Anyone had cervical ADR done in Ontario? IMPORTANT

[fortitudine]

Hi Katie,
I live in Alberta. I tried to find out about getting reimbursement for out-of-country surgery for c-spine. I was told I had to have a doctor's letter concurring that the surgery I was going away for was appropriate and not available in Canada.

I was told to get a consult from another doctor, anywhere in Canada. It's called an independent medical exam (IME). I researched my options and found Dr. Neal Duggal, who has co-written papers with Dr. B. who I was planning to go to. For that reason I thoughht he'd probably be responsive. I even got my own family doc to contact Dr. Duggal and he called her and said he'd do an IME on me. So I tried for a year and a half to get through his nurse, and finally gave up. She was extremely difficult to deal with.

I gave up, after my cheque was stale-dated. I have put off the surgery, but I'm thinking that if I do go to Dr. B. I might ask HIM to request that Dr. Duggal see me and get my IME that way.

Don't know if that helps, but I'm pretty sure that you need to go through a doc, not a medical device manufacturer. There's a person who used to be on the forums who lives in Ontario who might be able to help you. Mark helped her get lumbar ADR about 6 or 7 years ago. He or I can probably put you in touch with her if you'd like.

Good luck!

[Katie]

Thanks so much fortitudine. I am familiar with Dr. Duggal's office, and actually tried to contact him just a bit ago. You are right on all counts ;-)

I need to have confirmation that the surgery IS done in Ontario, just not available...if that makes any sense. In my case, there is no one who does both lumbar and cervical, so I am assuming I fit the criteria. I have proven that there is a billing number, that multi-level surgery has been done before (over 130, according to the Access to Information agency), etc. And the referring doctor has to be in Ontario; elsewhere in Canada is of no consequence. And the Appeal board wants more proof than from the above source, even if it is a different branch of the same government department (the Health board).

My problem is like yours, I cannot get in to see anyone within a year. The one fellow (neurologist) I did have an appointment with has done almost nothing; no follow up appointment or referral to an NS, etc. I am tearing my hair out. I do feel that I have built a good case for my upcoming appeal though, but I won't know until I get there.

Dr. Duggal is probably the most published NS in the country, and the only one doing multi-level cervical ADR, from what I can find.

I don't know your circumstances, but there is a doctor in Vancouver who started doing ADR about a year and a half ago, and I can give you his contact number if you like. He is restricting his patients to BC and Alberta right now, but his staff is incredibly nice, one of the very few in that category and he is highly regarded as well. He trained under Dr. B also, I think.

This has been very helpful, thanks. If you do remember the other lady who went through similar struggles, please pass it on. Every detail helps with the battle. My appeal is coming up very quickly, and I need all the ammunition I can get.

I wish you the best as well.

[Katie]

Have you tried contacting Dr Duggal directly via email or phone? I have his direct email, found on a medical journal site that asked for feedback to an article. If you put in there that he did agree to do the IME, but you have had problems contacting him, then you might have more success.

Perhaps you have tried that already and she has intervened? Tough getting past the 'moat' some days, hey

[fortitudine]

Hi Katie,

For some reason, I don't think I am getting email notification of PMs from iSpine. So I am writing this to let you know I sent you a pm with contact info ofr other Candians.

[Katie]

Thanks! I didn't know I had any PMs...off to do a bit of reading ;-)