the back of her neck and it looks uneven.

I don't know if that can be a sign without a major tilt or not. I am

glad you told me your experience with the PT. If I do need to take

her to another one,I will be sure to find out if they have treated

many for tort. and the success rate!!!

& la

- In Plagiocephaly@y..., " rmanias " <rmanias@a...> wrote:

>

> I felt the need to chime in here. From what I read in your post,

it

> appears to me that your PT isn't too experienced with tort. You

can

> have ROM and still have tort. Tummy time is a necessity and a band

> doesn't interfere with it at all. How many children has she

treated

> and were they ever resolved? You might want to ask her for

> references. Our first PT just told us to move his chin to his

> shoulder 3 times a day. We wasted 2 months with this PT and saw

> very limited improvement. I was appalled when we got a new PT and

I

> got so much more info. I never thought of asking a PT for

> references or what her experience level is. I learned my lesson!

>

> Dane's mom (DOC Band 2/14)

>

>

> > > ,

> > > Unfortunately it is all too common on this board that the

> parents

> > are having

> > > to get a quick education on tort and plagio because Docs are

> > failing to dx or

> > > direct the parents on what to do. Although my doc spotted

> > ' tort at

> > > 2 months- she never thought he needed a DOC band and felt his

> > misaligned ears

> > > were an optical illusion due to the head tilt. We decided to

do

> it

> > and now

> > > she is always saying it was the best decision and his head

looks

> > great!!

> > > Well, thanks but no thanks to you I always want to say- but try

> to

> > remain

> > > civil as I am grateful for the tort dx at 2 months.

> > >

> > > I would highly recommend doing as much research as you can on

> > torticollis-

> > > the fact that the pt told you she was too young and it would

> make

> > her mad is

> > > a huge red flag to me. We started at 3 months with therapy-

and

> > would have

> > > started sooner with stretches had we known. Tort is very much

> like

> > plagio,

> > > the quicker you start working on it, the faster and better the

> > outcome. The

> > > body at this young age is developing quickly, and the wrong

> posture

> > can

> > > create upper scoliosis with tort as the spine will shift to

> > accomodate the

> > > posture of the brain stem (tilted). Also, the muscle if left

> > unstretched or

> > > unworked, will only get tighter and stiffer through time, so it

> is

> > very

> > > important to work on this asap. We had days of therapy where I

> > would blow

> > > bubbles to distract him (or dance like a clown, or play with

> toys!)

> > and we

> > > would turn his head to the left and he would cry and cry.

Other

> > days he

> > > could turn and do great. If we had given up because he didn't

> like

> > it, he

> > > probably would be unable to turn his head to the left today (or

> go

> > midline as

> > > this is all related, the muscle is tight so it is pulling that

> head

> > down

> > > towards the shoulder creating the tilt, once you have stretched

> it

> > out, they

> > > will be able to go midline normally and only revert back for

> > comfort zone

> > > when hitting milestones, etc). Having the pt say it makes her

> mad

> > so lets

> > > not do it, is not doing your child any favors. There is

> > controversy over

> > > whether to stretch while the child is crying or not- I feel

that

> > sometimes he

> > > would cry because he didn't want us to mess with him and other

> > times probably

> > > because it was painful- but therapy is never easy and I knew it

> had

> > to be

> > > done to be where we are today (plenty of adults in pt will tell

> you

> > its no

> > > fun either- but know the importance of it). We went 2x per

week

> > and I would

> > > stretch and massage every night without fail (with the help of

> my

> > husband,

> > > boy was that tough! We had great success with doing his

> stretches

> > while he

> > > was sleeping). Through time, it got easier, and he was able to

> > turn his

> > > head. The tilt is always the very last to go. We really

didn't

> > see it leave

> > > " for good " ( I say that in quotes because it does come back

with

> > milestones,

> > > teeting, etc.) until about 9 months old (that was 6 months of

> > therapy, 2x per

> > > week, everyday at night). Although it may take you less time

to

> > see resolve,

> > > be prepared for the long haul as tort is not fixed overnight.

> You

> > also need

> > > to work on that non-tort muscle, and strenghten that side.

Have

> > your

> > > daughter reach for things with both hands alternately. Make

> sure

> > she is

> > > using both sides of her body equally and don't let her pull her

> > shoulder or

> > > hip up on the tort side. I found massage very helpful. Well,

> good

> > luck on

> > > your appeal. Keep the faith. Through hard work you will find

> > results, it

> > > will just take time and dedication- something that I know you

> have

> > because

> > > your looking out for the well-being of your child like a great

> mom

> > does.

> > > Please keep me posted and if I can help you in anyway, please

> feel

> > free to

> > > email me! Hugs to la! Hoping your appeal turns a

> victory

> > in your

> > > favor!!!!

> > >

> > > ' Mom

[Guest guest]

,

I agree with here that your pt does not sound too experienced with

treating tort!!! Tummy time is absolutely important to strengthen those neck

muscles. Also, there are children that have great range of motion, but still

tilt. And there are tort children with no tilt that have no range of motion.

Torticollis can have different causes, as well as different symptoms- so its

confusing to say the least. Your pt is 100% wrong in saying that the helmet

will cause more strain on the neck. The DOC band in particular, is only 5

grams, very lightweight. I can't comment on other types of helmets, but I

have never heard of this causing a problem. I would start seaching for a new

pt- this one sounds like you could give her an education, not vice versa. I

know exactly what your saying when you look from behind and the neck muscles

look " missing " or you can see that one is not as prominent as the other.

had this and with hard work, they look to be the same now. I would

continue to do rotation exercises as well, the fact that she cannot turn as

good as the other indicates that some improvement could still be made there.

