By the time Nala White graduated high school, the back pain she first noticed at age 13 had spread to her leg, leaving her in constant agony. Standing during her graduation ceremony was nearly unbearable, forcing her to dig her nails into her palms to endure the moment.
At home in Round Rock, Texas, even short walks left her in tears. A simple trip to the mailbox caused burning pain so severe that she often crouched or sat on the ground for relief.
White, now 18, was diagnosed with degenerative disc disease at age 15 — the same spinal condition her mother developed as a teenager. While the disease typically emerges later in life, early onset cases can run in families. Doctors recommended spine surgery to relieve nerve compression that was causing her debilitating pain.
But White’s insurance provider, Aetna, twice denied coverage, claiming the procedure was “not medically necessary.” Physicians who treat degenerative disc disease say such denials are increasingly common, particularly for spine surgery, which can cost up to $35,000 without insurance.
“Spine surgery tends to be one of the more likely things to be denied,” said Dr. Anthony DiGiorgio, a neurosurgeon at the University of California, San Francisco. “There’s a lot of gray area. You could show the same MRI to five surgeons and get 10 different opinions.”
Aetna cited studies suggesting no significant benefit of surgery over nonsurgical care. However, other research has found that surgical intervention often provides superior relief compared to physical therapy or injections.
White’s family was shocked by the denial. Her father, Wrath James White, the policyholder, said: “I had never had insurance reject a legitimate claim before, and my daughter’s pain seemed about as legitimate as you can get.”
Before turning to surgery, White underwent physical therapy, steroid injections, and medication — all with little relief. Dr. Randall Dryer, an orthopedic surgeon who treated White, said the case was clear: “I could significantly improve her condition with a simple decompression and discectomy.”
With insurance refusing to pay, the family launched a GoFundMe campaign. In just days, donations poured in, raising more than $33,000 to cover hospital, anesthesiology, and surgical fees.
Her father said he believes many donations were “small and silent protests” against what families like theirs face when battling insurance companies.
The case reflects a broader tension between patients, physicians, and insurers. A 2023 survey by health care consulting firm Premier found that nearly 15% of claims to private insurers are initially denied, though more than half are overturned after appeals. Doctors say those delays can prolong suffering for patients who urgently need care.
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