According to Cross River Therapy, at least eight out of ten Americans will experience back pain at least one or more times during their lifetime. About 80 million workers, or half of all Americans who are employed, will be forced to take time away from work as a result of back pain. At least five percent of those who are struggling with mild back pain symptoms will develop chronic, severe back pain. Americans spend $635 billion annually to treat back pain, with clerical workers having the highest levels of workplace-related pain in their lower back.
If you are one of the many people across the nation who live with chronic back pain, receiving a back pain treatment insurance denial from your health insurer can be devastating. Back pain can affect every aspect of your life, preventing you from accomplishing day-to-day tasks or enjoying your life. If you have received a back pain treatment insurance denial, you need the very best assistance from a dedicated legal professional like Scott Glovsky. When you contact the Law Offices of Scott Glovsky, you have taken an important step in getting the treatments you need for your back pain.
Why You May Have Received a Back Pain Treatment Insurance Denial
Your doctor may have prescribed physical therapy, steroid injections (triamcinolone methylprednisolone, and betamethasone), nonsteroidal anti-inflammatory medications (Celebrex, Voltaren, Naprosyn), acupuncture, selective root nerve blocks, specific pain-relieving drugs (Flexeril, Skelaxin, Zanaflex), or a combination of these treatments. You may also have been prescribed the Intracept procedure—a minimally invasive outpatient procedure that targets and deadens the nerves responsible for low back pain using radiofrequency heat.
While an insurer may have denied your treatment because there was information missing on the paperwork, you failed to obtain a pre-authorization, or your plan specifically excludes it, more often it comes down to one thing—money. Insurance companies are often primarily interested in the financial bottom line, so any time a treatment is considered expensive they may deny it since they have little to lose and everything to gain. Many people do not have the time or the knowledge of how to appeal a back pain treatment insurance denial, so they simply accept the denial and deal with the pain.
What Can You Do About a Back Pain Treatment Insurance Denial?
You do have options following a back pain treatment insurance denial. If your treatment was denied because of missing paperwork or improperly filled out paperwork, you can fix this issue and resubmit the claim. If the cause of the back pain treatment insurance denial is that your plan specifically excludes the treatment or you failed to obtain pre-authorization, you may or may not be able to have the denial reversed.
If, however, your insurer states the treatment is “experimental,” “investigational,” or “not medically necessary,” you can and should begin the appeal process. Your insurance denial attorney from the Law Offices of Scott Glovsky can help you with an internal appeal, and then an external appeal if the internal appeal is unsuccessful. It can also help to have a letter from your doctor detailing why the treatment is necessary for your health.
Specific Insurance Companies That Are Known to Deny Back Pain Treatments
Any insurance company can deny a claim—but some are more likely than others to do so. Some of the major California insurers who could potentially deny your back pain treatment include:
Different Types of Back Pain
Obtaining the right treatments that can help alleviate back pain can be a challenging task. While most types of back pain may not have an actual “cure,” the right treatments can effectively manage back pain, reducing the negative impact on your day-to-day life. There are several distinct types of back pain, including:
- Disc injury (flexion dominant back pain) where symptoms are worsened when you sit, bend, or lift. This type of back pain may include spine pain, leg pain, or both. Loss of range of motion is common with this type of back pain.
- Extension dominant back pain includes pain after standing, temporary relief from sitting or bending, stable range of motion, pain after high-impact activities, stiffness, and localized pain in the back, with the possibility of leg pain, tingling, and numbness.
- Neurogenic claudication is back pain that tends to affect older individuals when the nerves are compressed as the patient stands and walks. Upon rising and walking, pain, numbness, and weakness in the legs can occur which improves when the patient sits or bends forward.
- Inflammatory back pain is caused by excessive inflammation in the spinal joints including ankylosing spondylitis. This type of back pain is not due to trauma, usually affects those under the age of 35, and persists for more than three months. Immobility causes pain and stiffness associated with inflammatory back pain to worsen, particularly at night and in the early morning.
- Back pain characterized as a chronic pain disorder can be more challenging to treat because the nervous system interprets stimuli that are not normally painful or harmful as dangerous, then the brain treats it as painful. Chronic pain disorder is a complex issue that can be incredibly frustrating for patients.
How a Back Pain Treatment Insurance Denial Can Affect Your Life
Receiving a back pain treatment insurance denial can be devastating. When you live with chronic back pain, it affects everything from your ability to work to your ability to enjoy your life outside of work. The future may look dim when you consider living the rest of your life with chronic back pain. If your doctor has prescribed a treatment or prescription drug that could deal with this pain, yet your insurer refuses to pay for it, don’t give up—contact attorney Scott Glovsky today.
How the Law Offices of Scott Glovsky Can Help with Your Insurance Denial for Back Pain
When you are suffering chronic back pain and your insurance company seems indifferent to your plight, it’s time to call the Law Offices of Scott Glovsky. We go after big insurance companies who care more about their quarterly profits than the people they insure. Attorney Scott Glovsky is happiest when he and his legal team are fighting for justice against big insurance companies that think they are untouchable. Scott is ready to make a positive difference in your life by helping you get the back pain treatment you need and deserve. You can rest easy, knowing you are no longer in this fight for justice alone. Contact the Law Offices of Scott Glovsky today.