TennCare
9/14/2009
“Ben’s” obesity reached a critical level when his doctor diagnosed a variety of related medical issues and he found himself forced to walk with a cane.
But diets were not working, and Ben’s doctor recommended immediate gastric bypass surgery. TennCare denied Ben’s application under the rules then in effect, noting that the procedure was not yet necessary, given the fact that Ben was not confined to a wheelchair or required to use a walker. At that point, Ben asked LAET for help; and an LAET staff attorney succeeded in having TennCare’s decision reversed, obtaining approval for Ben’s surgery.