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\nAurora McCausland, a 30-year-old mom of 2, says her doctor recommended liposuction for lipedema, a condition which has caused fat to accumulate in her lower bodyHowever, she claims she was denied coverage for the surgery because they said she doesn\u2019t \u201cfeel tenderness\u201d in the affected areasHer insurance company, Cigna Healthcare, said in a statement, \u201cBased on the information submitted by her doctor, she did not meet the clinical criteria for liposuction at that time”; McCausland now has a new insurance company and is trying to get the surgery approved<\/p>\n
A mom of two with a painful disorder that causes fat accumulation<\/a> in her legs says she\u2019s been denied surgical treatment \u2014 claiming she was told it\u2019s not \u201cmedically necessary\u201d and that she didn\u2019t feel tenderness in the affected areas.\n<\/p>\n Aurora McCausland, a popular influencer from West Valley City, Utah, who\u2019s known for her DIY home projects, went viral with a video<\/a> explaining that her insurance company at the time, Cigna Heathcare, denied her recommended surgery for lipedema<\/a>, which she says she was diagnosed with the prior year.\n<\/p>\n As the Cleveland Clinic<\/a> explains, it\u2019s a chronic condition marked by \u201cabnormal fat buildup on both sides of your lower body, usually in your legs.\u201d It doesn\u2019t respond to diet and exercise, and \u201ccause pain and make daily activities difficult.\u201d\n<\/p>\n PEOPLE has reached out to Cigna for comment, which shared the same comment they provided to NBC News<\/a> for a recent report on McCausland: \u201cLipedema is a painful condition that disproportionately impacts women, and we cover a range of treatment options, including liposuction, for patients that meet evidence-based clinical criteria. Ms. McCausland\u2019s case was carefully reviewed by multiple doctors, including a plastic surgeon with expertise in lipedema. Based on the information submitted by her doctor, she did not meet the clinical criteria for liposuction at that time.\u201d\n<\/p>\n Aurora McCausland says she was denied surgery for lipedema.<\/p>\n Courtesy of Aurora McCausland\u00a0<\/p>\n In McCausland\u2019s case, the 30-year-old is impacted in the lower half of her body, specifically her lower legs and ankles. When other treatments failed to help, her doctor recommended liposuction<\/a>. The procedure would cost $35,000, but McCausland said she was denied coverage \u2014\u00a0twice.<\/p>\n McCausland claimed she was told that she met all the medical criteria, except that she did \u201cnot feel tenderness in my affected joints, and that they can tell that there\u2019s no fat accumulation in those spots. First of all, I asked them, how can whoever is reviewing my appeal tell what the inside of my body feels like? How can they see that I don\u2019t feel tenderness?\u201d she said in her viral video. \u201cHow can they look at my swollen ankles and be able to tell by looking that there is no tenderness?\u201d\n<\/p>\n She also shared her belief that she was denied because she\u2019s \u201cgenetically thin,\u201d and appears slender online. \u201cYou\u2019re looking at me and thinking, \u2018Diseased fat where?\u2019 \u201d because the top half of her body isn\u2019t impacted by lipedema.\u00a0\n<\/p>\n<\/p>\n Cigna told PEOPLE the same comment they shared with NBC regarding McCausland\u2019s social media presence: \u201cOur coverage decisions are based on the clinical information submitted by a patient\u2019s treating physician in accordance with coverage policies and the patient\u2019s plan design.\u201d\n<\/p>\n As she explained to NBC News, her condition also causes brain fog, fatigue and she can struggle to go up a single flight of stairs. \u201cIt\u2019s definitely gotten much worse the older I\u2019ve gotten,\u201d she said. \u201cThings that I feel like I should be able to do cause pain pretty quickly, and then I kind of have to tap out. Getting down to play with my kids is really hard.\u201d\n<\/p>\n