In 2021, Desiree was a single mother and traveling nurse assistant. With nine years of military service behind her, she was active, capable, on the move. Then she slipped on ice in a work parking lot and injured her spine. Years of surgery and pain followed. Limited mobility brought significant weight gain, which put more pressure on her spine. Her surgeon made a clear recommendation: bariatric surgery should be part of her spinal care.
Desiree’s daughter was five when the injury struck. Suddenly she was carrying things her mother couldn’t carry, helping her mother in and out of the bath. “We were used to being so active — to suddenly be unable to do anything was miserable,” Desiree recalls. When her surgeon recommended bariatric surgery, she saw a different future. “It would take off all this pressure on my spine and relieve the pain. My daughter could be a kid again.”
But the Washington State Department of Labor & Industries (L&I) workers compensation program sent a letter denying coverage, claiming the surgery was unrelated to her injury. Her Medicaid insurer, Community Health Plan of Washington (CHPW), denied it as not medically necessary. She appealed and was denied again. She filed for a hearing and showed up alone. “They kept saying things I did not understand. I couldn’t get my side out.” She was referred to Northwest Justice Project. That’s when things began to shift.
Breaking through barriers
Attorney Elizabeth Landry found something her client never could have: CHPW had been applying outdated eligibility criteria. Updated state Medicaid standards — ones Desiree met — existed but had never been implemented. Nothing in any denial letter said any of this. Landry negotiated with CHPW and the Health Care Authority, working through weeks of back-and-forth to reach final approval.
“My case would have gotten dropped without NJP,” Desiree says. “Their services are an amazing gift for those of us who need help and don’t know where else to go. Knowing there’s someone out there who could help — that’s amazing. It takes time. But it’s possible.”