Bad News - Denied for CI

Hask12

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Boy, I wish my speech comprehension was 72%.
 

Lissa

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i thought more people with CI's had it done in their worst ear, I know I did. My left(implanted ear) unaided was 100db at 250hz 110db at 500hz 115db at 1000hz and NR 120 at 2hz.

my better ear was a bit better at 75db at 250hz, 90 at 500hz 100 at 1000 and 120db at 2hz
 
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vallee

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LTHF has a wonderful success rate because they pick candiates that qualify for implants. If he qualifies through his doctor and insurance denies than they might pick his case. If doctor does not approve then I do not think they will touch the case.

They helped me and I think the world of them. Also AB has a great insurance assistance program. Does Cochlear have one as well?
 

deafdyke

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Phi I worry about one thing, the CI ear tends to become the better ear. You might not be able to have as much use out of your "good" ear. It might be more damaging to that ear in sound. I do not want you to become frustrated.
vallee......that's a REALLY good point! Phi, we know that you're thinking that the CI and HA will work together, and it does for quite a few people (it does seem like bimodal seems very common) but it's possible that those people had speech scores that while low, were enough to get some speech perception.....and they may have had a dead ear or VERY low speech perception in the ear they chose to implant.
 

SouthFella

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Phil how about accepting your hearing loss ? Look like you trying so hard to be a hearie...

I am a candidate for either ear for CI... I declined bilateral... I chose my worse ear to be implanted and my better ear left alone with a HA... That way I can still enjoy music...

If I had 72% speech comprehension, I would be a happy camper !!!
 

Babyblue

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Phil how about accepting your hearing loss ? Look like you trying so hard to be a hearie...

I am a candidate for either ear for CI... I declined bilateral... I chose my worse ear to be implanted and my better ear left alone with a HA... That way I can still enjoy music...

If I had 72% speech comprehension, I would be a happy camper !!!


Funny that you say that.

Isn't that what some people say to you?

People get CI's to better their hearing. Nothing wrong with that. With you being a CI user as well, I just find that comment somewhat "off the wall"

:lol:
 

SouthFella

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Funny thing is I do accept who I am ... And I work within my limits...

I got a CI because I got married to a hearie wifey lol
 

Babyblue

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Funny thing is I do accept who I am ... And I work within my limits...

I got a CI because I got married to a hearie wifey lol

You got a CI because of her?

Now you just put your foot in your mouth. Before you judge others on the reasons why they got a CI. Take a good look at yourself.

Now who is not right in their head. :lol:


Still :ily: South! :giggle:

I have considered a CI for myself. Then I sat back and thought. I function fine with my HA's as of now.

The speech recognition vary, IMO. Depends on who may have training and actually had to fit the the sounds with the words. In my saying that. I will probably fail to become a CI candidate due to I can pretty much "guess" what they are saying along with the garble I may hear. Fit the pronunciation with the sound, and I "may" just get the word right in the test. I bet each test I take will have a different score. Depends on the words they use to test you with.
 

deafdyke

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Phil how about accepting your hearing loss ? Look like you trying so hard to be a hearie...
I don't think he's trying to be a hearie......but I do think that he thinks that the CI will totally overcome every disadvantage of being hoh. He doesn't understand that A LOT of hoh people have difficulty in non-one on one sittuions. Even unilateral dhh people have difficulty in non-one on one situtions.....but we ALL adapt to it.
 

Phi4Sius

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deafdyke- You are correct. I'm not "trying" to be anything. I accepted my loss my whole life (if you recall, I lost all my hearing in my left ear and over half in my right ear at 3-4 years old) and now there's something that can be done about it.

I realize it's not a "cure" (after all when you take off the processor you're still deaf in the ear that you wear it in), nor is it a miraculous be-all end-all device that restores perfect hearing. And I know it won't overcome everything that we all have to deal with. But, in the end, it's worth it to restore a good amount of hearing in that ear. I've never known what it's like to have two ears, and finally I have a chance to have some of the hearing back that I lost before I ever had a chance to enjoy it.

For those that were talking about the other ear becoming the dominant ear, I'm aware that that can happen. But, at the same time, I'm thinking: OMG, how awesome is that? An ear that's been deaf for 25 years gets to become an ear that's more powerful than the one I've been using at less than half its capacity my whole life? How awesome is that?

I have researched and soaked up everything the Cochlear Implant can and can't do for the better part of the past six months.

I'm prepared for anything that may happen.
 

deafdyke

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Again, I can see both sides. I mean you pretty much have NO residual hearing to amplify. On the other hand, you do have quite a bit of hearing with your aided ear. This is a hard case. Like if you had lower speech perception it would be easier to qualify....but you do have a lot of speech perception with your aided ear. I have to say....I think unless you have a VERY generous insurance plan, you're probaly going to get denied again.
I think it may be a combonation of the recession. (Health care tends to be rationed in recessions) as well as a bulge of " AG Bell "gotta have the latest hearing gizmo" types who may have been ambigious for implantation.
I think part of the reason why insurance companies covered it, initially was b/c although the associated costs were high, very few people qualified for it. So they didn't lose out on money, when covering it. With the loosening of canidacy, the insurance companies are going to get more stingy about who and who can't get the CI.
 

