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Hi:

My son has Oral Apraxia and has been receiving speech therapy since he was 3

1/2. He is now 5 1/2 and Blue Shield of CA decided to deny paying for speech

therapy on the basis that he has not shown significant improvement in his goals

over the past 6 months, thus they are determining that the therapy is no longer

medically necessary.

Has anyone been denied services based on this type of denial?

They initially denied services because they didn't consider Apraxia as a

recognized medical condition but I worked on an appeal letter to disprove this

and they actually overturned their decision.

Now I'm at a loss as to how to approach the fact that he hasn't made significant

improvement in a timely manner. This is so frustrating and in my opinion, very

unethical. (He also needs OT as he has Sensory Processing Disorder and I am on

my second appeal with that. Not giving up!)

Thanks for any advise you can offer.

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