Hi Everyone,

I hope someone can offer some insight and help! I have an uncle who has been suffering with depression since the 80's. He has also been going through treatment since then. He had one med that worked fairly well for a few years (Paxil) but then after reaching max doses the Paxil lost it's effect. He of course has tried every other med on the market and has only suffered the bad side effects and certainly has had no relief from the depression. He has had better times and maybe some worse times...but currently is doing poorly. He has applied for the VNS and was denied, so they appealed the denial and were denied again. Unfortunately, at this time, I don't know what the reason for the denial is! I can't imagine that with his history, that he would be denied.

Is this normal to get denied and have to keep appealing?

Please let me know what the process was like for those of you who were approved!

Thank you,

KIm

Have your Uncle ask his doctor to contact Cyberonics and see if he can be in on the study they are about to do. It is for TRD only (treatment Resistent Depression)
The patient has to be diagnosed as TRD, which your Uncle appears to be, that have had ECT's and not responded or were suggested to that they should have ECT, but declined.



:im_033: Labrat :im_033:

Dear Kim,
I hope this helps you. I had to fight my insurance company to get my VNS. My insurance company denied me three times. They basically stated that VNS was experimental and was not covered under their plan. After that, I asked my husbands employer to help me fight the insurance company; and they agreed. I also saw a doctor who evaluated me for the VNS; and she said I was a candidate. She also helped me. It also helped my case that I am disabled, and on Social security disability. It took one year of fighting with Aetna before they awarded me the permission to have the VNS. I also used casemanagers at Cyberonics. These are the people at the company who make the implant (VNS). They also helped. So, everyone together helped me. I sent in over 100 pages of documentation of my TRD, disability records, and medical records for the medical doctor to use to appeal my case against Aetna to get my VNS. Anything you have documenting the disease of depression you can use. I have a 25 year + history of stuff that I sent in. I hope things are going better for you family member. Please write back. I will check back to see if you have written. It is a fight to get what you need.
Sincerely,
Bonnie :goodluck:

Appeal again, no matter how long it takes. Appeal,appeal, appeal.

I agree with Bonnie on how you might be able to get the VNS. Ask your Dr. to write you a letter stating the history of your depression.

My Dr. wrote a letter for me and it was approved on the first try. I am also on SS disability. Medicaid paid for mine. No questions asked. The letter my Dr. wrote was wonderful though. He was able to tell them how hard I have tried to get better. I never miss my councelling, not in 8 years, I have tried every med out there. I have been suicidal all of my life also.

I do believe though that the Dr. has to let them know your complete history of how bad your depression is and how they have tried to help you get better from it.

Ada

My Dr. and Psychologist did the same thing. They documented all the years I had been in treatment, my suicide attempts and how serious and life threating they were. They also told the insurance company that I had taken every medication there was and had ECT's. My disability and VNS both came through on the first try. : xmas :