SouthFella

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Well if you researched for 6 months, then you will know the criteria... I only researched for 2 months and made a lot of phone calls...Hearie wifey is happy I got the CI ... lol

Woemen make us men do strange things at the strangest times....
 

Phi4Sius

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SouthFella- Despite our different views on the subject of implantation, I'd have to agree there. Women do make us do strange things at times.

I've only been researching this long because when I get obsessed about something I want to learn anything and everything about it...past...present...and even the possible future. But I have to admit that in the midst of the research, I didn't know that my insurance company would be going strictly by FDA criteria. I was told by my audiologist that 1. a CI can help me with my loss significantly because I've been having a lot of trouble and struggling with my hearing aid, and there are people with much less hearing loss than I that HAVE gotten even bi-lateral CIs, and 2. the insurance company told me that as long as it's medically necessary (with NO mention of FDA regulations/insurance company following such criteria at ALL until I went through the process) they would cover it. Because it is medically necessary - my left ear is dead with no chance of any amplification helping it.

I have some great news that I will be announcing in another thread.
 

deafdude1

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Well if you researched for 6 months, then you will know the criteria... I only researched for 2 months and made a lot of phone calls...Hearie wifey is happy I got the CI ... lol

Woemen make us men do strange things at the strangest times....

I would never be with any woman that tried to push CI(s) on me. Id still be deaf with CI(s) anyway. If she didn't accept my deafness, she can go find a hearing man to be with.

Good luck Phi4sius! :D
 

jackiesolorzano

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I know of people that have learned how to fail the test so they can become a cand. just a thought.

So I've been denied claiming "too much speech recognition". That's horse***.

Time to fight.

For those who have been denied, what have you done? How did you appeal? What steps did you take to bring down the insurance company?

Okay, I was just kidding on the last one, but in all seriousness, how did you do it?
 

deafdude1

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I know of people that have learned how to fail the test so they can become a cand. just a thought.


Anyone that cheats deserves to hear worse and insurance should reserve their right to make you pay them back all costs incurred. :mad: I suspect a percentage of people are cheating. Many refuse to guess when they know they are supposed to guess. Others set their volume/gain down or they go with 5 year old hearing aids.

It really makes me upset because we end up paying a higher insurance cost. I wouldn't care if you want to waste $50,000 out of pocket and risk hearing worse. That's your ears and choice but don't dare make any of us pay for your bad choice. Pay for your choice yourself! :mad:
 

deafdyke

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Deafdude I agree totally! There's nothing wrong per se with "off-label" usage.....as long as it's legit. (ie tintiaus, Meinere's or very signficent recruitment)
I do think that if insurances covered hearing aids, that the popularity of implantation might actually take a really signficent nosedive. There will always be folks who obviously need CIs, and who don't benifit much if at all from hearing aids.
 

coolgirlspyer90

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Phi4Sius,

I'm excatly like you. I lost my hearing when i was almost about 4 years old but i actually lost my hearing at 3 years old. And now i'm 15 years old. (will be 16 next month on the 26th of august)

I have my left ear implanted. Which my left ear is dead as well. My right ear, is hard of hearing. While growing up i never heard any sounds coming from my hearing aid to my left ear. Because its dead and its no use to anymore. But While i was growing up, (about the age of 6 or 7 years old) I was thinking about getting a CI alot. And when I finally decided to get a CI i talked to my parents about it. And they supported me in many situations of my decisions in whether i wanted a CI or not. And I remember those long unbearable waitings for getting my CI. I waited for every phone call that came from the CI company that would call and say that i'm accepted.


I'm not sure what my hearing level is, I never really knew how to read the audiogram or learned how to. Thats just a whole 'nother math stuff for me to learn. But I'm pretty good in my speech.

I also learned that a dead deaf ear, can become a better and good deaf ear because that has happened to me. Every time i go to my CI audiologist for a appointment to "tune up my CI" I get better with my audiogram everyday. And 2 weeks ago which is my last CI appointment, I have improved triple my audiogram than before. So many of you guys are arguing about getting your good ear implanted. But thats not what Phi4sius wants. It is his DECISION. Phi4sius is right too. He has never gotten anything through both hearing aids in his left ear. I was experiencing the same. And I would also take advantage of whats out there now and experience it.

Honestly, I think people should learn to accept it. It doesn't really matter if some deaf people don't want us to have one because it's so permanent. All it matters is that it's your decision. I mean, isn't deaf people is also your second family? I think we should all support each other whether we like it or not. I'm actually tired of hearing the same stories over and over and over again. It's always: "Implant it in your good ear because it would improve your hearing alot MORE."-- sure that might be true, but with a dead ear, you can learn MORE from it.

"But a implant is so permanent"--Yes it is permanent, but its also worth it than having a hearing aid, because after having a implant, a hearing aid just makes sounds louder. your life with a implant would be so much better because there will be some situations where you will need to hear in case like a tornado alarm, or when somebody breaks into your house, or when you're out in the city somewhere and somebody is screaming for help, or when you want to hear your child's first cry when they're born or their first word.

