Guest guest Posted June 6, 2002 Report Share Posted June 6, 2002 Hi Gale! My son was a whooping 9 lbs and I know he must have gotton torticollis from being in my womb funny. His head was 16 inches around at birth and I was 30 minutes away from a c section. All they had to do was threaten me once and I got him out in three pushes. Afterwards I noticed he wouldnt turn his head in one direction and if I tried to help him turn it he would scream in pain. I cant see how a flattened head as a result of in inutero torticollis would be considered "cosmetic" Even if it wasnt from torticollis and resulted from him lying on his back they still shouldnt let babies or parents suffer. How could it be cosmetic. Its not like your asking for a nose job. Good Luck. Hopefully more Drs. will realize that this should be covered at least 1/2 by all insurance companies Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 6, 2002 Report Share Posted June 6, 2002 Wow Gail: Way to research! I would definitely give it a try! It sounds like you may have found a loop hole. It sounds like a great idea to me. I bet you found some interesting info in all those medical files. I'd love to search thru mine sometime (or maybe not!) Debbie Abby's mom DOCgrad MI > Hi All, > I lost my spark for a while, but I'm back at it and working on my Level 2 appeal to Cigna. I think I'm on to something and want to get your opinions and advice. > > I spent the morning at the hospital where Sam and Sara were born going over all of our medical records. I think that if I can prove intrauterine constraint I will have a good argument that banding is reconstructive and not cosmetic. Has anyone pursued that route before? In Sam's file I found several places where they said he was " large for gestational age " . He weighed nearly 8 pounds at birth (37.5 weeks). In Sara's file I found where the nurses in the nursery made notes about the bruising on her back where she was stuck against my pelvic bones. There is notations in both their charts that they were breech. Does that matter? Then I got copies of all my sonograms (done at least every 4 weeks throughout the pregnancy) and the last few reports had a hand-drawn scketch of their position in the womb, and it never changed. I think that all this combined is enough to prove that my big, fat babies were pretty cramped inside me. > > Also, I think I have found the article that CIGNA alluded to but didn't reference in our most recent denial, and there is a huge section in there about tort, plagio and constraint. I think this would counter the part they used that said plagio is " simply a cosmetic problem " . > > What's your take on this? Do you think it will work? Any suggestions? > > Thanks, > Gail, official Cigna crusader, Sam and Sara's mom, DOC grads Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 7, 2002 Report Share Posted June 7, 2002 I say GO GAIL!!!! I got a letter from my perinatologist about Braedens size too...he was 9lbs 11 oz 2 1/2 weeks early so I hope that helps.... Another Cigna Crasader!!!! Trisha > Hi All,> I lost my spark for a while, but I'm back at it and working on my Level 2 appeal to Cigna. I think I'm on to something and want to get your opinions and advice. > > I spent the morning at the hospital where Sam and Sara were born going over all of our medical records. I think that if I can prove intrauterine constraint I will have a good argument that banding is reconstructive and not cosmetic. Has anyone pursued that route before? In Sam's file I found several places where they said he was "large for gestational age". He weighed nearly 8 pounds at birth (37.5 weeks). In Sara's file I found where the nurses in the nursery made notes about the bruising on her back where she was stuck against my pelvic bones. There is notations in both their charts that they were breech. Does that matter? Then I got copies of all my sonograms (done at least every 4 weeks throughout the pregnancy) and the last few reports had a hand-drawn scketch of their position in the womb, and it never changed. I think that all this combined is enough to prove that my big, fat babies were pretty cramped inside me.> > Also, I think I have found the article that CIGNA alluded to but didn't reference in our most recent denial, and there is a huge section in there about tort, plagio and constraint. I think this would counter the part they used that said plagio is "simply a cosmetic problem".> > What's your take on this? Do you think it will work? Any suggestions?> > Thanks,> Gail, official Cigna crusader, Sam and Sara's mom, DOC gradsFor more plagio info Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 7, 2002 Report Share Posted June 7, 2002 Gail, First off, I have to congratulate you! Sam was a wonderful size, especially for a twin!!! Great job Mom!! Second, I think you might really have something going for you here. Its definitely documented that it was cramped quarters in there, which is one of the leading causes of plagio. The fact that they were breeched might help, esp. if they're heads were stuck up under your ribcage. You go girl! Hopefully this will do the trick! Niki Kaylie & Danny (STAR grads) Phila., PA > Hi All, > I lost my spark for a while, but I'm back at it and working on my Level 2 appeal to Cigna. I think I'm on to something and want to get your opinions and advice. > > I spent the morning at the hospital where Sam and Sara were born going over all of our medical records. I think that if I can prove intrauterine constraint I will have a good argument that banding is reconstructive and not cosmetic. Has anyone pursued that route before? In Sam's file I found several places where they said he was " large for gestational age " . He weighed nearly 8 pounds at birth (37.5 weeks). In Sara's file I found where the nurses in the nursery made notes about the bruising on her back where she was stuck against my pelvic bones. There is notations in both their charts that they were breech. Does that matter? Then I got copies of all my sonograms (done at least every 4 weeks throughout the pregnancy) and the last few reports had a hand-drawn scketch of their position in the womb, and it never changed. I think that all this combined is enough to prove that my big, fat babies were pretty cramped inside me. > > Also, I think I have found the article that CIGNA alluded to but didn't reference in our most recent denial, and there is a huge section in there about tort, plagio and constraint. I think this would counter the part they used that said plagio is " simply a cosmetic problem " . > > What's your take on this? Do you think it will work? Any suggestions? > > Thanks, > Gail, official Cigna crusader, Sam and Sara's mom, DOC grads Quote Link to comment Share on other sites More sharing options...
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