Exactly as you described. "Near Syncopy" is the section.

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Posted by John Behle on March 06, 2003 at 22:15:15:

In Reply to: afib and disability posted by Kati on March 06, 2003 at 17:24:30:

I applied for disability before I knew about the MAZE because of the AF. As they usually do, they declined it at first and I got an attorney. I didn't care about the benefits and had severely under estimated my income, so they weren't that great, but the medical coverage WAS a lifesaver.

It was a little up in the air as to where it falls, but my attorney found a section in their manual that deals with "Near Syncopy". That means "Nearly fainting". It is clearly spelled out that that is an acceptable condition for Disability.

Just like a lot of doctors, they wanted to believe AF is no big deal, but fainting or nearly fainting is dangerous. That's kind of humorous in some ways since there is little risk that I could have fainted and caused a problem. With me AF kind of would give notice and I could always pull off the road if driving or have somewhat of a controlled fall if walking. The greater risk as far as work is having any continuity of momentum. No employer, no matter how sympathetic, can live under the constant uncertainty of will somebody be able to show up today - or even this week. But they don't seem to have a section for that.

So anyway, they approved it. I found out about the MAZE and Medicare paid for most of it. Even though I was responsible for 20%, some of the medical professionals accept a lessor amount or write off some of the 20%. The worst part of the whole surgery was sorting through that whole billing mess. So many different bills and billers. I basically just waited until the dust cleared and Medicare had paid their part and then I paid the rest. I think my part was less than a couple thousand.

Then, out of the blue, they send me something to review my case. I'm not sure if that was just a timed thing or if my attorney tipped them off. I had called him to see if I should tell them that the main cause of the disability had been cured. I still wonder if somehow he called or informed them.

If I knew what I knew now, I would have documented the Fibromyalgia and severe back problems more instead of just focusing on the AFIB.

So, they did a review and took away the disability.

I'm deeply grateful for Medicare covering it. I had no insurance and may not have even been insurable as severe as the heart problems were. If I had been insurable, I'm sure it would have been very costly. Paying for the MAZE out of pocket would have been painful, but I would have done it in a minute for the results it gave.

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