KNEEtalk

The WAITING ROOM => GENERAL KNEE QUESTIONS and comments (good for new threads) => Topic started by: spattan on September 01, 2005, 07:16:12 PM

Title: Term Chrondromalcia after crush injury to knee--insurance dispute
Post by: spattan on September 01, 2005, 07:16:12 PM
I saw the article written by Dr. Ronald Grelsamer dated Oct 05, 2004 about is it really chonromalacia--such a broad term.
My husband was 46 when he was severely crushed by a steel dumpter operated by hydralic pressure.  He's had six surgeries and is awaiting bilateral  partial knee replacements. (his whole body sustained injuries)
Workers comp department is stating that chrondromalacia grade IV is not a covered condition (pre-exisiting).  Even though it had not been diagnosed in the past, he hadn't seen a doctor for over 9 years.  But the ortho surgeons are saying that the damaged cartlidge, and  bone on bone is the result of the accident.
IS the problem the term.  Should we be using another term.  Any resources you can give me to read, I'd really appreciate it.

Title: Re: Term Chrondromalcia after crush injury to knee--insurance dispute
Post by: Janet on September 01, 2005, 10:22:13 PM
You could ask his doctor is there is another diagnosis he could use. I found that it did make a difference as to diagnosis and what the insurance company would cover. I had two diagnoses: chondromalacia and internal derangement of knee. The insurance company wouldn't cover anything unless they used chondromalacia. It's certainly worth a try to get it changed.

Although cartilege damage can occur over time, it can also be directly related to a trauma to the knee. Perhaps his doctor could also explain that it was a result of a trauma.

Janet
Title: Re: Term Chrondromalcia after crush injury to knee--insurance dispute
Post by: stgiles16 on September 02, 2005, 02:55:27 PM
I had what could be called chondro from an trauma to my knee. Another name for it is chondral defect. It can also be called articular cart. damage.  Maybe your surgeon will change his wording so that the insurance will cover it. I am absolutley sure that mine was caused by my accident. Just talk to your OS , I am sure that he will help you out.
good luck
missy