Important info..

February 19, 2008

I applaud you in your fight. One thing to remember. The spec scan will

more than likely be covered they usually cover one. OK now when you get the scan

back they will fight you on HBOT we all know that. Make sure the Dr. when filing

for HBOT makes reference that this procedure in vital to his/her recovery.

When we were fighting for Kaltyn they paid for the Spec Scan the first one that

was it.. and when the second came back although there was marked improvement

they denied HBOT. This child went from completely coma tose to Tracking and even

attending school although it was specialized services it was still leaving our

home for three hours a day..

When we fought our battle it came down to the final decision and I quote.

" although this procedure has shown to be beneficial in Kaltyn's recovery we find

this procedure to be experimental and investigational " I was upset they totally

ignored paragraph 5. They also went on to say that they contacted the leading

authority in this Field the UHMS and pulled information from there web site that

showed it to be experimental as well.

So the reason I'm saying all this is this as long as your Dr. say's that in his

opinion that this procedure is correcting or ameliorating your child's condition

according to paragraph 5 it does not matter about the experimental part.

When we were looking to reopen Katlyn's case at one point one of the attorney's

made a comment about that he said in court ruleing's that often you will find

although they said it was benificial that in the wording of paragraph 5 it say's

correcting or ameliorating. He said it is all about wording in court. One wrong

or right word will make the difference. Of course he had never saw or heard of

paragraph 5 till that day. If any of the information I have on her case will

help you let me know. I belive I gave a Copy as well at one point. But

when your battleing this as many cases as you have to refer to that was fought

the better. That way the attorney will have an Idea on where the battle has been

fought before and where it has not.

Good luck and we are all here for you.. My goal is to see this paid for by

medicaid and anything I can do to help you let me know.

Darin

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