Here are copies of the letters I used

 

My letter from my PCP:

May 7, 2002

Texas Rehabilitation Commission

1015 Jackson Keller, Suite 103

San Antonio, Texas 78213

(210) 349-2684 Fax: (210) 349-3944

 

Dear Mr. (Counselor's Name),

This letter is regarding Mr. Douglas L. Heyde, who is a patient of mine seeking the Roux-En-Y Gastric Bypass.  Mr. Heyde is more than twice his ideal body weight, which puts him well within range for the diagnosis of Morbid Obesity. He also has several co-morbidities, which are exacerbated by his weight,. The patient is 5'11", weighing 515 lbs and has a body mass index (BMI) of 70.
 
The patient displays the following co-morbidities which gastric bypass surgery and the resulting weight loss has been proven to alleviate:

Type II Diabetes

Hypertension

Sleep Apnea

Chronic back, hip, and knee pain

 
Despite numerous diet attempts, since the age of 8, Mr. Heyde has never been able to maintain a healthy weight.  These methods include prescription medication intended to support weight loss such as Xenical and Prozac, seeing a Nutritionist, over-the-counter weight loss/appetite suppressants, Weight Watchers, Nutri-System, and numerous other diet attempts. Mr. Heyde has lost weight on these methods, and then regained the weight, with additional pounds.  Due to the patient’s diet history and serious health concerns, I do not consider him a candidate for currently approved weight loss medications. In addition, weight loss surgery is by far the most effective long-term treatment for patients with morbid obesity.

I consider this patient a good candidate for gastric bypass.  My referral to Dr. Dana Reiss who perfoms this surgery was refused by Mr. Heyde’s insurance company. I believe, not only would surgery improve, and in some cases totally remove,  his co-morbidities, it would most probably extend Mr. Heyde’s life.  I am therefore, strongly recommending the approval of his case, so he may receive the RNY Gastric Bypass, as soon as possible.  

Sincerely,

 

Dr. (Your Doctor's Name)

Primary Cary Physician

 

 

My letter from my Pulmonologist: 

May 7, 2002

Texas Rehabilitation Commission

1015 Jackson Keller, Suite 103

San Antonio, Texas 78213

(210) 349-2684 Fax: (210) 349-3944

 

Mr. (Put your Counselor's Name Here),

This letter is in support of my patient

Douglas L. Heyde

123-45-6789

11/11/11

 

receiving Gastric Bypass surgery.  I treat Mr. Heyde for sleep apnea, a life-threatening condition often caused by obesity in which the patient stops breathing during sleep.  This condition causes sufferers to sleep poorly which often results in drowsiness and inattentiveness during the day. This can significantly impede performance on the job and in daily life situations, such as driving a car.

In the initial sleep study performed by my staff, Mr. Heyde stopped breathing an average of 60 times an hour.  To treat this condition, the patient uses a CPAP machine every time he sleeps.  This device merely assists Mr. Heyde in breathing, it does nothing to cure sleep apnea. 

I strongly recommend weight loss surgery for Mr. Heyde.  Losing weight would in all likelihood alleviate his sleep apnea.

Sincerely,

 

(Your Doctor's Name Here)

 

My Endocrinologists letter

 

 

 

 

May 7, 2002

C ounselors Name

Texas Rehabilitation Commission

1015 Jackson Keller, Suite 103

San Antonio, Texas 78213

(210) 349-2684 Fax: (210) 349-3944

 

Re: Douglas L. Heyde

D.O.B. 11/11/11

SSN 123-45-6789

 

Dear Mr. (counselor's name),

I am writing this letter on behalf, of my patient, Douglas L. Heyde, who is currently seeking coverage of the Roux-En-Y Gastric Bypass.  I have prescribed Xenical for him which failed to provide enough weight loss to positively impact his health.  Mr. Heyde participated in the education program affiliated with my practice which included a nutrition/diet plan developed specifically for him.  Even when he has been successful in losing weight, he has been unable to keep the weight from returning.  

Mr. Heyde has several health issues which are negatively impacted by his weight.  I have been treating him for Type II diabetes and hypertension for several years.  He takes several medications as well as daily insulin injections to control these problems.  It is my opinion that Mr. Heyde’s current medical conditions would be vastly improved by the loss of the bulk of his excess weight.  Surgical treatment is medically necessary because it is the only proven method of achieving long term weight loss for the morbidly obese.

Sincerely,

 

Dr. (Your Doctor's Name Here)