The New Mexico US District Court – 2009-1039 Glibowski versus United States Office of Personnel Management (OPM) offers hope for Lyme patients trying to get insurance coverage.
After running to ground the internal appeal process through their insurance as well as an external review by OPM, a federal branch of government to protect access to evidenced-based care for the chronically infected, Robert and Debra Glibowski sought out an attorney to sue OPM.
After a long and grueling battle the tide finally turned when in 2013 a judge ruled in favor of the Glibowskis and required OPM and the insurance company to ‘justify any denials of coverage based on any lack of medical necessity under the policy.’
After a black out, another motion was filed for the judge to take up the case.
It is thought that the judge will rule to take this to the higher court of appeals, the Tenth Circuit Court of Appeals, representing one of 12 regional circuits in the nation which are right below the Supreme Court.
This is big.
Lyme Disease has a chance to be on legal record, and according to the attorney, there is a great chance this higher Court will rule in favor of the Glibowskis, setting a precedent for all OPM external reviews of Lyme Disease, not to mention shake up the insurance world by making it tougher to deny coverage.
A big “thank you” to Jenna Luche-Thayer https://www.linkedin.com/in/jenna-luche-thayer-b75b902b for a superb article delineating all of this.