Guest guest Posted June 6, 2002 Report Share Posted June 6, 2002 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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