@bluebonnet242 As I said previously your prior fracture first and your T-Scores second should be ironclad evidence. Done deal. Your insurance company may just have a policy of rejecting requests out of hand using the logic that most people won't appeal further. So it may be that once you appeal they will do the reasonable thing and approve due to a recent prior fracture.
Still I would present all kinds of evidence just to show them "you mean business".

Here's an example of a study showing 7% increase in one year in fracture risk with a prior fracture. 12% in two years. Another study mentioned had 16%. The study says there should be health services to speed emergency action after fragility fractures in order to prevent subsequent fractures.
ttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6422949/

Be sure to call your prior fracture a fragility fracture.
If you could find a passage in one of the US osteoporosis guidelines about fragility fractures increasing future fractures that would be a good thing to include.

With effort I think you will succeed with this and maybe more easily than you think. I managed with a lot of hard work to get approval from both Medicare and Amgen safety net for Evenity. And I'm a guy and had no prior fragility fractures. You should have a much easier path to the meds you need.