Use toys, bubbles, Elmo, whatever it takes and make her really work towards

looking the unfavored way. Also, work on that tilt by stretching the

opposite way of the tilt. Do as much stretching and massaging on your own at

home- you are ultimately your child's biggest pt- you should take advantage

of this time as often as possible. Tort is not a quick fix, but with

continued work, you will see great results. It sounds as if you are well

aware there may be a problem continuing with this pt- do your best to find

someone that can actually teach you a few tricks. Good luck to you and

please feel free to email me anytime!

' Mom

[Guest guest]

,

Did you finally send in your appeal? Have you heard anything yet? We sent ours to CIGNA today and I'm a bit nervous. We took a very conservative approach and kept our letter very simple. We only addressed the 3 reasons for denial and nothing more. We are saving a lot of documentation and references for if they deny us again. When we really scrutinized the 3 reasons we found that they had nothing specific to do with our twins. It was just a canned denial letter from CIGNA. Jerks! What are you expecting to happen next? Now we are in that 30 day waiting period, but at least now it is on their desk and not mine.

On a lighter side, we found out yesterday that Sara may have only 3 weeks left in her band, 4 max. That would make only 6-7 weeks total. I'm totally amazed. She almost looks like a normal kid. I think we banded her at a perfect time to get the quickest correction. Sam has a longer way to go, but he is also doing great. His forehead is nearly normal now, and his flat spot on the side is starting to round out. The clinician is totally convinced that he was born with a flat spot, but no one really notices anything like that at birth, and since it was the fall, he wore hats all day, every day just to stay warm. Anywayk, that's why his correction is a bit slower.

Please keep me posted on your appeal.

Gail, Sara and Sam's mom

My appeal is ready!

Please keep your fingers crossed for my daughter gabriella and me that cigna will reverse their decision! Her craniofacial surgeon,Dr. Beals, did send me a letter of medical necessity and also a letter to get an expedited review!!He is such a great doctor!! I wasn't aware when we first went to see him but he is one of the founders of the DOC band.In my appeal I included both letters and a list of excersises we were given by the PT for la's Tort. that I consider to be conservative medical treatment.(cigna denied this visit because they said someone did not ok it first!)Also I included the AMA statement about plagiocephaly not being cosmetic,an article about this happening often with twins,an article about the couple winning the lawsuit against doctors for plagio.,then of course my letter disputing the non functional and no documentation of conservative medical therapy. Can anyone think of something I have missed? I plan to send on Monday..thanks in advance~

[Guest guest]

---

Gail, Yes we faxed ours on April 17. They refused to do an expedited

review because they don't feel it is life threatning and I guess it

has to be to do expedited review We are supposed to hear something

by May 17. Gabby will be 1 day shy of 11 months. I am so mad!!!! I

have called and tried to get a quicker response and also my doctor is

supposed to fill out some form to again request a quick review. I am

calling tomorrow to check on that. Cigna gives me the run around and

last call I was on hold after asking to talk to someone higher up,for

20 minutes and mysteriously I was disconnected from their side

Hmmmmm. I am getting very frustrated!!! I have my fingers crossed for

you!!!!!!! Let me know if you hear anything!!!!!

& Gabby

In Plagiocephaly@y..., " Gail " <momofivftwins@a...> wrote:

> ,

> Did you finally send in your appeal? Have you heard anything

yet? We sent ours to CIGNA today and I'm a bit nervous. We took a

very conservative approach and kept our letter very simple. We only

addressed the 3 reasons for denial and nothing more. We are saving a

lot of documentation and references for if they deny us again. When

we really scrutinized the 3 reasons we found that they had nothing

specific to do with our twins. It was just a canned denial letter

from CIGNA. Jerks! What are you expecting to happen next? Now we

are in that 30 day waiting period, but at least now it is on their

desk and not mine.

> On a lighter side, we found out yesterday that Sara may have

only 3 weeks left in her band, 4 max. That would make only 6-7 weeks

total. I'm totally amazed. She almost looks like a normal kid. I

think we banded her at a perfect time to get the quickest

correction. Sam has a longer way to go, but he is also doing great.

His forehead is nearly normal now, and his flat spot on the side is

starting to round out. The clinician is totally convinced that he

was born with a flat spot, but no one really notices anything like

that at birth, and since it was the fall, he wore hats all day, every

day just to stay warm. Anywayk, that's why his correction is a bit

slower.

> Please keep me posted on your appeal.

>

> Gail, Sara and Sam's mom

> My appeal is ready!

>

>

> Please keep your fingers crossed for my daughter gabriella and me

> that cigna will reverse their decision! Her craniofacial

surgeon,Dr.

> Beals, did send me a letter of medical necessity and also a

letter to

> get an expedited review!!He is such a great doctor!! I wasn't

aware

> when we first went to see him but he is one of the founders of

the

> DOC band.

> In my appeal I included both letters and a list of excersises we

were

> given by the PT for la's Tort. that I consider to be

> conservative medical treatment.(cigna denied this visit because

they

> said someone did not ok it first!)Also I included the AMA

statement

> about plagiocephaly not being cosmetic,an article about this

> happening often with twins,an article about the couple winning

the

> lawsuit against doctors for plagio.,then of course my letter

> disputing the non functional and no documentation of conservative

> medical therapy. Can anyone think of something I have missed? I

plan

> to send on Monday..thanks in advance~