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Military insurer restores coverage for veterans suffering from chronic pain

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By Katie Wedell, Staff Writer Updated 3:16 PM Thursday, November 11, 2010

Veterans dealing with chronic neck and back pain are celebrating a victory this Veterans Day after a military health insurance provider, Tricare, restored coverage for several pain management techniques.

In July 2009, Tricare, which provides medical coverage for all U.S. active duty service members, family, retirees and survivors, stopped paying for the techniques, which are alternatives to steroid injections or surgery to relieve back pain due to arthritis and other conditions.

Pain management specialist Ricardo Buenaventura, a former lieutenant colonel in the U.S. Air Force, treats dozens of veterans at his practice in Centerville.

He alerted the American Society of Interventional Pain Physicians, who lobbied for the return of coverage in October for the lumbar and cervical joint procedure, which costs about $600 compared to thousands for a spinal surgery in a hospital.

“I’m glad that it’s finally gotten turned around,” Buenaventura said. “Medicines don’t work for everyone and medicines can be addictive. This is a very safe procedure.”

One retired Air Force Col., Terry Spitzmiller of Bellbrook, dealt with coverage hardships and was left with few options for dealing with neck and back pain.

“They told me this isn’t proven,” said retired Air Force Col. Terry Spitzmiller of Bellbrook.

Spitzmiller, 53, has painful arthritis in his neck which prevents him from turning his head from side to side. He’d tried everything to stop the pain including medication and steroid treatments.

“The meds helped a little bit. The steroids lasted maybe three months,” he said. But it wasn’t until he tried radiofrequency ablation, an outpatient procedure which uses heated probes to burn away nerves that cause pain, that he found relief.

“It was fantastic,” he said. “I could actually turn my neck.” The pain went away for more than nine months.

Spitzmiller said he wanted to jump up and down and tell Tricare that his pain-free neck proved the procedure works.

But it took lobbying by the American Society of Interventional Pain Physicians to get the decision reversed in October.

Centerville specialist Dr. Ricardo Buenaventura was one of the physicians who brought the issue to ASIPP’s attention.

Buenaventura has decades of experience working with Tricare patients, first when he ran a pain clinic at Wright-Patterson Air Force Base and in his current practice where 15 percent of his patients are veterans.

“There are some very good studies, done 15 to 20 years ago that show these procedures work,” he said. “Every other insurance company pays for this, but Tricare felt it was experimental.”

That meant veterans like Spitzmiller had to make do when their pain inevitably returned.

“I lived the best I could with the pain.” He said he increased the amount of pain medication he was taking. It was either that or go back to taking steroid injections, which in too large of quantities can be harmful, especially for insulin dependent diabetics like him.

“I was hoping and praying that sooner or later this would be reapproved,” he said.

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