I don't like it when i see good deaf friends are arguing over a cochlear implant or a hearing aid. I mean if its a ADA situation, i completely understand. But with a CI and a HA, i mean whats the point in arguing about it with your deaf family? Its like not getting what you want and acting like a 5 year old. I understand if some deafies out there are completely fine with what they are now. And i also understand deafies that they don't believe that a CI is going to help anything. It may not help for some specific people but it would also help others. I have seen myself grow with a CI and a HA. I would have to say both technology are amazing.

And you know what else? With my dead, deaf, left implanted ear, I am in my school's year book, as in my own paragraph about me being in the marching band, telling them that It may be hard at times, but I managed to do it. I am the only and the first time deaf girl to be in my high school's marching band, And they are amazed of what I do, and how i managed to do it. With marching band, I'm hearing new notes in music that i never reconized before.

So, Phi4sius, keep fighting. Don't give up. Someday you will have your chance with sounds and you will be so happy with it like I am now. If i were you I would contact your audiologist for any suggestions they might have for you. Or like they said contact your CI company. I'm sure they would be happy to help you out.


and sorry if i am off topic. I just wanted to defense Phi4sius.
 

deafdude1

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I have my left ear implanted. Which my left ear is dead as well. My right ear, is hard of hearing. While growing up i never heard any sounds coming from my hearing aid to my left ear. Because its dead and its no use to anymore. But While i was growing up, (about the age of 6 or 7 years old) I was thinking about getting a CI alot. And when I finally decided to get a CI i talked to my parents about it. And they supported me in many situations of my decisions in whether i wanted a CI or not.

Well you had no residual hearing to risk in a completely deaf/dead ear. I am 27 and CI technology was primative when I was 7. Back then they only implanted those with two dead ears, one ear was implanted.


I'm not sure what my hearing level is, I never really knew how to read the audiogram or learned how to. Thats just a whole 'nother math stuff for me to learn. But I'm pretty good in my speech.

If you know how to use a scanner(or digital camera), we can interpret your audiogram for you.

I also learned that a dead deaf ear, can become a better and good deaf ear because that has happened to me.

Deaf people have been getting CIs since before I was born. I think it's a great idea to get a CI when you can't even tell if your HA is on or not.

Every time i go to my CI audiologist for a appointment to "tune up my CI" I get better with my audiogram everyday. And 2 weeks ago which is my last CI appointment, I have improved triple my audiogram than before.

Funny that people take CI more seriously than HAs. Howcome so few people have a desire to "tune up" their HAs so they can hear better? :roll:

So many of you guys are arguing about getting your good ear implanted. But thats not what Phi4sius wants. It is his DECISION. Phi4sius is right too. He has never gotten anything through both hearing aids in his left ear. I was experiencing the same. And I would also take advantage of whats out there now and experience it.

If I had a dead ear and my "good" ear scored below 60% speech, id be a CI candidate and wouldn't have to worry about losing my residual hearing in an ear that already has none to begin.

Honestly, I think people should learn to accept it. It doesn't really matter if some deaf people don't want us to have one because it's so permanent. All it matters is that it's your decision. I mean, isn't deaf people is also your second family? I think we should all support each other whether we like it or not.

I never had a problem with the profoundly deaf getting CI if they can't hear with HAs. It's a different story for those who can still hear with HAs but think a CI will cure their deafness or give them normal hearing. :roll:

It's always: "Implant it in your good ear because it would improve your hearing alot MORE."-- sure that might be true, but with a dead ear, you can learn MORE from it.

It never made sense to risk your good ear. Implant in your bad ear and you can benefit by hearing from both ears instead of only one. :roll:

"But a implant is so permanent"--Yes it is permanent, but its also worth it than having a hearing aid, because after having a implant, a hearing aid just makes sounds louder.

For those with residual hearing, we need all the amplification we can get in order to hear sounds/speech. Those that have no residual hearing left won't benefit from HAs so yea a CI would be worth it. :D

Your life with a implant would be so much better because there will be some situations where you will need to hear in case like a tornado alarm, or when somebody breaks into your house, or when you're out in the city somewhere and somebody is screaming for help, or when you want to hear your child's first cry when they're born or their first word.

You could use flashing lights as a visual alarm.

And i also understand deafies that they don't believe that a CI is going to help anything. It may not help for some specific people but it would also help others. I have seen myself grow with a CI and a HA. I would have to say both technology are amazing.

Agreed. :cool2:

And you know what else? With my dead, deaf, left implanted ear, I am in my school's year book, as in my own paragraph about me being in the marching band, telling them that It may be hard at times, but I managed to do it. I am the only and the first time deaf girl to be in my high school's marching band, And they are amazed of what I do, and how i managed to do it. With marching band, I'm hearing new notes in music that i never reconized before.

:D:D:D
 

deafdyke

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coolgirlspyer90, just to inform you....being anti CI is getting more and more unusual. I remember back in the old days A LOT of deafies being anti-CI. Now, it's a lot less. Which is good. CI is AWESOME for those who basicly have zero help (even enviromental or some speech sounds) from HA.
 
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