My health problems is why my surgeon wrote the letter. BTW it was his idea not mine, but now I reap the benifits. I have had 7 back surgeries due to degenerative disc disease and the extra 147 pounds I was carring around sure didn't help matters. Plus I have high BP, sleep apnea, asthma and due to a bad case of meningitis, I have had 10 brain surgeries in the past 2 1/2 years for a VP shunt. So that is why I am sure the insurance paid. Good Luck to you.