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BayouBoy reacted to tumblersmom in Omg! My External Appeal Was Approved!I was denied bcuz my bmi was under 50. My advice is jump thru their hoops & fight for it!! I did an expedited internal appeal & then had to do an external appeal to an IRO (independent review organization) before I was approved. If you have to do appeals put as many medical facts in it as possible & explain why the vsg is the best surgery for you without making the letter to personal.