Northern Ont. woman wins fight to have OHIP pay for surgery to remove excess skin
A review board has ruled that Ontario’s health system should pay for surgery to remove a ring of excess fat and skin a northern Ontario woman was left with following weight loss surgery.
Known as a "pannus," it extends as far as three inches around her waist and causes the woman skin irritation, infections, odour and back pain, said the transcript of the Health Services Appeal and Review Board hearing.
After her gastric bypass surgery, the woman’s weight dropped from 248 pounds to 148 and has been stable for more than a year.
Her plastic surgeon submitted an invoice to the province seeking payment for the surgery, but it was rejected.
OHIP said there are three requirements to have the surgery funded: the pannus must be causing health problems, the patient’s weight must be stable for at least six months and the pannus has to extend to the "pubis symphysis," a joint sandwiched between your left pelvic bone and your right pelvic bone.
"The pannus does not extend to a level below the pubis symphysis," OHIP said, in turning down the request.
In her appeal, the woman argued that she needed the surgery not for cosmetic reasons, but for real medical concerns.
"The appellant believes that eligibility for a panniculectomy should not be based on measurement criteria alone, but rather based on medical need, which she believes she meets," the transcript said.
While not ruling on that argument, the board accepted more recent measurements of the woman’s pannus, which found it did extend below her pubis symphysis, making it an eligible surgery under OHIP rules.
"The appeal board finds that the proposed panniculectomy is an insured service … and is eligible for payment," the board ruled.
CTVNews.ca Top Stories
MPP Sarah Jama asked to leave Ontario legislature for wearing keffiyeh
MPP Sarah Jama was asked to leave the Legislative Assembly of Ontario by House Speaker Ted Arnott on Thursday for wearing a keffiyeh, a garment which has been banned at Queen’s Park.
Mountain guide dies after falling into a crevasse in Banff National Park
A man who fell into a crevasse while leading a backcountry ski group deep in the Canadian Rockies has died.
2 teens charged in Halifax homicide: police
Two teenagers have been charged with second-degree murder in connection to an alleged homicide near the Halifax Shopping Centre earlier this week.
'Deep ignorance': Calls for Manitoba trustee to resign sparked after comments about Indigenous people and reconciliation
A rural Manitoba school trustee is facing calls to resign over comments he made about Indigenous people and residential schools earlier this week.
12-year-old hippo in Japan raised as a male discovered to be a female
When Gen-chan arrived at a zoo in Japan in 2017, no one questioned whether the then-five-year-old hippopotamus was a boy. Seven years later, zoo staff made a surprising discovery: Gen-chan, now 12, was female.
Here's why Harvey Weinstein's New York rape conviction was tossed and what happens next
Here's what you need to know about why movie mogul Harvey Weinstein's rape conviction was thrown out and what happens next.
Legendary hockey broadcaster Bob Cole dies at 90: CBC
Bob Cole, a welcome voice for Canadian hockey fans for a half-century, has died at the age of 90. Cole died Wednesday night in St. John's, N.L., surrounded by his family, his daughter, Megan Cole, told the CBC.
Humanist group threatening to sue Vancouver over council prayers
The B.C. Humanist Association has threatened legal action against the City of Vancouver for allowing prayers at council, following a similar warning issued earlier this month to a smaller community on Vancouver Island.
LHSC performs a Canadian first in robot-assisted direct lateral spine surgery
Spine surgery may never be the same for people with chronic back pain and other physical ailments.